What is the andropause? The male version of the menopause explained

By (reproductive endocrinologist), (embryologist) and (biochemist).
Last Update: 09/20/2023

The andropause is a concept relating to the male aging process, from a reproductive point of view.

In this stage of the man's life there is a gradual decrease of testosterone production (male hormone synthesised in the testicles). As such the andropause is also known as testosterone deficiency syndrome, or Androgen Deficiency Ageing Male - ADAM.

This decrease in testosterone levels has consequences on the sexual capacity, strength and other abilities of the male.

At what age does andropause begin?

In contrast to the female menopause, the age at which testosterone levels begin to decline in men varies widely.

From the age of 30, testosterone begins to decline very slowly, but it is not until the age of 45-50 that the first signs of andropause appear in 50% of men.

Once they reach 70 years of age, most of them will have low testosterone levels.

The andropause is a concept tha is likened to the menopause of women, but it is not the same. Andropause is a less marked process, there are no such abrupt mood changes and the symptoms appear very gradually over time.

In addition, the main difference is that men do not lose fertility with andropause, but only see it diminished. Men can remain fertile and have children naturally beyond their 50s and 60s.

Andropause symptoms

Andropause tends to be ignored as the symptoms are often confused with stress or other causes.

However, if, when doing a hormonal blood test in the male, it is found that he has a testosterone deficit, the following symptoms will be related to this andropause.

  • Depression and sleep alterations.
  • Decrease in sexual desire.
  • Emotional, psychological and behavioral changes.
  • Less body resistance and body mass.
  • Loss of energy
  • Increase in the body fat in the middle and upper part of the body.
  • Cardiovascular risk and circulatory problems.
  • Osteoporosis or weak bones and back pain.
  • Loss of genital hair.

It should be noted that there is great variability in symptoms related to testosterone depletion. Therefore, not all men will experience the same symptoms when they reach andropause.

Andropause treatment

In order to relieve the symptoms of this ageing stage, testosterone replacement therapy is used.

It can be administered orally, by intramuscular injections or topically with a gel administered on the arms, back and abdomen.

However, it is important that men meet certain requirements before proceeding with the administration of testosterone:

  • Hormonal tests should show that there is indeed a testosterone deficiency.
  • The male must present symptoms of andropause as mentioned in the previous section..
  • Treatment should be followed under medical supervision.

Hormone replacement therapy has some contraindications, such as prostate cancer, apnea or cardiovascular problems.

Assisted procreation, as any other medical treatment, requires that you rely on the professionalism of the doctors and staff of the clinic you choose. Obviously, each clinic is different. Get now your Fertility Report, which will select several clinics for you out of the pool of clinics that meet our strict quality criteria. Moreover, it will offer you a comparison between the fees and conditions each clinic offers in order for you to make a well informed choice.

Other advice

In addition to hormone treatment, there are other ways to stimulate testosterone production in men and prevent andropause.

Below, we will discuss some tips for coping with both the physical and psychological symptoms of male menopause:

  • Maintain a balanced diet, rich in proteins and minerals, and avoid excesses.
  • Engage in high-impact physical exercise to relieve stress and regain muscle mass.
  • Take care of the hours of rest and sleep at least 7 to 9 hours a day.
  • Maintaining sexual activity to avoid erection problems.
  • Decrease or avoid caffeine, tobacco and alcohol consumption.
  • Sharing what it feels like with friends and their partner.

Men who manage to maintain high testosterone levels after the age of 50 have better physical endurance, better moods, responsiveness and better dilated blood vessels.

FAQs from users

Does the man's age affect the quality of his sperm?

By Mark P. Trolice M.D., F.A.C.O.G., F.A.C.S., F.A.C.E. (reproductive endocrinologist).

Advanced paternal age (APA) is usually defined above age 35-40 and is associated with decreasing sperm analysis parameters. Men above age 45 take approximately 5 times longer to achieve a pregnancy compared with men less than 25 years of age. Further, there is evidence for APA increasing risk of miscarriage, birth defects, and autism. Men older than 40-45 have a twice as likely risk of an autistic child and five times higher risk of a child with schizophrenia.

What causes the andropause?

By Zaira Salvador B.Sc., M.Sc. (embryologist).

The main cause of andropause is age. The aging of men leads, on the one hand, to a deficit of circulating or bioavailable testosterone in the blood and, on the other hand, to an increase in sex hormone binding globulin (SHBG), which traps part of the testosterone and does not allow it to carry out its functions.

Imagen: Andropause and symptoms

In addition, there are also risk factors that accelerate the onset of andropause: obesity, hereditary factors, diabetes, thyroid disease, alcohol, tobacco and drug abuse, etc.

