Andropause: What It Is, Symptoms, Diagnostic Methods, and Treatment

As men age, symptoms such as irritability, fatigue, and a decrease in physical strength may occur. While most people refer to these symptoms as signs of aging, there is a different explanation for this condition in medicine. Andropause, also known as male menopause, is a syndrome related to the decline in testosterone levels in the body. This syndrome has a subtle onset and progresses gradually, affecting all men and is considered a natural process of the body. Understanding and being informed about andropause can help many men navigate this period.

What is Andropause?

Androgen hormones, also known as male sex hormones, begin to decrease in the body starting in their thirties. With aging, testosterone levels may decrease by about 1% each year. The decline in free testosterone levels is a particularly notable medical process. This decrease in testosterone levels can trigger the onset of andropause and lead to various symptoms. Andropause is a commonly observed syndrome in society that typically affects men aged 50 and older.

Although andropause is referred to as male menopause, there are significant differences between menopause and andropause. Menopause describes the process in women where the ovulation period ends, and hormone production drops sharply within a short time. In contrast, andropause is a process in men characterized by a gradual decline in testosterone and other androgen hormone levels over the years, leading to certain consequences.

What Are the Symptoms of Andropause?

The symptoms resulting from andropause can vary from person to person. The threshold for testosterone levels that triggers symptomatic complaints differs among men. Some men may have low testosterone levels without exhibiting any symptoms. However, if symptoms begin to develop, the following signs are commonly observed:

• Decreased libido
• Erectile dysfunction
• Increase in breast size or swelling of breast tissue
• Infertility
• Low bone mineral density
• Decrease in height
• Sweating
• Hot flashes
• Loss of energy and motivation
• Depressive mood
• Concentration problems
• Sleep disorders
• Decrease in muscle mass
• Increase in fat mass

What Causes Andropause?

Andropause is a process that develops due to low testosterone levels, emerging with aging. It typically results from late-onset hypogonadism or age-related decreases in testosterone levels.

Hypogonadism is a medical condition that arises from a decrease in the activity level of the gonads in the body due to various reasons. The gonads are comprised of the ovaries and testes. The male gonads, which are the testes, are responsible for producing androgen hormones such as testosterone and gametes, commonly referred to as sperm. With the onset of hypogonadism, a decrease in testosterone levels begins, leading to cognitive and functional symptoms. Hypogonadism is closely related to the development of andropause.

Hypogonadism is classified into two different types. The first type, called primary hypogonadism, occurs due to a problem originating from the testes that leads to reduced hormone production. The secondary type develops due to issues in the hypothalamus and pituitary gland located in the brain. Problems in the signaling transmission between the hypothalamus and pituitary gland can lead to secondary hypogonadism. Secondary hypogonadism can be congenital or can develop later in life due to trauma or infectious diseases.

Another factor influencing the development of andropause is the decline in testosterone levels with age. Testosterone levels are low before puberty, but with the onset of puberty, these levels increase, leading to numerous changes in the body. Male-pattern hair growth, erections, increased strength, and muscle tone are all facilitated by testosterone. Starting in their thirties, men experience a natural decrease in testosterone levels. After the age of fifty, there is a significant drop in free testosterone levels. This can lead to symptoms of andropause.

How is Andropause Diagnosed?

Individuals who undergo regular urological examinations with age or seek healthcare due to symptoms of andropause are subjected to various tests. During the examination conducted by the doctor, a patient history is initially taken. Your doctor will ask questions to determine whether you have noticed any symptoms and what those symptoms may be. Following the patient history, a physical examination is conducted. During the physical examination, the structure of the penis and testes is evaluated. Laboratory tests are performed to identify the main problem that may cause symptom development or to determine androgen hormone levels. A blood sample will be taken to examine the levels of various androgen hormones, primarily testosterone. Based on the results, the patient may receive a diagnosis of low testosterone. The emerging symptoms can then be associated with low testosterone levels and, consequently, with andropause.

How is Andropause Treated?

Andropause is a process that typically does not require intervention unless it creates significant symptoms in a person's life. However, if symptoms increase and the individual's quality of life declines significantly, hormone replacement therapy may be considered. Through the treatment, issues such as decreased libido, feelings of exhaustion, and tendencies toward depression can be managed.

Hormone replacement therapy is a controversial topic in the medical community. Performance-enhancing steroids are a type of synthetic testosterone that can cause some side effects in the body. Synthetic testosterone can negatively affect the development of prostate cancer or promote the growth of cancer cells. There are also claims that it can increase the risk of heart disease. Therefore, it is advised to avoid testosterone intake unless it is included in a treatment plan.

Making lifestyle changes is also recommended for managing the andropause process. With certain precautions, the process can be navigated more comfortably. Regular exercise and a healthy diet can alleviate the severity of emerging symptoms. In necessary cases, support from antidepressant medications may also be considered.

How Can Andropause be Prevented?

If the rate of decrease in testosterone levels can be managed or reduced, the onset of andropause syndrome can be delayed to later ages. Taking specific precautions can help you control the symptoms that develop during the andropause process. At this point, incorporating healthy living factors into daily life is of great importance.

Studies have shown that obesity, emotional stress, excessive medication use, and chronic diseases can increase the rate of decline in testosterone levels. Obesity is particularly considered an important risk factor for low testosterone and androgen deficiency.

Implementing a healthy diet plan is the top priority in controlling andropause symptoms. Individuals should consume the necessary amount of calories daily, maintain a balanced diet, and manage their weight to preserve an ideal body composition. This can help prevent changes in androgen levels due to excessive fat accumulation. Regular exercise is also among the recommendations for maintaining or improving body composition. Eating a balanced diet and exercising can support the maintenance of ideal weight, thereby slowing down the rate of decrease in testosterone levels.

Another essential factor that forms the foundation of a healthy body is sleep. Individuals should try to establish a sleep routine and ensure they are getting enough sleep. Reducing stress levels is also a necessary measure for individuals experiencing a decline in testosterone levels. If individuals tend to show signs of depression, they can seek therapy from a psychiatrist or, in appropriate cases, receive support from antidepressant medications.

Andropause is a syndrome commonly seen in society that every man may encounter. If the decrease in testosterone levels is causing symptomatic reactions in your body, you can seek support from a specialist to manage this process and navigate it more smoothly.