Hormone Health: Male Andropause
Karan Y. Baucom, MD, FACOG, FAAAM
December 2, 2008
What Is Male Andropause?
When it comes to hormone decline, equal rights mean men suffer
the same fate as their female counterparts. In fact, by the time
men reach ages 45-55 they can experience the same phenomenon similar
to female menopause called andropause. Unlike menopause, which generally
occurs in women during the mid-forties to mid-fifties and is marked
by the cessation of menstruation; men’s transition is more
gradual and can expand over several decades.
As men age they begin to experience changes in attitudes and moods,
mild depression, fatigue, lower sex drive, reduced erections, abdominal
weight gain, loss of energy and reduction in physical agility.
Both menopause and andropause are distinguished by a drop in hormone
levels. Estrogen for women and testosterone for men. Andropause
was first cited in medical literature in the 40’s, so it is
not new. However, for a very long period of time it was under-diagnosed
and under-treated. A recent World Health Organization report states
that male androgens progressively decline with age. The impact of
decreasing androgens is known has andropause or PADAM Partial Androgen
Deficiency in the Aging Male.
Symptoms of Andropause
Andropause is often under-diagnosed because symptoms can be vague
and vary between men. Some men find it difficult to admit they have
a problem. Common symptoms associated with Andropause include:
- decreased libido
- abdominal weight gain
- decreased quality of erection
- decrease in strength and endurance
- lower energy
- poor concentration
- joint pain and stiffness
Two other important symptoms are:
Low testosterone associated with andropause is thought to
reduce the ability to regenerate bone tissue necessary to
help prevent osteoporosis.
- Cardiovascular Risk:
It is accepted that women’s risk of atherosclerosis
(hardening of the arteries) increases after menopause. Estrogen
replacement therapy seems to reverse this trend. New evidence
suggests that a similar phenomenon occurs with men as testosterone
diminishes with age. A cause and effect relationship has
not been established in large clinical trials and more research
Symptoms of andropause occur gradually over time. In addition,
there is great variability of testosterone levels among healthy
men, so all men do not experience the same symptoms to the same
Physicians didn’t always think of low testosterone levels
as the cause behind andropause symptoms. So often doctors would
conclude that they were caused by other medical conditions (i.e.
depression) or were simply related to “growing old”
and encouraged their patients to accept the reality of aging.
Today, this situation has changed and there is increased interestin
male aging among medical researchers. In addition new blood and
saliva testing methods have been developed that enable a trained
and experienced physician to accurately diagnose andropause and
prescribe a treatment plan to significantly reduce the symptoms
Diagnosing andropause involves extensive blood testing and interpretation.
Importance of Testosterone
Testosterone is an important hormone produced in the testes and
adrenal glad that affects the whole body. Testosterone is essential
to normal sexual behavior to include erectile quality, as it is
the hormone of sexual drive.
When it is low, so is sexual desire. Testosterone affects many
metabolic activities such as: production of blood cells in the bone
marrow, bone formation, lipid metabolism, carbohydrate metabolism
and liver function. Testosterone helps build protein. Maintaining
normal levels of bio-available testosterone is an important part
of age management medicine.
Treatment for andropause involves bioavailable hormone replacement
therapy. Not all patients are eligible for treatment as there are
conditions where testosterone replacement therapy should not be
used such as: prostrate and breast cancer. Other conditions may
include: heart or blood vessel disease, enlarged prostate, liver
disease, kidney disease and diabetes mellitus.
The metabolism of testosterone to dihydrotestosterone (DHT) and
estradiol is important in the safety and efficacy of testosterone
restoration therapy. In inexperienced hands these metabolites can
interfere with achieving the health benefits of testosterone replacement
therapy and contribute to side effects.
There are four treatment options available: oral, transdermal,
intramuscular and pellet implant.
Once weekly testosterone injections for men is a reliable, safe,
easy and least expensive option. It can be done in-office or by
the patient himself with minimum discomfort.
Testosterone Replacement Therapy (TRT) begins with precision diagnoses
to include baseline lab results. Once diagnosed and treated, TRT
then requires periodic follow-up lab test to monitor results and
assure proper dosage. At the Baucom Institute safety is our number
There is no scientific evidence that TRT causes prostate cancer
or heart disease. In fact, there is overwhelming evidence that testosterone
helps protect against: heart disease, diabetes, obesity, osteoporosis
Medical monitoring is an essential part of age management medicine.
TRT should only be conducted under the medical supervision of a
qualified physician experienced in age management and hormone replacement
In addition to disease prevention, there are many positive health
improvements that can be expected to include:
- Fat loss and leaner body
- Improved energy
- Increased libido and sexual function
- Higher concentration
- Improved sleep and,
- Enhanced strength
Medical managed TRT should not be confused with reported abuse
of anabolic steroids by athletes resulting in aggressiveness and
hyper sexuality, as this stems from unlawful testosterone use by
men with normal levels using dosages way beyond TRT supplementation
for the treatment of andropause.
Do You have Andropause?
The passage to middle age is a complicated phase of life. Not all
men going through this phase of life will experience it the same
way, as everyone is different. There are many changes and challenges
during this phase of life to include: personal , family, work, economic
, social etc. It can be difficult therefore to differentiate the
symptoms of andropause with symptoms of changes in your life that
are unrelated to andropause. The following quiz may help. Answer
each question with a YES or NO. No need to cheat yourself, so be
very honest with your answers.
- Do you have a lack of energy?
- Do you have a decrease in your sex drive (libido)?
- Are your erections less strong?
- Do you have a decrease in strength and/or endurance?
- Do you find it harder to concentrate?
- Do you fall asleep after dinner?
- Are you sadder or grumpier than usual?
- Have you lost height?
- Have you noticed a decrease in work performance?
- Have you noticed a decreased enjoyment in life?
If you answered YES to three or more questions to include question
number 2 or 3, you may be a candidate for the treatment of andropause.
If so, The Baucom Institute may be your best alternative for diagnoses
and treatment. Otherwise, discuss your symptoms with your physician
and feel free to share this information with them.
For more information visit the website of
Y. Baucom, MD, FACOG, FAAAM
Fellow American College of OB-Gyn
Fellow American Academy of Anti-Aging Medicine
other articles by Dr. Baucom:
Glands and Cortisol: the Stress Hormone