What is the male menopause?

Male menopause, also called Androgen Deficiency in the Ageing Male (ADAM), refers to a set of age-related hormonal changes that occur in some men as they get older. It is characterised by a drop in testosterone levels, the primary male sex hormone, and can lead to various physical and psychological symptoms. Male menopause is also known as androgen deficiency, andropause, testosterone deficiency, or late-onset hypogonadism.

Female menopause transition starts with a slow fluctuating decline in sex hormones followed by the complete cessation of hormone production, which leads to periods stopping altogether. However, testosterone levels in men typically peak in their 20s, and for some men, they slowly decline over the next several decades.

We don’t understand exactly what causes testosterone levels to decline with age. Interestingly, 75% of men maintain normal testosterone levels into old age, which means that the decline is not solely due to ageing. We do know, however, that testosterone decline is more common in older men with the following risk factors:

- Obesity

- Type 2 diabetes

- Taking certain long-term medications

Symptoms of ADAM are very diverse and non-specific, and again we don’t completely understand why it happens.

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Symptoms of male menopause can vary among individuals but may include:

1. Decreased libido or loss of sex drive: Many men may notice a reduced interest in sex or a decline in sexual desire.
2. Erectile dysfunction: Some men may experience difficulty achieving or maintaining erections, particularly a reduction or loss of morning erections. 52% of men will experience erectile dysfunction at some point in their life.
3. Fatigue and decreased energy levels: Some men may feel tired and lack the energy they had in their younger years.
4. Mood changes: The sudden decline in testosterone levels can have a big impact on a man's mental health. This can often lead to mood swings, irritability, depression, as well as decreased motivation. Mood swings can also cause relationship issues and impact a person's quality of life.
5. Loss of muscle mass and strength: Testosterone plays a role in maintaining muscle mass, and its decline can lead to reduced muscle strength and increased body fat. Strength training is often recommended to try and combat this decline. A sign of testosterone deficiency in men can also be weight gain, especially in the abdominal circumference area.
6. Decreased bone density: Low testosterone levels can contribute to a loss of bone density and increase the risk of osteoporosis and low-impact fractures.
7. Sleep disturbances: Men may experience insomnia, difficulty falling asleep, or restless sleep patterns.
8. Memory and concentration problems: Some men may notice a change in cognitive abilities such as increased short-term memory, lack of focus, and poor concentration.

It is important to note that not all men will experience these symptoms, and the severity can vary. Additionally, other medical conditions and lifestyle factors can contribute to similar symptoms such as a poor diet, lack of exercise, increased consumption of alcohol, and lack of sleep.

If you suspect you may be experiencing male menopause, it is advisable to speak to your healthcare professional who can evaluate your symptoms, perform appropriate tests, such as blood tests, and provide appropriate guidance or treatment options if necessary.

Your doctor will usually start off by providing you with advice on how to improve your general health through lifestyle changes, such as reducing stress, eating a healthy balanced diet, getting plenty of sleep, stopping smoking, reducing alcohol intake and exercising regularly. This is particularly important if you have heart problems, diabetes, and/or kidney conditions. Furthermore, you may notice improvement in your symptoms by making these lifestyle adjustments.

If the results show a testosterone deficiency then you may be given testosterone replacement therapy, which typically comes in the form of a gel or injection. If you have any questions about the male menopause or any testosterone-related concerns, speak to your GP or your Fertifa Patient Advisor. We are always here to help 💜