Andropause is more commonly known as the 'male menopause'. It is not a disease, but a physiological stage in the life of every man. It is a kind of mirror response to what is called menopause in women. Scientifically, the late-onset hypogonadism or partial androgen deficiency in the elderly man is called andropause. Doctor Alexandru Machidon urologist explains the risk factors, the symptoms of adropause, the treatment and, especially, how we can reduce the changes induced by andropause by minimizing their effects.

If changes occur in your couple life and you have questions about the signals that your body sends you, you can schedule an online consultation with one of the doctors available on the Digital Clinics platform for competent advice.

When does andropause occur?

As men age, the level of the male hormone testosterone in the blood gradually decreases. The decrease occurs slowly. Doctors say that the maximum testosterone in the blood in men is reached around the age of 20-30, after which this level decreases by 1% per year. The optimal level of testosterone in the blood for an adult man is between 300 and 1,000 nanograms/milliliter. Because this level varies at different times of the day, testosterone dosing tests are done between 7:00am and 10:00am.

“Andropause is not a disease, it is a normal physiological stage in a man’s life, just as menopause is a normal stage in a woman’s life. Andropause is mainly related to a decrease in testosterone levels in the blood, but it is also related to an increase in sex hormone binding globulin, a protein in the blood that makes testosterone no longer available for use in tissues, even if the level of testosterone in the blood is within normal limits,” explains urologist Alexandru Machidon.

Types of andropause

Physiological andropause is the one related to a decrease in testosterone in the blood and an increase in sex hormone binding globulin naturally, with advancing age.

Artificial andropause/iatrogenic andropause is caused by a surgical act – castration for example, but also by chemotherapy treatments, prostate cancer treatments by administering gonadotropin agonists (substances that act on the hypothalamic-pituitary axis and suppress testosterone secretion).

Risk factors for andropause

Doctors say that there are a number of factors that favor the onset of andropause:

Lack of physical activity can lead to a decrease in muscle mass and, as muscle mass decreases, so does the level of testosterone in the blood. Some researchers and doctors consider muscle mass to be an endocrine organ because it is involved in testosterone metabolism.

Obesity and increased fat on the abdomen also contribute to a decrease in testosterone levels in the blood. Obviously, obesity is often linked to metabolic syndrome and diabetes, two other factors that favor the onset of andropause.

Chronic alcohol consumption, smoking, mental stress, but also lack of sleep are all factors that can bring about changes in the body, changes that can involve the induction of andropause, as well as other more severe health disorders.

Symptoms of andropause

If in the case of female menopause the symptoms are more sudden and obvious, in men the symptoms often set in slowly, insidiously and can go unnoticed. They usually appear around the age of 48-50 and are not the same for all men. Symptoms include:

• fatigue and attention deficit;

• onset of erectile dysfunction;

• decreased muscle strength;

• weight gain and increased belly volume;

• decreased interest in sexual intercourse and decreased libido;

• decreased morning erections;

• decreased testicular size;

• decreased facial, axillary and pubic hair;

• the appearance of psychoemotional changes – depression, anxiety, irritability;

• the onset of hot flashes.

Usually, two or more of the above symptoms are associated with andropause. If the person experiences only one of the symptoms, it is not necessarily the onset of andropause. To be sure of the diagnosis, a visit to the endocrinologist or urologist is the best solution to educate ourselves regarding the true reason for what we feel.

Remember! Some men may never experience any of the symptoms described above. The specialists' explanation is that some people start from a higher level of testosterone in the blood, or because they have always maintained their muscle mass by being very active.

Diagnosis in andropause

The definite diagnosis of andropause is based on a test of the serum level of free testosterone and total testosterone, as well as a test regarding the level of sex hormone-regulating globulin.

Andropause Treatment

For severe cases of andropause, that is, if testosterone levels are below 300 nanograms/milliliter (male hypogonadism in older men), men face severe osteoporosis and serious erectile dysfunction, bone fractures, etc. There are several ways to administer testosterone:

1. Applying patches and gels directly to the skin (on the shoulders, thighs, arms)

2. Testosterone injection (an injection is given every 2 or 4 weeks)

3. Administering testosterone capsules.

Contraindications to testosterone administration

Testosterone administration is completely prohibited for patients suffering from:

1. breast or prostate cancer because it promotes the spread of cancer

2. stage IV heart failure

3. sleep apnea syndrome

4. those who want to conceive a child in the near future, because it leads to infertility

5. prostate adenoma, because it causes even greater growth in the volume of the prostate and induces urinary retention

Recommendations of doctor Alexandru Machidon:

The best treatment for andropause is prevention, and caring for a healthy lifestyle is the best and most accessible solution.

Lifestyle changes can make testosterone levels return to normal so that there is no need to administer exogenous testosterone (i.e., testosterone intake produced outside the body).

A healthy lifestyle involves:

1. Physical activity 2-3 times a week, minimum 30 minutes;

2. A healthy diet rich in proteins, low in sugars, fats and carbohydrates;

3. Quality sleep of 7-8 hours/night;

4. Optimal hydration and avoidance of alcohol and smoking;

5. Stress reduction.

If all of this is not enough, dietary supplements, especially those with zinc, are extremely useful, because zinc is important for achieving an optimal level of testosterone in the blood.

Andropause is not a disease, but a normal physiological process. Symptoms often go unnoticed, but where changes are clear, these changes do not go away on their own and can worsen if measures are not taken. Appropriate treatment removes any complications and can provide an active and normal sex life to men who can enjoy a "second youth" even after 50 - 60 years.