WHAT IS ANDROPAUSE?

It’s likely that most guys reading this are more familiar with the term menopause than andropause.

That’s a sad reflection on society that even in this day and age, men’s health isn’t prioritised (or discussed) in the same way women’s health is. This is particularly true with regards to the topic of hormonal health.

Understanding the medical term ANDROPAUSE.

Andropause is also called the male menopause and more affectionately known as the “man-o-pause”.

These terms are used to describe the “natural age-related decreasing testosterone levels related in men.”

Some men have described andropause as “puberty in reverse”. This helps set a picture both men and women can understand.

The Stigma of ANDROPAUSE.

Let’s start by breaking down the definition.

“Andras” in Greek means human male and “pause” in Greek a “cessation”.

This definition in itself doesn’t help the stigma attached with andropause. What man wants to think of themselves as a man no more?

Attaching any labels to the ageing process is bad enough without insinuating that men are any less masculine as they age.

If you look to nature, gorillas only turn into Silverbacks when they are around 13. Which is 41 in human years – just when the andropause is starting! This time should be the prime of men’s lives. But that isn’t always the case.

Therefore, it’s not surprising to know that few men want to discuss (or even acknowledge) a decline in their hormones, particularly with other men and definitely not publicly.

This in turn, perpetuates the myth that its culturally taboo for men to talk about the very things that make them men in the first place and keeps this conversation on the low down rather than out in the open where it deserves to be.

Arguing the facts – Andropause Myths V Reality.

It also doesn’t help men that there is much controversy and argument in the medical profession as to whether or not the andropause actually exists.

This is in spite of the body of evidence and the facts in front of us every day with men suffering with the very real symptoms and issues of testosterone deficiency and andropause - mainly in silence.

Thankfully the tides are turning with the medical profession coming to acknowledge the reality of andropause / testosterone deficiency syndrome.

Although in the UK we are somewhat behind in our attitudes than our American friends who have embraced this issue some time ago.

In fact, although the NHS accept that the symptoms of testosterone deficiency exist, they do not like the term andropause. This again isn’t a particularly helpful approach as if men have found the courage to go to their GP to discuss their symptoms in the first place, and are then dismissed out of hand, then this could have serious detriments to their health.

The Gender Gap In Societal Approaches to Men’s Hormonal Health.

Imagine telling women that peri menopause wasn’t real and that their symptoms of hormonal balance were just a natural sign of ageing! Maybe this is what happened twenty years ago but thankfully times move on and we should be optimistic that the same will be true when understanding, and talking about, andropause and TD.

The Andropause Society believe so strongly in the size of the issue that they are encouraging doctors to treat patients based on their hormonal health symptoms alone, even without any testing in recognition of the magnitude of the problem.

Thankfully there is a growing body of evidence to wholly support the andropause and many modern medical professionals are changing their approach to men’s hormonal health.

Obviously, the history of menopause is well documented, yet it’s only been in the past decade that it as has become a mainstream topic.

Of course, this does not mean that prior to it being publicly acceptable to discuss and talk about peri menopause and menopause freely, that they both did not exist. Can we assume the same positive journey of awareness for andropause?

What Happens In Andropause?

Medical definitions of Andropause also confusingly include testosterone deficiency syndrome, androgen deficiency, and late-onset hypogonadism.

Testosterone Deficiency (TD) is a term most men may have heard of and used more regularly. It is commonly defined as a “syndrome”. Meaning that it presents itself as a group of signs and symptoms that occur together and characterise a particular condition.

This in itself is a problem many of the symptoms are commonplace to many other medical concerns and make it hard for men to pinpoint in relation to their hormones. Or they simply put it down to ageing and dismiss it to their own detriment.

TD / Andropause is associated with a decrease in sexual satisfaction and / or a decline in a feeling of general well-being with low levels of testosterone in older man (and increasingly younger ones).

Also, men aged 40 plus can be impacted by oestrogen dominance. Symptoms can range from mood swings, night sweats, poor sleep, depression, anxiety, and poor muscle tone. One of the most obvious symptoms of oestrogen dominance is gynecomastia, more commonly known as ‘man boobs’, which is an enlargement of the male breast tissue.

Testosterone Deficiency Syndrome / Andropause can be diagnosed by your doctor who may ask you to undertake a blood test and answer a questionnaire.

When does it start to impact men?

Historically, it's a hormonal imbalance affecting men, which typically presents symptoms from the age of 40+.

