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Andropause

Male andropause, often referred to as "male menopause" or late-onset hypogonadism (LOH), is a condition associated with the natural decline in testosterone levels as men age. Unlike menopause in women, andropause is a more gradual process and does not involve a complete cessation of reproductive function. It typically occurs in men aged 40 to 65 but can vary based on individual health factors.

Diagnosing andropause involves reviewing symptoms and lifestyle, checking physical signs like reduced muscle mass, and measuring testosterone levels through blood tests while ruling out other conditions.

Symptoms

  • Physical symptoms of andropause include fatigue, reduced muscle mass and strength, increased abdominal fat, decreased bone density, and reduced body and facial hair growth.
  • Sexual symptoms of andropause include reduced libido, erectile dysfunction, and decreased sexual performance and satisfaction.
  • Emotional and cognitive symptoms of andropause include depression, anxiety, irritability, difficulty concentrating, memory problems, and a loss of motivation and self-confidence.
  • Sleep disturbances (insomnia or sleep apnea)

Causes

  • Lifestyle factors influence andropause. Obesity lowers testosterone by converting it to estrogen. Poor diet and lack of exercise may also reduce testosterone levels, while chronic stress raises cortisol, further disrupting hormonal balance.
  • Certain medical conditions can lead to lower testosterone levels and contribute to andropause. Chronic illnesses like diabetes, hypertension, and obesity, along with sleep disorders such as sleep apnea, negatively impact testosterone production. Additionally, mental health issues like depression can affect hormone levels. Injuries or infections in the testes, responsible for testosterone production, may also cause a decline in hormone levels.
  • Medications may impact testosterone levels. Long-term use of anabolic steroids or corticosteroids may disrupt natural hormone production and lead to symptoms of andropause. Similarly, medications for hypertension, depression, or prostate issues can interfere with testosterone levels. Additionally, genetic factors may predispose some men to earlier or more severe declines in testosterone.
  • Environmental factors, particularly exposure to endocrine-disrupting chemicals like BPA in plastics and certain pesticides, may impact testosterone levels and lead to hormonal imbalances. Prolonged exposure to these pollutants may worsen testosterone decline and andropause symptoms. Although a decrease in testosterone is a natural aspect of aging, making mindful lifestyle choices, addressing health issues, and seeking treatment can help relieve andropause symptoms.

Treatments

  • Testosterone Replacement Therapy (TRT) is a common treatment for andropause. It can be given through injections, patches, gels, or pellets and helps restore testosterone levels, improving symptoms like low libido, fatigue, and reduced muscle mass. However, TRT may not be suitable for everyone and requires careful monitoring due to potential side effects, including an increased risk of prostate issues.
  • Other medications for andropause include phosphodiesterase inhibitors, such as sildenafil or tadalafil, to treat erectile dysfunction. Antidepressants or anxiolytics may be prescribed for mood-related symptoms like depression or anxiety. Additionally, supplements like Vitamin D and calcium are often recommended to support bone health and prevent osteoporosis.
  • Alternative Therapies: Some men explore herbal supplements like tribulus terrestris or ashwagandha, though scientific evidence is limited. Always consult a healthcare provider before trying these.
  • Lifestyle changes are crucial for managing andropause. Regular exercise, including resistance training and cardio, boosts mood, energy, and muscle mass. A diet rich in protein, healthy fats, and micronutrients like Vitamin D and zinc supports health, while stress management techniques such as mindfulness or therapy improve mental well-being.