What is andropause?

With all the media reports on menopause, the cessation of menstruation that only women can experience, some researchers now believe that men undergo a similar period. This period in life is often called “andropause” or “viropause,” and refers to the loss of virility that often occurs during the 40s and 50s.

During this time, a man's strength, sex drive, and peace of mind may take a nose dive. Some men go to their physicians and tell of being extremely despondent or depressed, thinking that their best years are over. Others may make drastic changes like changing careers, buying a fast boat or sports car . . . or even leaving their wives and families for a younger partner.

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Andropause is the name given for male menopause. Testosterone levels may decline as early as the 40s and 50s. Men are commonly given Viagra even though the sexual dysfunction is occurring from a lack of testosterone.

An important distinction from menopause is that in some men, this fall in testosterone can be reversed without the need for testosterone. Men should first undergo an evaluation by an endocrinologist to determine the CAUSE of the low testosterone. Common conditions that lower testosterone include:  sleep apnea, insomnia, stress and prescription drugs. While unusual, low testosterone can result from pituitary or brain tumors that require surgery or other drugs. Failure to recognize this serious condition could be life threatening. If the root cause is identified and treated, a man’s testosterone level may be restored without the need for testosterone treatment!

If an endocrine evaluation reveals a true testosterone deficiency, then it’s appropriate to replace testosterone either as topical gels or injections.

You're tired and cranky, and your sex drive ain't what it used to be. You may even have some issues with erectile dysfunction. Could you be going through "the change?" Turns out, midlife hormonal fluctuations aren't just a "woman thing." Men can experience menopause, too -- in the form of low testosterone (Low T).

Though the phrase male menopause -- also known as andropause or, as some have dubbed it, "men-opause" -- is a bit of a misnomer, the condition is real, says Robert Brannigan, a urologist at Northwestern Memorial Hospital and associate professor of urology at Northwestern University Feinberg School of Medicine.

Whereas women experience a sudden drop in hormones that signals a change in their ability to reproduce, with male menopause the result is a gradual decline in testosterone. Because it happens slowly (over a period of years), the symptoms of male menopause (e.g., fatigue, sluggish sex drive, irritability, depression, muscle loss, and erectile dysfunction) may be subtle and hard to detect.

Testosterone levels fall naturally as we age -- on average, about 1% a year after age 30. That means that by the time you reach 70, your testosterone level may have dropped by half from its peak. Though aging is the main cause of Low T, other conditions and medications, such as testicular cancer, a scrotum injury, chemotherapy, radiation treatment, and mumps, are all possible culprits.

According to a study in the New England Journal of Medicine, male menopause is relatively rare, affecting only 2% of men over 40. Other stats show that 5% of all men (and nearly 20% after age 70) suffer from Low T. However, urologists, such as Steven Kaplan, director of the Iris Cantor Men's Health Center at New York-Presbyterian/Weill Cornell Medical Center, argue that numbers don't tell the whole story.

While the New England Journal of Medicine study defined male menopause as low testosterone plus at least three sexual symptoms, Brannigan says symptoms can manifest themselves differently depending on the patient.

If your sex drive has taken a nosedive, your apparatus isn't working the way it used to, your muscles have gone flabby, or you have no energy, you may want to have your testosterone levels checked with a blood test. Normal testosterone levels range between 300 to 1,200 ng/dl. Brannigan recommends testosterone replacement therapy for men with levels below 300.

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