Most of us are familiar with menopause and the misery it causes for so many women.
A recent awareness campaign, successfully conducted by celebrities and doctors, highlighted what more than one million US women around the age of 50 experience as their estrogen levels plummet and their reproductive years end.
Now doctors want to draw attention to a “silent epidemic” affecting men with extremely low testosterone levels – male menopause.
As with women, the term is used to describe that time in an adult man’s life when his hormone levels plummet, causing a variety of symptoms that are confidence-shattering or downright crippling for those affected — including erectile dysfunction, depression, anxiety, and rapid fat gain.
As with women, male menopause is used to describe the period in an adult man’s life when his hormone levels plummet, causing a variety of symptoms that can be life-altering and debilitating – from erectile dysfunction to depression, anxiety, and rapid fat gain
Testosterone levels peak in young adulthood, around age 20, but decline by about 1 percent annually after age 30
Male menopause, which doctors admit is somewhat misleading, is medically referred to as andropause. Unlike menopause in women, andropause is characterized by a more gradual change.
dr Bob Berookhim, a New York City urologist and director of male fertility and microsurgery at Lenox Hill Hospital, told , “In men, declining testosterone levels tend to come on more slowly and can show up at any age and most men are less likely to do so with a sudden onset of symptoms of low testosterone levels.
“I think the name hurts men’s chances of getting treatment. The term may be seen as emasculating by some, and these symptoms are common and uncomfortable for men to talk about when they start college.
“Besides, when patients come in and I’ve diagnosed them, I call it ‘manopause’ to get a smile out of them!”
Male babies are born with testosterone. Their T levels rise rapidly during puberty, causing boys to develop deeper voices, larger muscles, and body and facial hair. The hormone also helps the testicles produce sperm, which is crucial for reproduction.
Testosterone levels typically peak around age 20, followed by a slow decline throughout the rest of adulthood. At its highest, testosterone levels should be somewhere between 300 and 1,200 ng/dL. Once men hit their mid-thirties, testosterone levels begin to decline by at least one percent per year.
TRT has been highly praised by podcaster Joe Rogan, who regularly talks about its benefits on the air
Jeff Bezos reportedly underwent testosterone replacement therapy to achieve his new buff physique
Actor Dax Shepherd, 46, is also a supporter of TRT and credits it with helping him gain 24 pounds of muscle
Urologists consider testosterone levels too low when they drop below 300 nanograms per deciliter (ng/dl). This most commonly happens in men in their 40s and 50s.
Estimates from the University of Wisconsin show that low testosterone affects about 12 percent of men in their 50s, 19 percent in their 60s, 28 percent in their 70s, and 49 percent in their 80s
Testosterone is produced in the testicles in men and fuels sexual development. It regulates sex drive, bone mass, fat distribution, muscle mass and strength, and the production of red blood cells and sperm.
It also acts on the brain and spinal cord as an important regulator of neurological functions. Low testosterone levels are associated with depression and anxiety.
Low testosterone levels could indicate a problem in the pituitary gland, a pea-sized gland at the base of the brain that monitors and regulates myriad bodily functions through the hormones it produces.
Age-related hormone changes in men are gradual, and while they don’t render the male reproductive system inoperable, the change can cause sexual complications.
Unlike in women, hormonal changes do not make men infertile. Although testosterone is a hormone that drives male fertility, people with low testosterone levels can still produce healthy sperm, although sperm count and quality usually decrease.
And while a woman’s transition is quite drastic – within a few years – men experience an annual drop in testosterone from the age of 40 into old age.
dr Kevin Campbell, a urologist at the University of Florida, told : “There’s no fixed plateau that guys suddenly fall off.
“Over time, our bodies will experience an insult where they stopped producing the same amount of testosterone.
What is “male menopause”
The term “male menopause” is used to describe the period in an adult man’s life when his testosterone levels drop.
In fact, “menopause” is a misnomer, doctors say.
Menopause is generally understood as a dramatic change in hormone production that usually occurs over a relatively short period of time.
A lack of testosterone can lead to decreased sex drive, erectile dysfunction, unexplained decrease in muscle mass or sudden increase in body fat, hair loss, osteoporosis and depression.
In men, falling testosterone levels tend to come on more slowly and can occur at any age, and most men are less likely to have a sudden onset of low testosterone symptoms.
Testosterone is produced in the testicles in men and fuels sexual development.
The hormone regulates sex drive, bone mass, fat distribution, muscle mass and strength, and the production of red blood cells and sperm.
Low testosterone in men is very common. In fact, it affects about 40 percent of men over the age of 45 and 50 percent of men in their 80s.
Men with low T may opt for hormone replacement therapy to help manage symptoms and replenish hormone levels.
Testosterone replacement therapy comes in many forms, from topical gels to intramuscular injections.
“Over time, our bodies become less optimized and we begin to produce less testosterone or we use it less effectively. And that can lead to a symptom constellation that is colloquially referred to as male menopause.”
Doctors usually run a barrage of blood tests on people with these symptoms to determine what’s causing the testosterone deficiency and how to treat it. For example, low testosterone levels have been linked to an increased risk of cardiovascular disease and fatty liver disease.
dr Boback said: “The blood test is absolutely crucial for the diagnosis. It is important to note that this blood test must be taken within three hours of waking up, as this is when testosterone levels peak in men. A late evening test will show an artificially low level.’
Comprehensive blood tests are the gold standard for determining the cause of low testosterone when men start noticing any symptoms. But many men either fail to report their symptoms or have no symptoms at all.
dr Campbell said: “Some people have family histories or they have someone close to them being treated for testosterone deficiency and then it makes more sense to them [to get tested]You are a little more aware of the condition to come in and get checked out for it.
Men with low testosterone may opt for hormone replacement therapy to help manage symptoms. Testosterone replacement therapy comes in many forms, from topical gels to intramuscular injections.
TRT helps restore blood levels of this hormone and reverse the symptoms of low testosterone levels.
Doctors also want men to know that exercise is known to increase testosterone levels. Resistance exercises like lifting weights have been shown in research to help increase short- and long-term T levels.
Some foods, such as Foods such as magnesium-rich dark leafy greens, eggs, and oily fish can also increase T levels. Meanwhile, research has shown that ultra-processed foods and foods that aren’t rich in nutrients can erode testosterone levels.
dr Boback said: “I generally consider testosterone replacement therapy in men with testosterone levels below 300 ng/dL and the presence of symptoms. In general, there is no clear evidence that a simple lab result requires treatment when patients have no symptoms.
“The decision on how to treat, whether with topical gels or injections or otherwise, depends on a number of different factors. Men should know that actual testosterone replacement will most likely reduce sperm count significantly, to zero in many cases.”
Many men who start testosterone replacement therapy will see good results. A 2019 study reported that therapy can improve libido and treat symptoms of sexual dysfunction. Additional research from 2019 found that TRT may help maintain bone density, while previous research from 2016 said it helped improve cognitive function and attention span.
TRT has been highly praised by podcaster Joe Rogan, who regularly talks about its benefits on the air. Amazon mogul Jeff Bezos is also rumored to have TRT to thank for his new buff physique. And actor Dax Shepherd, 46, revealed on his podcast “Armchair Expert” that he’s gained 24 pounds of muscle during quarantine with “heavy testosterone injections.”