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Male menopause: Fact or fiction?

Posted on by Richard L Grunden, MD


Like women, men experience changing hormones as they age. But unlike women, whose hormone production dramatically changes in a relatively short time with menopause, the decline in male hormones is gradual and its effects are not as thoroughly studied or as well understood.

Men do not go through a well-defined change, which makes it difficult to identify any blatant symptoms like the hot flashes women experience, but men do report some symptoms similar to those of women, although the changes can be subtle and not immediately noticeable.

The medical community, however, is not united on the topic of male menopause or whether there is any relationship between decreased levels of testosterone and any of the symptoms. In addition to aging, testosterone can also decline because of diseases, such as diabetes and thyroid problems, and medication side effects.

Male hormone fluctuations

Testosterone levels decline throughout adulthood on average about 1 percent a year, after age 30. By about age 70, the decrease in a man’s testosterone can be as much as 50 percent. Declining testosterone can lead to:

  • Sexual issues, such as erectile dysfunction, reduced sexual desire, infertility, and smaller testes.
  • Sleep problems, including insomnia or increased sleepiness.
  • Physical changes, such as increased body fat, reduced muscle mass, strength, and endurance, and decreased bone density.
  • Emotional issues, such as a loss of motivation or self-confidence, feelings of sadness depression, a lack of concentration, or trouble remembering things.

These same symptoms, however, can be found in numerous other disorders, such as hypothyroidism, depression, and anemia, to name a few, so men should not automatically attribute them to male menopause.

Is there a treatment?

The only way to determine testosterone levels is through a blood test to measure the hormone. Testosterone replacement therapy, like estrogen replacement therapy for women, can help relieve symptoms but there are potential risks. It could worsen prostate cancer, for example.

Men who are experiencing symptoms of low testosterone should talk to their physician about lifestyle changes and other medications besides hormone replacement therapy, such as antidepressants, that can help with symptoms. The pros and cons of any therapy should be thoroughly evaluated.

 | Susquehanna Family Medicine

Richard L. Grunden, MD, is a family doctor with LG Health Physicians Susquehanna Family Medicine. A graduate of the Penn State College of Medicine and the Lancaster General Hospital Family Medicine Residency Program, Dr. Grunden’s areas of special interest include integrative medicine, patient education, and urgent care.

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