Men's Health

Is there such a thing as ‘male menopause’?

Maybe you’ve heard the term ‘male menopause’ and wondered what it is. Isn’t menopause what women go through and not men?

The answer is yes and no. Menopause literally means “the end of monthly cycles” and is retroactively defined as the final menstrual period followed by 12 months of no menstruation. Menopause in females is usually a natural change, yet may be accompanied by some very unnatural feelings! Think hot flashes, night sweats, and rapid heart rate.

So, what is male menopause?
Male menopause is a commonly used term, but isn’t the most accurate, as it actually refers to a gradual decline in androgen (particularly testosterone) levels, rather than a sudden drop in sex hormones and the end of a monthly cycle like in women. Although that is not to say that men don’t have hormonal cycles. In fact, testosterone levels in men tend to cycle throughout the day (highest in the morning and lowest in the evening), month, and maybe even with the seasons (1).

More accurate terms for the age-related decline of testosterone in males include testosterone deficiency syndrome, androgen deficiency of the aging male, and late-onset hypogonadism (2).

Testosterone declines in all males with age
Male testosterone levels decline as much as 0.4–2% a year from the age of 30 years onwards (3). This gradual decline is mainly due to a reduction in Leydig cell mass in the testicles and/or dysfunction in the normal hormonal control of testosterone production (4). Most men still have testosterone levels within the normal range even as they get older, but there is an estimated 10–25% who have levels that are considered low.

What are the symptoms of low testosterone?
The signs and symptoms of low testosterone are changes that can also occur for a variety of other reasons; hence low testosterone often goes unnoticed. The symptoms can include:

  • Reduced libido
  • Erectile dysfunction
  • Breast discomfort or swelling
  • Infertility
  • Height loss
  • Reduced bone mineral density and muscle mass
  • Increased body fat
  • Hot flushes or sweats
  • Mood changes and/or depression
  • Fatigue
  • Poor concentration

What can affect testosterone levels in males?
Aside from age, there are various other things that can influence testosterone levels. Obesity is linked to lower testosterone levels, as well as lower physical activity. Other contributing factors may include exposure to environmental toxins and increased temperatures in homes and offices. Each of these factors is thought to also contribute to the gradual overall decline in male testosterone levels, with some reports showing that average levels (across all ages) are declining at a rate of about 1% per year (5).

Can low testosterone be treated?
Treatment recommendations vary for males who have low testosterone that is associated with increasing age. The American College of Physicians recommends testosterone therapy in men with sexual dysfunction, while the Endocrine Society recommends testosterone therapy for men who are showing typical signs and symptoms of low testosterone. However, other experts recommend offering testosterone therapy to men with low testosterone levels even if they are not showing any symptoms.

There are possible risks associated with testosterone therapy including stimulated growth of prostate and breast cancer, and increased risk of heart attack, stroke, or blood clots. Therefore it is important for every individual to consider the pros and cons of testosterone therapy.

Should you get your testosterone levels checked?
Usually, testosterone testing is only recommended for older men who are showing possible signs of symptoms. If low levels are indicated, it is often recommended to repeat the test to confirm the results. Follow-up testing may also be required to determine the cause, such as testing of the pituitary gland.

We offer several different tests that include testosterone:

Each of these tests can be ordered online with at-home sample collection and results available online immediately after testing is complete. No need to make a doctor’s appointment for sample collection. However, if any abnormal results are detected in these tests, we do recommend consulting with your health care professional to discuss additional testing and/or treatment options.

References:
1. Law BM. (2011) Hormones and desire. American Psychological Association. 42(3), 44.
2. Male Menopause. (March 2015) Hormone Health Network.
3. McBride JA, Carson CC, Coward RM. (2016) Testosterone deficiency in the aging male. Therapeutic Advances in Urology. 47-60.
4. Gould DC. (2000) The male menopause: does it exist? West J Med. 173(2): 76-78.
5. Howe N. (2017) You’re not the man your father was. Forbes