Navigating The Andropause: Understanding Hormonal Changes in Men’s Health

Andropause, sometimes referred to as male menopause or late-onset hypogonadism, is a common but rarely discussed condition that affects men as they age. In this article we’ll provide comprehensive information about exactly what andropause is, what causes it, the range of symptoms men may experience, and treatments.

Consulting a medical professional if you think you may be experiencing Andropause is essential for proper diagnosis and personalised treatment. At The GAP Clinic, we offer in-person or remote Andropause & TRT consultations.

Andropause is the term used to explain the gradual age-related decline in key male sex hormones, particularly testosterone. It parallels female menopause when women’s reproductive hormone levels also decline, however, it is not as a sudden change as it is in menopause. For men, hormone changes are typically very gradual and can begin in the 30s, become more prominent in the 40s and 50s, and continue into old age.

While sometimes referred to as an “androgen deficiency,” andropause is a natural consequence of ageing, not a disease state. However, the associated drop in testosterone can significantly impair physical, mental, and emotional health if left untreated. Recognizing and properly managing this hormonal imbalance is key to helping men feel their best as they age.

In younger men, testosterone is produced primarily by the testes with stimulation from the pituitary gland. Testosterone production begins slowing down around age 30 for reasons not fully understood yet, reduced pituitary signalling or testicular sensitivity may partly explain the decline. By around age 70, testosterone levels are generally only 20-50% of what they were at age 25.

Some additional factors can hasten the drop in testosterone and bring on the andropause earlier:

Certain lifestyle choices can impact testosterone levels. Factors such as excessive alcohol consumption, smoking, sedentary lifestyle, poor sleep quality, chronic stress, and inadequate nutrition can contribute to lower testosterone production. This is why at The GAP clinic we look at all aspects of your life to personalise your andropause treatment plan.

Fat tissue contains an enzyme called aromatase, which converts testosterone into estrogen. Increased body fat can lead to an imbalance in hormone levels, with higher estrogen and lower testosterone, potentially contributing to Andropause symptoms.

Certain chronic medical conditions can affect testosterone production. Conditions such as diabetes, obesity, metabolic syndrome, liver or kidney disease, and HIV/AIDS may have an impact on the endocrine system, leading to decreased testosterone levels.

Some medications, such as corticosteroids, opioids, and certain chemotherapy drugs, can suppress testosterone production. Additionally, treatments such as radiation therapy or surgical removal of the testicles can also lower testosterone levels.

Some men may have a genetic predisposition to lower testosterone levels. Conditions such as Klinefelter syndrome, a chromosomal disorder, can result in lower testosterone production.

The onset of andropause is gradual, so symptoms often come on slowly over months to years. The symptoms manifest differently in individuals, and the severity of symptoms can vary. Here are some common symptoms associated with Andropause:

Many men experience persistent fatigue and a noticeable decrease in energy levels, which can impact daily activities and overall productivity.

Andropause may contribute to a decline in sexual desire (libido), erectile dysfunction (difficulty achieving or maintaining erections), and a decrease in overall sexual satisfaction.

Fluctuating hormone levels can affect mood regulation, leading to increased irritability, depression, anxiety, and a general sense of decreased well-being.

Men may experience a decrease in muscle mass, strength, and an increase in body fat, particularly around the waist area. These changes could impact self-image and confidence.

Some men report difficulties with memory, concentration, and cognitive function, although more research is needed to establish a clear link between Andropause and cognitive decline.

Not all men will experience every symptom, and severity can vary widely based on your individual hormone balance. The more symptoms present, the more likely it is andropause is present. Keeping track of symptoms and communicating openly with your doctor is key. Blood tests are also required for a formal diagnosis, these can be carried out at the GAP clinic to confirm your diagnosis.

It’s important to note that Andropause is a natural part of the ageing process, and its impact varies among individuals. While it is not a life-threatening condition, left untreated, the symptoms of andropause often gradually worsen over time leading to impaired well-being and reduced quality of life. Some impacts like bone loss also increase the risk of fractures. The good news is that andropause is highly treatable. With proper testing and hormone therapy, most men can get back to optimal functioning. It does require an ongoing commitment to treatment and follow-up care.

Testosterone levels do continue to decline with advanced age, so adjustments to treatment may be needed over the years. Working closely with your doctor is important to maintain proper testosterone balance as you get older. With the right treatment, most men can enjoy robust health and an active, fulfilling life well into old age.

If blood tests confirm low testosterone, treatment focuses on replacing testosterone to restore normal levels. Testosterone replacement therapy (TRT) can profoundly improve energy, sexual function, muscle mass, motivation, mood, and overall health.

Types of testosterone replacement include:

Testosterone injections administered every 2-3 weeks are commonly used for TRT. This method provides stable hormone levels. Injections can be done either in-clinic or self-administered at home. The benefit of testosterone injections is the ability to quickly achieve normal testosterone levels as most men notice improvements in symptoms within a few weeks. They also provide avoid potential skin irritation that can occur with gels or patches.

Adhesive testosterone patches are applied daily to the arm, back, thigh, or abdomen and continually release hormones through the skin. The benefits of patches include a convenient daily application, similar to applying a bandage with no injections needed. Patches mean the testosterone is directly absorbed through the skin, bypassing the liver.

Testosterone gels provide another way to effectively and conveniently replace testosterone levels. These topical gels are applied once daily to the upper arms, shoulders or abdomen where the testosterone is directly absorbed through the skin into the bloodstream.

The benefits of testosterone gels include the flexibility of dosing through a range of concentrations and the ease of self-administered application at home.

Nasal gels represent a newer, less common option for testosterone replacement therapy. As the name suggests, these gels are administered directly into the nostrils where testosterone is rapidly absorbed into the bloodstream.

We will determine which TRT delivery method is right for your lifestyle and needs, and make dosage adjustments based on blood levels and symptom improvements. For optimal treatment, we will also:

– Monitor blood levels every 3-6 months to avoid excess levels
– Watch for side effects like polycythemia (high red blood cell count)
– Plan regular checkups – TRT can increase prostate cancer risk

Some men may also benefit from supplementation with zinc, vitamin D, DHEA, or other supplements to provide additional androgen support.

With the right treatment plan tailored to your needs, you can successfully manage andropause and continue thriving for years to come. We encourage you to be proactive by watching for symptoms of hormone decline. Be open with your doctor about changes you experience so you can get them checked out. Taking charge of your hormonal health is one of the best things you can do to enjoy the prime of your life.

The effects of male menopause, andropause, can last for many years as the body gradually adjusts to lower testosterone production. But because testosterone levels continue to decline over a lifespan, male menopause symptoms lasts indefinitely without treatment.

The most common signs of andropause are:
– mood swings, irritability and other emotional disturbances.
– loss of muscle mass, reduced endurance or strength.
– fat redistribution, such as developing a large belly or “man boobs” (gynaecomastia)
– a general lack of enthusiasm or “energy”.
– difficulty sleeping or increased tiredness and fatigue.
– poor concentration and short-term memory loss.

Although men do not go through the same hormonal process as described in a menopause, the decline in their sex hormones can be described as being a male menopause, or andropause. These changes are slower and less sudden than with the menopause.

Yes, men can experience hot flashes as a symptom of andropause and declining testosterone levels. Hot flashes in men tend to be less severe than those experienced by women during menopause. But they can still be quite bothersome.