Male menopause

male menopause

Male menopause

The subject of male menopause, or “man-opause” as some people like to call it, is still controversial. There are no clear-cut signs as in the female menopause.  The female menopause marks a definite stage of life.  Menstrual periods stop and hormones, like estrogen and progesterone, show a dramatic and abrupt decline.  Post-menopausal woman are also no longer able to become pregnant. Many men who are in their 90s have still been able to conceive children.

Doctors do notice age-related symptoms in their male patients which cannot be ignored.  Medical professionals prefer to use the term “andropause” when referring to the symptoms of the so called male menopause.  The word, andropause, is not yet recognized by the World Health Organization and it also has no ICD 10 code, while the female menopause is a clearly defined, recognized condition.

In the New England Journal of Medicine (June 17 issue, 2010), a European study attempted to define the criteria for male menopause.  This definition stated that male menopause can be identified when the patient experiences three sexual symptoms and has a free testosterone level which is less than a certain threshold. The three sexual symptoms include erectile dysfunction, decreased sexual thoughts and a decrease in the frequency of morning erections.  This study did acknowledge physical and psychological symptoms associated with low testosterone levels but proposed that it is not required as part of the definition.

Female menopause affects all women at some stage of life but not all men are affected by male menopause.  Male menopause is often linked to men who are in poor general health and suffer from obesity.  Most men experience a very gradual decline in the levels of testosterone. This decline occurs at about 1% every year starting from the age of 30 years.  By the time the male is 70 years old, his testosterone levels could be less than 50% of the level it was when he was in his 20s. It has been noted that about 50% of males feel some effect of decreased testosterone levels by their mid-50s.  The big difference between male and female hormonal decline with age is that in males it is much more gradual.

Low testosterone affects at least 4 – 5 million men in the United States.