Men’s testosterone declines over a period of many years
Q: My wife is 52 and just beginning menopause. We were talking about the changes she’s been experiencing, and I was wondering if there is such a thing as male menopause. I am 58.
A: Hormone changes are a natural part of aging. Unlike the more dramatic reproductive hormone plunge that occurs in women during menopause, however, sex hormone changes in men occur gradually.
The term “male menopause” has been used to describe decreasing testosterone levels related to aging. But aging-related hormone changes in women and men are different.
In women, ovulation ends and hormone production plummets during a relatively short period of time. This is known as menopause. In men, production of testosterone and other hormones declines over a period of many years, and the consequences aren’t necessarily clear. This gradual decline of testosterone levels is called late-onset hypogonadism, or age-related low testosterone.
Low testosterone levels in older men often go unnoticed as many men who have low testosterone levels experience no symptoms. In addition, the signs and symptoms associated with low testosterone aren’t specific to low testosterone. They also can be caused by a person’s age; medication use; or other conditions, such as having a body mass index of 30 or higher.
Testosterone levels can be checked by a blood test, but tests aren’t routinely done. That said, if you are experiencing certain signs
and symptoms suggestive of low testosterone, ask your health care provider to check your levels.
Some signs and symptoms suggestive of low testosterone include:
Reduced sexual desire and activity
Decreased spontaneous erections or erectile dysfunction
Breast discomfort or swelling
Height loss, low trauma fracture or low bone mineral density
Hot flushes or sweats Other possible symptoms include decreased energy, motivation and confidence; depressed mood; and poor concentration.
Experts recommend only testing older men for low testosterone if they have signs or symptoms. If low testosterone is confirmed, further testing of the pituitary gland is recommended to determine the cause and rule out other hormone deficiencies. The pituitary is a gland situated at the base of your brain. It is part of your body’s endocrine system, which consists of all the glands that produce
and regulate hormones.
Treatment recommendations for men with age-related low testosterone vary.
Though further research is needed, testosterone therapy might stimulate growth of metastatic prostate and breast cancer. Testosterone therapy also can increase the risk of heart attack and stroke, and contribute to the formation of blood clots in the veins.
Your health care provider likely will recommend against starting testosterone therapy if your fertility is important in the near future or if you have conditions such as breast or prostate cancer, untreated severe obstructive sleep apnea, uncontrolled heart failure or thrombophilia.
If you think you might have low testosterone, talk to your health care provider about your signs and symptoms, testing and possible treatment options.