What are the physical and psychological changes that appear with male menopause?

By Zaira Salvador B.Sc., M.Sc. (embryologist).

Andropause entails multiple and varied changes in the male body such as, for example, difficulty in achieving and maintaining an erection, hair loss and the appearance of gray hair, loss of muscle mass, progressive loss of sight and hearing, decreased ejaculatory strength and volume, etc.

As for psychological changes, the most common ones are decreased sexual appetite, insomnia, anxiety, depression, fatigue, apathy, irritability, etc.

How long does the andropause last?

By Zaira Salvador B.Sc., M.Sc. (embryologist).

Aging in both men and women is natural and inevitable. The only thing men can do is to follow all medical recommendations in order to avoid or counteract the symptoms associated with the lack of androgens.

It is also very important to recognize and accept all the changes that occur in the body in order to achieve a healthier and more understanding sex life.

What is the difference between andropause (menopause in men) and menopause in women?

By Marta Barranquero Gómez B.Sc., M.Sc. (embryologist).

The main difference between male and female menopause is that men do not lose their reproductive capacity, but male fertility is reduced. This means that men are able to be fathers despite being 50-60 years old.

Another difference between menopause in women and andropause in men is the age of onset. In the case of women, the menopausal stage begins at approximately 45-50 years of age, while andropause begins more variably.

Throughout this post, we have talked about testosterone as the main male sex hormone. If you want to know more about its functions and characteristics, you can visit the following post: The function of testosterone

If you would like to learn more about the female menopause, we recommend the following page: The menopause

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References

Ka Youn Lee, Seung-Hyung Kim, Won-Kyung Yang, Geung-Joo Lee. Effect of Tetragonia tetragonoides (Pall.) Kuntze Extract on Andropause Symptoms. Nutrients. 2022 Oct 31;14(21):4572. doi: 10.3390/nu14214572 (View)

Margherita Martelli, Laura Zingaretti, Gianmaria Salvio, Massimo Bracci, Lory Santarelli. Influence of Work on Andropause and Menopause: A Systematic Review. Int J Environ Res Public Health. 2021 Sep 25;18(19):10074 (View)

Maria C Ysrraelit, Jorge Correale. Impact of Andropause on Multiple Sclerosis. Front Neurol. 2021 Nov 5;12:766308. doi: 10.3389/fneur.2021.766308. eCollection 2021 (View)

Michal Rabijewski, Lucyna Papierska, Malgorzata Binkowska, Radoslaw Maksym, Katarzyna Jankowska, Wioletta Skrzypulec-Plinta, Wojciech Zgliczynski. Supplementation of dehydroepiandrosterone (DHEA) in pre- and postmenopausal women - position statement of expert panel of Polish Menopause and Andropause Society. Ginekol Pol. 2020;91(9):554-562. doi: 10.5603/GP.2020.0091 (View)

FAQs from users: 'Does the man's age affect the quality of his sperm?', 'What causes the andropause?', 'What are the physical and psychological changes that appear with male menopause?', 'How long does the andropause last?' and 'What is the difference between andropause (menopause in men) and menopause in women?'.

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Authors and contributors

 Mark P. Trolice
Mark P. Trolice
M.D., F.A.C.O.G., F.A.C.S., F.A.C.E.
Reproductive Endocrinologist
Mark P. Trolice is the Director of Fertility CARE – The IVF Center and Clinical Associate Professor in the Department of Obstetrics & Gynecology (OB/GYN) at the University of Central Florida College of Medicine. He is Board-certified in REI and OB/GYN, and maintains annual recertification. His colleagues select him as Top Doctor in America® annually, one among the top 5% of doctors in the U.S. More information about Mark P. Trolice
License: ME 78893
 Zaira Salvador
Zaira Salvador
B.Sc., M.Sc.
Embryologist
Bachelor's Degree in Biotechnology from the Technical University of Valencia (UPV). Biotechnology Degree from the National University of Ireland en Galway (NUIG) and embryologist specializing in Assisted Reproduction, with a Master's Degree in Biotechnology of Human Reproduction from the University of Valencia (UV) and the Valencian Infertility Institute (IVI) More information about Zaira Salvador
License: 3185-CV
Adapted into english by:
 Michelle Lorraine Embleton
Michelle Lorraine Embleton
B.Sc. Ph.D.
Biochemist
PhD in Biochemistry, University of Bristol, UK, specialising in DNA : protein intereactions. BSc honours degree in Molecular Biology, Univerisity of Bristol. Translation and editing of scientific and medical literature.
More information about Michelle Lorraine Embleton

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