Menopause in men

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Women are not the only ones suffering from the effects caused by hormonal changes. Doctors have found that even their male patients show some of the events that women experience in perimenopause and menopause.

The medical community is currently debating whether there is a definite type of menopause in men. Scientists believe that male patients who undergo hormone therapy with testosterone have reported improvements in some of the symptoms associated with so-called male menopause.


1. Overview
2. Specialists opinion
3. About testosterone
4. Causes of low testosterone
5. Symptoms of low testosterone levels
6. Diagnosis
7. Treatment

Specialists opinion

Male menopause is an informal term used to define disease caused by decreased testosterone levels in men due to aging. Experts have not reached a consensus on the spreading rate of this condition.

Some say that it is found in a proportion of 2% in men over 60 years, others believe that it was diagnosed in 40-80% of men aged over 70 years.

About testosterone

Testosterone is the male sex hormone responsible for male characteristics. This is the factor that triggers the formation of penis and testicles since fetal life. At puberty, testosterone stimulates penis and testicles growth.

These hormones cause facial and pubic hair, deepening of the voice, muscle building, balance the way body fat is distributed, influences height growth, during puberty. Testosterone controls sex drive and sperm production.

Testosterone is produced by the testicles and a small amount of adrenal glands, located on top of the kidneys. Testosterone production is controlled by a complicated process that begins in a portion of the brain called the hypothalamus.

The hypothalamus sends gonadotropin releasing hormone (GnRH) to the pituitary gland that produces luteinizing hormone (LH) which stimulates the testes to produce testosterone.

When there is enough testosterone, the hypothalamus sends a message to the pituitary gland to stop producing LH and testicles decreases the testosterone production. In an adult male, every day are released about 7 mg of testosterone.

Causes of low testosterone

In young men, testosterone levels decrease may be caused by genetic conditions such as:
- Klinefelter syndrome, a condition in which males have an extra X chromosome
- Hemochromatosis, a disorder in which too much iron is stored in body tissues, including the pituitary gland
- Kallmann syndrome – genetic disorder affecting the X chromosome in males
- Prader-Willi syndrome – disorder where the genitals are underdeveloped and often testicles do not descend into the scrotum
- Myotonic dystrophy or adult’s muscular dystrophy.

Other causes are common in young people:
- Trauma to the testicles
- Inflammation of the testicles caused by the presence of mumps after puberty
- Radiotherapy or chemotherapy
- Treatment of testicular tumors
- Removal of the testicles due to cancer
- Tumors of the pituitary gland
- Drugs such as narcotics, anabolic steroids and prednisone
- Medical conditions such as tuberculosis, fungal infections and autoimmune diseases affecting the pituitary gland.

Normal aging causes a decrease in testosterone production in men. This is called andropause. Andropause usually occurs between 40-55 years. When a man reaches the age of 40, testosterone production decreases by about 1% each year.

Symptoms of low testosterone levels

Decline in testosterone is normal as aging causes decreased testosterone levels more sharply than other hormones in the body.

Consult your doctor if you experience any of the following events:
- Progressive loss of muscle mass
- Decrease in sexual desire or libido
- Erectile dysfunction
- The feeling of weight or increasing the number of kilograms
- Sleep disorders
- Feeling of irritability or anger
- Loss of motivation
- Nervousness
- Problems with memory and concentration
- Low self-confidence
- Fatigue
- Depression
- Low energy
- Bone loss.


Through a simple blood test the doctor can determine testosterone levels; serum test for measuring total testosterone is the most common investigation. Samples will be collected in the morning, when the testicles usually release more testosterone.

Normal results usually range between 300-1000.The total level of testosterone which is lower than 250 indicate very low values of the hormone treatment and may need replacement.

Approximately 98% of blood testosterone is related to two proteins and is not available to body tissues. The remaining 2% that circulate freely affect body tissues in various ways.

In older men testosterone amounts are higher protein bound. Too little free testosterone can cause the symptoms listed above.


For men whose testes produce too little testosterone or do not produce at all (hypogonadism), the doctor may prescribe testosterone replacement therapy.

This works by restoring libido, fertility, muscle strength and prevent bone loss, but long-term benefits and risks of this type of therapy in healthy, aged men, have not been studied enough.

In most studies, testosterone replacement therapy decreases the amount of fat of a man and increases the muscle mass, improves its strength and increase bone mineral density.

High doses of testosterone can cause sleep disorders and infertility and increase the risk of stroke. In addition, high doses of testosterone can cause the appearance of benign masses in the prostate. This can trigger condition called benign prostatic hyperplasia.

If prostate cancer isn’t detected, testosterone replacement therapy can cause a rapid increase of the cancer cells. Breast enlargement and acne can be other side effects of this treatment.



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