All About Andropause, The Male Version of Menopause

Grumpy old men. Cantankerous coots. Grouchy grandpas. 

It’s easy to categorize older men (and sometimes not-so-older men) as simply being surly and irritable as a natural part of their aging process. But, as it turns out, hormonal changes in men are part of something that’s often misunderstood or simply underdiagnosed: andropause. 

Andropause is what’s known as “male menopause” and it’s defined by The Mayo Clinic as “aging-related hormone changes in men.” 

Men reach their hormonal prime between the ages of 25 and 30, explains Philadelphia-based hormone doctor Dr. Kenneth Varano, DO. “After that, hormones start to slowly decline in men.” 

So what, exactly, happens when men’s hormones levels begin to drop and can lead to andropause? Here’s what we learned: 

Menopause vs. Andropause 

While men and women share the same hormones (estrogen and testosterone), what happens when we lose certain levels of these hormones are quite different, especially as we age. 

For women, the onset of menopause brings upon hot flashes, vaginal dryness, mood changes, sleep problems and decreased libido, among others. “Menopause, obviously, can be very traumatic,” says Dr. Varano. “It hits, and the bottom falls out, hormonally.” 

In men, however, andropause is much more subtle, Dr. Varano explains. This is because “the testosterone levels, depending on how they were to begin with, drops slowly over time.”

New York-based physician Dr. David Borenstein, MD echoes that, while men may not have the dreaded hot flashes or night sweats, “they do feel changes.” 

Andropause Symptoms and Diagnosis

While andropause may not come on as suddenly as menopause or have similar effects, there are some telltale signs that men are going through this certain phase in their life. 

Some of the telltale signs of andropause can be loss of muscle mass, loss of sexual drive or stamina (erections), depression and weight gain. The most noticeable, Dr. Varano says, is the loss of motivation or inner drive, making men more apathetic and less willing to seize the day, as it were. 

Though it’s entirely possible that the symptoms of anxiety or feeling low can be caused by life stressors, these can also be tied to changes in testosterone. 

“Just because someone is getting older, it doesn’t mean they have to suffer [from these symptoms], whether they’re men or women,” says Dr. Borenstein. 

This is why talking to your doctor as you age becomes of the utmost importance. In order to be diagnosed with andropause, Dr. Borenstein explains that your doctor will check your blood work and your testosterone levels to determine where you are, as well as your treatment options. 

However, Dr. Varano reminds patients that it’s important to keep in mind that lower testosterone varies in each person, and can stem from genetics, as well as lifestyle choices, such as diet and exercise. 

Andropause Treatments

Because andropause settles in gradually over time, Dr. Varano says that men can sort of “adapt to this new normal.” But for those who have been diagnosed with andropause and want to improve the quality of their life, there are treatment options. 

Dr. Varano says that when it comes to your testosterone levels, it’s less about what the number is, and more about what’s relative to the patient and their needs. 

For instance, if you are a younger man with lower testosterone and you are looking to have children, patients may avoid testosterone therapy, so that it doesn’t interfere with sperm count. In this case, they may be prescribed certain medications or “biohacks” to help them produce more testosterone. 

With older men, they may be able to get testosterone therapies directly into their body through various therapies, injectables, or gels. (Risks associated with these therapies, according to Harvard Medical School, can include acne, disturbed sleep, breast tenderness, and ankle swelling.) 

Dr. Varano assures that any major risks for disease or death with these treatments (when properly dosed) are quite low, and can actually improve a person’s overall health and life. 

“[Patients] can feel a difference,” Dr. Varano says of testosterone replacement treatments, “They’re like new people.” 

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