Andropause: Do Men Go Through Menopause Too?
The male analog to menopause—or andropause—has been associated with menopausal-like symptoms, including weakened bones, decreased sex drive, and even hot flashes and irritability. More and more men are asking their doctors for testosterone replacement therapy (TRT) prescriptions to alleviate some of these symptoms. But is TRT a safe and effective treatment for age-related declines in testosterone? And which men—if any—should be taking it?
Male Hormones Over Time
Testosterone is one of the male sex hormones—or androgens—responsible for the development of masculine characteristics. During puberty, testosterone initiates the enlargement of the penis and testes, growth of facial and pubic hair, deepening of the voice, increases in muscle mass and strength, and growth in height. In male adults, testosterone is involved in the maintenance of sex drive, production of sperm cells, male hair patterns, muscle mass, and bone mass.
As men age, their production of testosterone naturally declines. But this age-related hormonal decline is much less dramatic in men than in women. During
Age-Related Changes in Men
Low levels of testosterone have been associated with weakened bones, increases in
If your doctor suspects your testosterone levels are low, a simple blood test can check it. But since testosterone levels fluctuate widely throughout the day, a single test may not be able to diagnose testosterone deficiency. Generally, the acceptable range of levels is between 300-1,200 nanograms per deciliter (ng/dl) for total testosterone.
While testosterone does decline with age, diseases and conditions of the testes, pituitary gland, hypothalamus, and various genetic conditions may also cause reductions in the production of testosterone. If your testosterone levels are abnormally low, your doctor may perform additional tests to look for damage to the testes, or hypothalamic or pituitary gland diseases. If one of these diseases or conditions is detected, treatment may resolve the testosterone deficiency, or TRT may be indicated. In addition, some medications may cause the testosterone level to drop. Diminished testosterone levels are a known complication of chronic opioid therapy for chronic pain. If you take medications like morphine, oxycodone, fentanyl, or methadone for longer than six months, you should have your testosterone levels checked periodically.
Testosterone Replacement Therapy (TRT)
The Food and Drug Administration (FDA) has approved four delivery methods of TRT for clinically low testosterone levels in otherwise healthy men: pills, injections, transdermal (through the skin) patches or gels, and a tablet that adheres to the gum surface. TRT has been shown to benefit men who suffer the symptoms of low testosterone in a number of ways, including:
- Increasing sex drive
- Restoring erectile function
- Improving mood
- Maintaining beard growth
- Increasing bone density
- Increasing muscle mass
For years, menopausal women took hormone replacement therapy (HRT, a combination of estrogen and progesterone) to relieve symptoms of menopause and increase bone density. But recent findings from the Women’s Health Initiative (WHI) trial have linked HRT with increased risk of
As of yet, there have been no long-term clinical trials testing the safety and effectiveness of TRT in men. However, as more and more men are getting prescriptions for TRT, more research is necessary. There are concerns that TRT may increase the risk of
Researchers did study whether TRT helps healthy, older men with low testosterone levels. Overall, patients taking testosterone therapy didn’t experience improvements in important outcomes, like cognitive function and mobility and strength.
If you are considering this therapy, talk to your doctor about the potential harms and benefits.
The Endocrine Society
National Institute on Aging
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Last reviewed April 2009 by
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