Male Menopause Isn’t Just About Low T

Male Menopause Isn’t Just About Low T

You’re feeling tired and weak, your sex drive is on the downswing, and you’re gaining weight. These so-called male menopause symptoms – also known as andropause – could be the result of a decline in your testosterone and estrogen levels (yes, the female hormone). True, testosterone is the main male sex hormone, but a small amount of testosterone men produce is also converted to estrogen. And as testosterone levels decrease, estrogen levels do as well.  

Could You Have Low T?

To that point, male menopause is more complicated than advertisements about low T and testosterone supplements lead you to believe. A study published in the New England Journal of Medicine describes how researchers recruited 400 healthy men between the ages of 20 and 50. All of them were given a drug that suppresses natural testosterone and estrogen production. They were then given various doses of testosterone gel or a dummy gel for 16 weeks. Half of the men were also given another drug to prevent testosterone from converting into estrogen. The results: Testosterone loss affected men’s muscle mass and strength, while testosterone and estrogen loss both affected men’s libido and erectile function. But it was the loss of estrogen, in particular, that appeared to promote a gain in body fat.

Male Menopause Symptoms Aren’t Created Equal
The study also found that male menopause symptoms crop up at different testosterone thresholds. Researchers identified that increases in body fat and waning interest in sex emerged at mild levels of testosterone deficiency. But muscle loss and erectile dysfunction didn’t begin until testosterone levels continued to drop -- around 200 ng/dL or below. Generally testosterone is considered low when levels are below 300 ng/dL, and it’s a sort of one-size-fits-all definition. But this study proves there’s variability in the amount of testosterone needed in relation to overall men’s health.

How Safe Is Testosterone Hormone Therapy?
The verdict is still out on whether or not testosterone supplements actually do more harm than good. And that’s a major issue since millions of men each year are prescribed testosterone gel, patches or shots for male menopause symptoms. Testosterone supplements also have potential side effects, including acne and enlarged prostate, but maybe the biggest worry is that the long-range health effects are unknown. (Find out more about the benefits and risks of testosterone hormone therapy.)

Medically reviewed in November 2018.

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