Every healthy male will have a decrease in the production of androgens - the male hormone, as he ages. The principle androgen in focus is testosterone. When the serum testosterone levels in an older man decline to below the normal range in young men, and that person experiences clinical symptoms and signs consistent with androgens deficiency, then andropause has occurred.
This decline in testosterone is gradual, spanning ten to fifteen years on average. This gradual decrease of testosterone does not display the profound effects compared to the menopause in women, particularly there is no such abrupt cessation of something like the menstruation. The onset of symptoms is gradual and vague, and can be easily missed. However, at the end, the consequences on health are similar.
30 - 40 is the age when testosterone levels begin to start their age-related decline. In fact, by their 50s, 50% of men have a significant reduction in bio-available testosterone.
Symptoms Of Andropause
Depression
Androgen deficiency can affect cognitive functions, resulting
in lack of mental energy, decreased sense of well-being and
depression.
Fatigue
Androgen deficiency causes loss of lean muscle mass, tone
and bone density. These losses can leave an andropausal man
with feelings of fatigue. There is also a multitude of generalised
aches and pains throughout their bodies.
Irritability
Androgen deficiency can also heighten feelings of irritability
that can lead to aggression, hostility, and anger.
Reduced Libido & Sexual Performance
Androgen deficiency reduces libido and causes erectile dysfunctions,
which include difficulty in achieving an erection, the time
of an erection, diminished force and volume of ejaculation,
diminished rigidity of the erection and diminished pleasure.
Sweating & Flushing
As with women, the fluctuating levels of hormones can cause
periods of diffuse sweating and hot flashes.
Diagnosis
Andropause is often under-diagnosed because symptoms can be vague and vary among individuals. Some men even find it difficult to admit that there is a problem, and doctors may consider the symptoms being related to other medical conditions, such as depression, diabetes, or simply aging which is an inevitable thing that nothing can or should be done.
This situation has changed dramatically and more doctors are actively diagnosing and treating andropause. A screening test called the ADAM (Androgen Deficiency in Aging Men) test and a laboratory measurement of testosterone can be done.
ADAM Test
The ADAM test is a questionnaire used to screen for symptoms of low testosterone in men over 40.
- Have you experienced a decrease in your sex drive (libido)?
- Do you lack energy?
- Have you lost height?
- Has your strength and/or endurance decreased?
- Have you noticed yourself enjoying life less?
- Are you frequently sad or irritable?
- Are your erections less strong?
- Have you noticed a recent deterioration in your athletic ability?
- Do you find yourself falling asleep after dinner?
- Has there been a recent deterioration in your work performance?
Bio-Testosterone Test
If your ADAM test seems to suggest andropause, the best test to follow is to determine low testosterone levels with the Bio-T Test.
The Bio-T Test measures levels of "bio-available testosterone", which is the testosterone not bound to the carriage-protein, Sex Binding Hormone Globulin (SHBG), and is freely available for the body to use on demand.
Treatment
This is achieved through Testosterone Replacement Therapy (TRT), which has been shown to be a very safe and effective treatment for men who have been diagnosed with andropause. The details are discussed in the section of testosterone.