Certain disorders have a stigma in many societies for no legitimate reason other than they are not considered “polite” topics of conversation—examples include hyperhidrosis, or excessive sweating; psoriasis, which causes cracked, scaly skin; and male menopause, during which men can experience a range of symptoms and changes as they grow older. Male menopause and another term, andropause, are used to describe decreasing levels of the male hormone testosterone that come with aging. The group of symptoms associated to age-related changes in male hormone levels are also known as testosterone deficiency, androgen deficiency, and late-onset hypogonadism.
Not Just Fighting a Stigma
Not only is there an unwarranted stigma against discussing male menopause that physicians and those working in the health care industry have to fight against, some question whether the condition really exists at all. The name itself is misleading. Relating the process to female menopause is not accurate: the condition affects only 2.1 percent of males, while menopause is a natural part of female sexual development. The hormone change happens suddenly and dramatically in women, while in men the change is gradual.
While only a small percentage of men are affected by male menopause, it’s important that men feel comfortable discussing all aspects of their health with their care providers. The first step in fighting any kind of misinformation and/or stigma is education. After all, the more you know, the more power you hold.
Symptoms of Male Menopause
Male menopause causes several physical, sexual, and psychological problems that worsen as men age. These symptoms are numerous and can include the following:
- Low energy
- Depression or sadness
- Decreased motivation
- Lowered self-confidence
- Difficulty concentrating
- Insomnia or difficulty sleeping
- Increased body fat
- Reduced muscle mass and feelings of physical weakness
- Gynecomastia, or development of breasts
- Decreased bone density
- Erectile dysfunction
- Reduced libido
- Swollen or tender breasts
- Decreased testicle size
- Loss of body hair
- Hot flashes
A Murky Picture
While some of these symptoms are similar to what women experience as they go through menopause, there are additional reasons why the term male menopause can be misrepresentative. Testosterone and other male hormones decrease slowly and gradually. The symptoms of female menopause are linked to estrogen levels, but the cause of symptoms in men is unclear, and some men with relatively high levels of testosterone still experience symptoms.
To muddy the water further, experts do not believe that normal, age-related decline of testosterone levels triggers male menopause symptoms. If so, every man would experience them. Doctors do know that symptoms tend to occur in older males with heart disease, obesity, high blood pressure, and type 2 diabetes. Several underlying health problems are also risk factors, including lack of exercise, smoking, alcohol consumption, stress, anxiety, and sleep deprivation.
Diagnosis & Treatment
Any man who experiences symptoms should make an appointment with his doctor—this is the major hurdle for most men. Doctors can try to overcome this by talking with patients about male menopause during annual physicals. Once a patient visits his doctor, a series of blood tests can easily diagnose whether low testosterone is the cause. Once diagnosed, treatment can include testosterone replacement therapy or prescription medication, but less drastic steps may also help. The side effects of testosterone therapy can include acne or oily skin, fluid retention, stimulation of prostate tissue, breast enlargement, worsening of sleep apnea, and decreased testicular size. Healthier lifestyle choices, such as diet changes, more sleep, exercise, and treatment for depression or anxiety can help alleviate symptoms. For many men the symptoms of a decline in testosterone levels are manageable without treatment, but the first step should be meeting with your healthcare provider without worrying about public perceptions.