NOTE: The following information is meant for educational and informational purposes only and is not intended as a tool to diagnose or treat any medical condition.
Andropause
What is Andropause?
Andropause refers to a decline in testosterone or low testosterone in men that can produce a group of signs and symptoms, as well as physical changes in the body. It can often be diagnosed with a blood test. Andropause, or low testosterone production, may be associated with other related hormone imbalances, particularly estrogen excess or higher estrogen levels (the main female hormone). The term “andropause” comes from the Greek prefix “andro” meaning male or man and the suffix “pause” meaning cessation or stopping.
Other terms for andropause are:
- Androgen Deficiency in the Aging Male (ADAM); androgen refers to male-like hormones
- Partial Androgen Deficiency in the Aging Male (PADAM)
- Viropause (decline in virility or masculinity)
- Male Menopause
- Male Climacteric
- Low Testosterone
Signs and Symptoms
Andropause in adult men can indicate reduced androgen production in the testes. This can bring about specific and non-specific signs and symptoms. There may be only a few or many symptoms, and not all men will have all signs and symptoms. They may include:
- Lower energy or fatigue
- Lower sex drive or libido
- Decreased sexual function
- Softer erections, erectile dysfunction, or loss of morning erections
- Breast growth or gynecomastia (enlargement of breasts possibly with a more female appearance)
- Breast pain
- Hot flashes or night sweats
Other non-specific signs and symptoms may include:
- Loss of motivation and self-confidence
- Feeling sad, depressed, or anxious
- Poor concentration
- Declining memory
- Sleep disturbance
- Increased need for naps
- Decreased physical strength
- Increased body fat or body mass index
Andropause and Gynecomastia
Gynecomastia can be an indicator of andropause which some men might not be aware they have. They may develop gynecomastia and seek out gynecomastia treatment because of its cosmetic effects. Gynecomastia (sometimes called male breast enlargement) is a separate but related condition where the breast tissue becomes enlarged in one or both breasts. One of the largest risk factors for gynecomastia includes unbalanced hormone levels including higher estrogen levels and testosterone deficiency. This means that andropause may cause gynecomastia.
In many cases, gynecomastia is treated on its own with gynecomastia surgery to remove swollen breast tissue and body fat. However, in the case of andropause, excess male breast tissue growth may be reduced with testosterone therapy and may treat gynecomastia. It’s best to consult an experienced gynecomastia and testosterone expert to explore gynecomastia and testosterone treatment options.
Causes
Testosterone levels in adult men start to decline at age 30 due to aging. Cells in the testicles make less and less testosterone as men become older. According to the New England Journal of Medicine, approximately 10% of men in their 40s have low testosterone; additionally, 25% of men in their 50s, 45% of men in their 60s, and 70% of men in their 70s also have low testosterone. This further increases in older men. Men with the following conditions and chronic disease have an increased risk of developing andropause:
- Diabetes or pre-diabetes
- Obesity or high body mass index
- Alcoholism
- Emphysema (chronic lung scarring) or chronic bronchitis
- Liver cirrhosis (scarring) or liver disease
- Chronic kidney disease
- Sleep apnea (stopped or shallow breathing while sleeping)
- HIV-AIDS
- Prior illegal steroid use (anabolic steroids)
- Other hormone imbalances
- Chronic pain that requires narcotic medications (other hormone declines may also occur)
- Shortened telomeres (telomeres are the tips of chromosomes in cells that become shorter as we age)
Diagnosis
As with all medical diagnoses, andropause is diagnosed by a constellation of symptoms, blood test, and physical exam by a physician who is qualified to make the diagnosis. Sometimes another abnormal test may be a tip-off for possible andropause. For example, a bone fracture might indicate low bone density that would be measured on a scan. Low bone density is a possible abnormality of andropause.
Treatment
After a competent physician has diagnosed andropause, the most common treatment is testosterone therapy (although there are other possible treatments). The most common forms of testosterone therapy are a gel, cream, or patch on the skin or by injection (shot) in the muscle. Sometimes, a specific cause for andropause is found and when that cause is treated, the andropause may resolve. Depending upon associated hormone imbalance other than testosterone itself, the treatment might be another hormone or hormone blocker.
Outlook
The outlook for andropause is good when treated by a knowledgeable and qualified physician. With proper hormone changes, andropause can resolve and many men find relief from common signs and symptoms including gynecomastia and breast tissue growth, erectile dysfunction, and increased body fat. Many men also enjoy higher levels of energy, mental clarity, and sexual function.
Contact Us
Gynecomastia is best treated by a gynecomastia expert such as Dr. Miguel Delgado. To learn more, fill out Dr. Delgado’s contact form.
Excerpted from an article by Harvey S. Bartnof, M.D., Founder and Medical Director at California Longevity and Vitality Medical InstituteВ® San Francisco, California. Dr. Bartnof passed away in 2015 and Gynecomastia.org and Miguel Delgado, MD are deeply appreciative of his contribution. Copyright 2011- All rights reserved