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Male menopause: when midlife throws a curveball

Male menopause: when midlife throws a curveball

Is andropause a real thing and does it happen to every man?

As the body ages, various new factors come to the forefront. Some we know about; some we have little knowledge of — such as the male menopause. Called andropause, it is derived from the Greek word ‘Andras’ (man) and ‘pause’ (cessation or slow down).

Not many men are aware that due to the natural process of ageing they can also go through similar though lesser symptoms of women’s menopause. Though it is hard to say when exactly this phase can happen, usually it is men over 40 who might experience this disorder – and not all men go through it.

Simply put, andropause is a condition or phase of life where a man experiences a decrease in general well-being or sexual satisfaction, with low levels of testosterone in older men.


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“Andropause is an age-related decline in testosterone concentrations. In women, menopause occurs around a specific age but in men it’s difficult to define a certain age at which the testosterone falls abruptly. Andropause is more of an internal process wherein the testosterone levels start declining slowly, starting from the third decade of life. This can mean various things, such as a decline in libido and sexual activity, decreased muscle mass and strength, depressed mood, decreased bone mineral density, and anemia too,” says Dr (Prof) SK Wangnoo, senior consultant endocrinologist, Apollo Hospitals, Delhi.

The chief cause of depleted testosterone is its reduced production from the testes, which is expected with ageing. In some men the fall may be greater. The most common contributory factor is found to be obesity as levels of estrogen in obese males are higher and this has a suppressive effect on testosterone production.

It is also called testosterone deficiency, androgen deficiency and late-onset hypogonadism. Testosterone is a hormone produced in the testes. Along with fuelling the sex drive, it also brings about changes in puberty, is responsible for mental and physical energy, and maintains muscle mass.

Symptoms of andropause

Most of the time, the three main symptoms to watch out for are: feeling less energetic than before, some weight gain, low libido. If one experiences these symptoms, it is advisable to seek a medical opinion since they signify low testosterone production in the body. Apart from the obvious physical problems, ignoring the symptoms could even lead to a host of psychological problems later.

Some other signs of depleting testosterone are depression, loss of hair, hot flashes, decreased motivation, insomnia, low self-confidence, reduced muscle mass, decreased bone density, erectile dysfunction and, in extreme cases, gynecomastia (development of breasts).

Age angle in andropause

According to a study by the Mayo Clinic, testosterone levels tend to decline an average of 1 per cent per year after men turn 30 and some health conditions can cause earlier or more drastic declines in testosterone levels.

Which is what 47-year-old Rohit Shetty found out after he was diagnosed with hypertension and a heart ailment, “I was depressed, had low libido, was always on the edge, felt unhappy with most things in my life and started having rage issues,” says the Delhi-based businessman, who underwent a series of tests and discovered that he had low levels of testosterone. “I was already on various medications and then along with low libido, I also started having erectile dysfunction, which had never happened before,” he says.

But some researchers instead associate the symptoms with a condition called androgen decline in the ageing male (ADAM), or late-onset hypogonadism. This occurs naturally when the gonads, or the organs that produce sex cells, begin to age and lose function. The condition affects only 2.1 per cent of males, while menopause is a natural part of female sexual development.

The general view is that andropause can happen around the ages of 50 to 55, but can also strike early. “Andropause can occur after the age of 40 too and even later. But once you are getting closer to 40 and experiencing any of the symptoms detailed, it is always better to get tested and start treatment since low testosterone level leads to decreased sex drive and immense mood swings that can affect the quality of your life,” says diabetologist Dr Manoj Lokhande of Lokhande’s Clinic in Kalyan West, Mumbai. 


Unless male menopause is causing severe hardship or disrupting life, one can probably manage the symptoms without treatment. Though there is not much one can do to stop the natural effects of ageing and its results on the body, adopting a healthy lifestyle can help minimise its effects.

“There is not much to do to stop the fall in testosterone levels that occurs naturally with ageing, but a healthier lifestyle may help reduce the perceived effects of this fall. For example, adequate calcium and vitamin D intake with regular physical exercise helps in maintaining bone strength and muscle mass,” says Dr Wangnoo of Apollo.

One should go to a doctor and give blood for sampling to evaluate testosterone levels.

There could be some blood tests advised to rule out vitamin deficiencies, to check testosterone levels and prostate test PSA (prostate specific antigen).

“The most common type of treatment for symptoms of male menopause is making healthier lifestyle choices by eating healthy food, exercising regularly, sleeping well and reducing stress. For issues such as depression, the doctor may prescribe antidepressants, therapy and lifestyle changes,” says Dr Lokhande.

“Hormone replacement therapy is another treatment option, though it is not widely advocated because of serious side effects. As with all many such issues, one way to live a fulfilling healthy life with minimal problems is to focus on the diet and avoid dairy, refined flour and oil, sugar intake and bakery products. Instead consume good nuts, vitamins and minerals (specially vitamin D, zinc, selenium). Also, make sure you sleep seven to nine hours, do some activities that help you relax and get a daily dose of exercise either at the gym, by walking, yoga or swimming.”

While it is not necessary that every man go through andropause, it is always better to be aware that it can happen, especially if one has other health-related issues and best to go in for a consultation and recommended tests. One big hurdle in treating male menopause might be talking to the doctor about the symptoms since many men shy away from discussing sexual topics with their doctors

“I felt most of my physical problems were related to my mental state then, which was not too good, due to stress at work and my failing emotional relationships. But after the diagnosis and significant lifestyle changes that I started, things are improving, though not fully yet,” says Shetty.

Some studies call andropause a male midlife crisis or “puberty in reverse”, usually with changes in hormonal, psychological, interpersonal, social, sexual and spiritual life.

But with corrective measures, some age-related changes can be delayed if not wholly prevented — and that can mean improved well-being and a good quality of life in older men.


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