The Male Menopause: What You Need To Know

Robert C. Robinson III, MD

 

Low T: Male Menopause

While it has long been recognized that women go through a hormonal change sometime around their fifth decade of life, not until recently has it been suggested that men may go through a similar change which could explain some of the stages of “mid-life”. Previously viewed as a “mid-life crisis”, there has been increasing consideration given to the possibility that medical and hormonal changes are the basis for some of the experiences that middle aged men go through.  The phenomenon that I’m referring to is known as “low T” or low testosterone.  Here we will explain what “low T” is, who experiences it, the symptoms and some of the more common treatment options available.

 

What is testosterone?

Testosterone is the hormone that differentiates the male from female genders.  Responsible for the embryonic development of male sex characteristics, testosterone plays a significant role in a male’s life from boyhood throughout manhood. Surges in testosterone in pubescent boys, results in increased muscle build up and bone strength, deepening of the voice and stimulation of the sex drive.  In our adult lives, testosterone contributes to a maintenance of a man’s sex drive, energy level, maintenance of secondary
sex characteristics (facial hair, pubic hair etc), muscle mass and even maintenance of a healthy weight.  While it is normal for testosterone levels to drop after age 40, the decline is usually rather small with an average rate of about 1-2% per year. More rapid drops in testoterone may be indicative of the condition known as “low T”.

 

What is Low T?

As stated above, declining testosterone levels are a natural phenomenon that occurs as a normal part of the aging process.  Testosterone levels can be measured via a blood test and levels less than 300ng/dL are considered abnormally low irrespective of age. Sometimes referred to as the “male menopause” or “andropause”, “low T” occurs when the testosterone levels drop below this threshold of 300ng/dL.

 

What are the symptoms of “low T”?

Some of the more commonly recognized symptoms of “low T” include decreased sex drive, erectile dysfunction, mood instability, fatigue and sleep disturbances. While it seems that “low T” symptoms would be easily recognizable in men just as the symptoms of menopause are in a woman, men don’t often appreciate the onset of these symptoms due to their gradual development. This is because of the slow decline of testosterone levels over YEARS as compared to a woman’s more rapid menopause which occurs over months. Symptoms of “low T” may not be quite as pronounced if the changes have occurred over a long period of time.  For example, a man may think that he has a normal sex drive, not realizing that it is nowhere near as strong as it once was.  Of all men with low testosterone, approximately 50-70% will experience symptoms of “low T”.

 

How is “low T” treated?

“Low T” can be treated by raising testosterone levels with topical testosterone gels and patches applied to the skin daily, testosterone injections, or orally disintegrating tablets. 
The goal of therapy is to raise testosterone levels to the normal range and to help alleviate the symptoms of low testosterone. The appropriate replacement therapy for you will need to be determined by you and your healthcare provider.

 

Will I see improvement in my symptoms if my “low T” is treated?

Data suggests that approximately 10% of men saw no improvement.  However 90% of men treated for “low T” report some improvement in symptoms.  It is impossible to know for sure if you will see improvement in your symptoms with treatment, however the vast majority of men do.

 

Who should be tested for “low T”?

It is recommended that only those men experiencing symptoms should be screened for “low T”. Declines in testosterone levels are normal after age 40, and not all men who have low testosterone levels will become symptomatic.  Over half of men with “low T” do experience symptoms, and these are the individuals who need to be screened.

If you are a man experiencing any of the symptoms listed above you should speak with your healthcare provider about being tested for “low T”.  

It’s a health thing and we’ve got to understand!