Do Men Go Through Menopause? A Comprehensive Guide to Male Hormone Cycle

Male hormone cycle: how does it work?

The major androgens in the male human body are dihydrotestosterone (DHT) and testosterone. The testicles make most of the androgen, but a fair quantity of them are also made by the adrenal glands.

Levels of testosterone vary significantly — generally, older males have lower levels of testosterone than younger males. There is a gradual decline in the levels of testosterone throughout adult life; the level declines by about one percent per year after the age of 30, on average.

Male menopause or andropause?

Starting around the age of 40, levels of testosterone in the male body decrease and may lead to the occurrence of certain pathophysiologic changes. Sometimes this declining level of testosterone due to aging is referred to as male menopause or andropause. But this so-called “menopause in men” and actual menopause are not the same.

In the female body, the production of hormones plummets and ovulation ends in up to four years from the moment perimenopause begins. But in the male body, the production of hormones declines over a longer duration of several years, and the effects of this aren’t always clear.

Although levels of testosterone decrease in the male body over time, this is a gradual decline at a rate of less than two percent per year starting from 30–40 years of age, and it’s unlikely it will lead to any problems by itself.

Male menopause symptoms may sometimes occur due to a deficiency of testosterone that develops during the later stages of life (also referred to as late-onset hypogonadism). However, in many cases, these symptoms may occur irrespective of any hormonal imbalance in men.

Apart from andropause, doctors may also refer to male menopause as testosterone deficiency syndrome, late-onset male hypogonadism, and androgen deficiency of the aging male.

Male menopause symptoms

Both sexes experience a decline in the levels of sex hormones starting around age 40. But because this decline in the male body occurs gradually over several years, the onset of male menopause symptoms may be ill-defined and subtle. These are some of the recognizable signs and symptoms:

• Sexual function changes: This may include erectile dysfunction, fewer (than normal) spontaneous erections — for instance, during sleep, decreased sexual desire, and infertility. The testes may also become smaller.
• Sleep pattern changes: Sometimes, low levels of testosterone can cause sleep disturbances, including increased sleepiness or insomnia.
• Physical changes: These may include reduced muscle strength and bulk, increased body fat, and reduced bone density. It’s also possible to have a loss of body hair and tender or swollen breasts (referred to as gynecomastia). Reduced energy and hot flashes may also occur as male menopause symptoms, although rarely.
• Emotional changes: Reduced levels of testosterone may cause reduced self-confidence or motivation, depression, sadness, and difficulty remembering things or concentrating.

Other symptoms that may occur due to androgen deficiency include a decrease in high-density lipoprotein or HDL cholesterol and the proportion of red blood cells in the blood.

How is menopause in men diagnosed?

The procedure to diagnose male menopause includes a complete medical history, laboratory tests, and a physical exam. In the medical history, the doctor will discuss childhood development, fertility, any abnormality of the testes, exposure to occupational toxins or medicines, and recent sexual function changes. They will also ask questions to determine the start and severity of several of the male menopause symptoms mentioned above.

During the physical examination, the doctor will palpate the testes to check for consistency and volume and assess secondary sexual characters like breast size, body musculature, and hair distribution. The doctor may conduct a digital rectal exam (DRE), especially in men 50 or older to check the size of the prostate.

Laboratory tests are done to measure the levels of testosterone hormone along with other hormones, including follicle-stimulating hormone (FSH) and luteinizing hormone (LH). To make a definitive diagnosis of male menopause or androgen deficiency, the doctor must determine and evaluate hormonal levels in relation to the physical symptoms present in a male.

Treatment for andropause

People should consult their health care provider if they experience symptoms and signs that may occur due to male menopause. The provider can evaluate the possible causes and discuss various treatment options.

Low testosterone therapy

Treating age-related low testosterone levels using testosterone replacement therapy is a controversial practice. For some, testosterone therapy may help relieve bothersome male menopause symptoms, whereas in others, the advantages aren’t very clear, and it may pose some risks, including sleep apnea, stimulation of nonmalignant growth of the prostate gland, and stimulation of the growth of already present prostate cancer.

The risk of occurrence of stroke and heart attack is also increased by testosterone therapy. It may also contribute to the development of clots in the veins.

Testosterone may affect the levels of cholesterol and production of red blood cells; hence, these should be monitored by a health care provider during the initial year of testosterone therapy.

Low androgen therapy

Androgen replacement therapy is also evolving as a treatment for androgen deficiency that may lead to the occurrence of menopause in men. Testosterone is the major hormone that is given as part of androgen replacement therapy in a wide variety of preparations. Some of these include short- and long-acting intramuscular injections, scrotal and skin patches, oral preparations, and skin gels. What type of therapy is appropriate is determined by consulting a specialist.

The main aim of supplementation with testosterone is to get the levels of the hormone within the normal range without exceeding the range. Furthermore, there shouldn’t be any adverse effects of the therapy on serum lipid levels or prostate, cardiovascular, lung, or liver function. It should be affordable, and patients need to be able to administer it on their own with little discomfort.

The takeaway

Do men have menopause? The male body has a progressive and slow loss of androgen that is unlike estrogen loss, which is abrupt and results in actual menopause. Androgen loss may cause gradual, subtle, and vague male menopause symptoms. Testosterone therapy shouldn’t be started until a health care provider evaluates and diagnoses them with androgen deficiency. To be considered, they should make sure to have a complete assessment of their health and their testosterone levels should be consistently low. It’s not uncommon for other health issues to be present and in need of treatment, including diabetes and obesity, making testosterone therapy unnecessary.