A natural part of aging is a change in our hormones. Contrary to what is often thought, both men and women go through this phase of their lives. In fact, some men claim they also go through a change of life just like women. Sometimes this is referred to as “male menopause.”
Now, most women who have gone through menopause will laugh and say “no way” if you ask them if a man goes through the same thing. And it’s true, the hormonal shifts are very different for women. Unlike the more dramatic reproductive hormone free fall that occurs in women during menopause, sex hormones changes occur in men much more gradually. Menopause in women and male menopause are two very different things.
Female and male menopause compared.
For women, menopause begins when the hormone estrogen produced by the ovaries declines sharply, ending ovulation and the chance to become pregnant. With the start of menopause, estrogen production dramatically plummets during a relatively short period of time. Most but not all women will have specific symptoms associated with this phase of life.
Male menopause is due to the natural, more gradual decline in the hormone testosterone. All men will experience shifting levels of testosterone, but by the age of 80, between 40 to 50 percent of men will have a testosterone range considered low. The normal range of testosterone levels in healthy adult males is between 280 to 1,100 nanongrams per deciliter (ng/dL), though often if it falls below 300 ng/dl, a doctor will test to determine if the low levels are due to normal aging or another issue.
It is typical for older men to see a drop in this hormone, as testosterone levels decline throughout adulthood at about 1 percent a year after the age of 30. As the testosterone levels decline, men may notice body changes of a decrease in muscle mass and an increase in body fat.
Instead of the term male menopause, many doctors use the term “andropause” or “testosterone deficiency syndrome” or even “androgen deficiency of the aging male.” No matter what it is referred to, the hormonal changes men experience are real and are considered a normal part of aging.
How to recognize male menopause.
To definitively diagnose a low testosterone level, blood tests will need to be done including checking on free testosterone, which gives more information when total testosterone is low. Because testosterone levels vary and are generally highest in the morning, blood testing is usually done early in the day, around 8 a.m.
It is common for some men with a lower than normal testosterone level to have no signs or symptoms. If this is the case, then no treatment is necessary. Some men though, may experience the following:
Sexual function changes: Erectile dysfunction, fewer spontaneous erections, low libido, infertility and a reduction is the size of the testes.
Sleep pattern disturbances: Insomnia or increased tiredness.
Physical changes: Increased body fat or weight gain, decreased muscle mass and strength, reduced bone density, increase in size of breasts (gynecomastia), and loss of body hair.
Emotional changes: Reduced motivation or self-confidence. Feelings of sadness, depression, trouble concentrating or remembering things.
Underlying factors can sometimes be the cause of symptoms other than low testosterone. Such factors could include the side effects of medication, thyroid problems, depression or excessive alcohol use. If an underlying factor is discovered for the cause of symptoms, it should be treated as soon as possible.
Treating male menopause.
Whenever a man is experiencing any of the symptoms of low testosterone or just not quite like himself, he should discuss it with his doctor. They can evaluate the reasons for these changes and prescribe a treatment option. A doctor will first rule out any possible underlying factor causing symptoms of low testosterone. After that, the doctor may recommend:
- Eating a healthy diet, and increasing physical exercise in your daily routine. Adopting a healthy lifestyle helps maintain strength, energy and lean muscle mass. It can also have a positive impact on achieving better sleep.
- Seeking counseling for emotional changes.
Avoid herbal supplements touting to treat low testosterone. They haven’t been tested or approved by the Food and Drug Administration (FDA) and some could be dangerous.
Testosterone replacement therapy (TRT) is another option but it’s controversial. It can be tempting for a doctor to want to treat all men with low testosterone with TRT but this is not advisable. Some men will experience reduction in the signs and symptoms of testosterone deficiency when placed on TRT. Other men may not. The advantages of it include decreasing the risk of heart disease and osteoporosis. The disadvantages can be an increased risk in blood clotting, acne, and breast enlargement.
Ultimately, a man and his doctor will need to decide the best ways to treat any symptoms associated with male menopause. Just like every woman is different, every man is different too. What works for one may not be beneficial for another.
Dr. Samadi is a board-certified urologic oncologist trained in open and traditional and laparoscopic surgery and is an expert in robotic prostate surgery. He is chairman of urology, chief of robotic surgery at Lenox Hill Hospital. He is a medical contributor for the Fox News Channel’s Medical A-Team. Follow Dr. Samadi on Twitter, Instagram, Pinterest, SamadiMD.com, davidsamadiwiki, davidsamadibio and Facebook
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