Having peaked at around 19/20, testosterone levels decline from around 1% from age of 30 and then can tail off more significantly and quickly from the age of 40 and onwards.

However, symptoms can (and appear to be) starting early – sometimes from the mid-30s.

A Closer Look At The Symptoms.

There is a definite difference of opinion as to whether all men experience the andropause.

If you look at it in terms on age related decline in hormone levels, then the reality is all men will experience andropause as levels of testosterone decline in all men.

However, the extent of decline can vary and the age at what this happens too is varying – even more so with today’s lifestyle factors. Whether or not men acknowledge this or even identify the symptoms due to lack of awareness is quite another matter.

The important thing to note is that there is widespread agreement of the crucial role in men’s health that testosterone plays and therefore decline of this dominant male hormone needs to be taken seriously.

Bone Health:

Testosterone is required for health bones.

When a person has osteoporosis, their bone density decreases, and bones are more likely to break. The risk of osteoporosis rises in men with testosterone deficiency / low T levels.

Yet because of the dominance of female health in the press, we wrongly only tend to think about this condition as impacting women.

Fertility:

This shows some interesting differences between men and women’s hormonal health journeys.

Whilst menopause does mark the end of women being able to bear children, andropause does not.

There are many examples in the media of famous older fathers.

Formula 1 legend Bernie Eccleston recently became a father again at 89. Rock star Mick Jagger was 73, Hollywood legend Jeff Goldblum 62, and music mogul Simon Cowell 52 to name a few.

Undoubtedly, men do experience a decline in their fertility with age, but don’t become infertile as a result of it which is a key difference.

Age related hormonal health decline and sex.

While fertility doesn't necessarily end for men, andropausal men undoubtedly experience reduced sexual drive and function which can have devastating impacts on relationships.

This often first presents by the loss of morning erections. Then commonly erectile dysfunction can present itself in older men (although this is affecting many younger men now).

Many men turn to pharmaceutical interventions for their symptoms rather than seek the underlying causes for fear of embarrassment in talking about deeply personal problems. This is compounded by the fact that meds like Viagra are now freely and widely available without prescription for men of all ages.

In the UK erectile dysfunction is thought to affect up to one in five adult men, 4.3 million in the UK. Like any medication though, the drug can cause side-effects.

How declining hormones impact mood.

In recent times, we have learnt more about the connections between the reproductive hormones and the brain, and how they affect not only women but men as well.

The causal relationship between testosterone levels and mood in men is less well documented but appears to impact men equally as much as women. Men are frequently misdiagnosed with depression instead of testosterone deficiency due to a lack of awareness of the symptoms.

Men report unexplained feelings or anger and irritability which can cause problems at work and home. General fatigue, lack of energy and motivation over sustained periods of time can lead to a catch 22 situation leading to lower mood and depression.

We’ve all heard of grumpy old man syndrome, which has recently been coined irritable male syndrome. Could this be more easily (and kindly) explained by andropause?

Weight gain:

Hormonal imbalance can cause weight gain and considerable upset in men due to the lack of control over their changing bodies.

It’s often more complicated than just involving testosterone. Many other hormones are also controlled by the endocrine system and imbalance of any combination of these can wreak havoc on your metabolism.

In men, rising incidences of obesity are actually causing testosterone levels to decline faster than ever before and at alarming levels.

A study in 2008 found that a four-inch increase in waist size increased a man's odds of having a low testosterone level by 75%.

Other signs and symptoms.

Additional signs of andropause include:

• decreased motivation

• decreased self-confidence

• difficulty remembering things

• increased nervousness

• reduced muscle mass and strength

• reduced body hair

• hot flashes

In addition to these male menopause symptoms, there is mounting evidence indicating that very low testosterone can be linked to a host of serious diseases in later life and older age.

There is even research suggesting that Low T levels can make men more vulnerable to the effects of Coronavirus/Covid-19.

What Can I Do About Andropause?

The most important thing to do is to acknowledge your symptoms.

Pay attention to how you feel, when and why.

If you are concerned about your hormonal health, contact your GP to test your T Levels.

Create Healthy Lifestyles and Routines to remain positive T Levels in ageing.

Laying the foundations for positive and healthy ageing is crucial to wellness and disease prevention.

Ensure you understand what lifestyle factors negatively impact T levels and address these as early as possible. Correct any nutrient deficiencies as these are increasingly common and key nutrients provide the building blocks of hormones.