It’s part of the natural process of aging. As women go past their child-bearing age, their bodies go through a series of changes that can sometimes have very uncomfortable side-effects: hot flashes, night sweats, vaginal dryness, pain during intercourse, weight gain, hair loss, etc. This frustrating period is called menopause. However, while the latter is well documented for women, one question remains: do men too go through menopause?
The answer is not straightforward. Indeed, much less known than menopause, the male counterpart “andropause” is linked to the decline in testosterone production in men. But it is not recognized by the scientific community even though real symptoms exist.
For many scientists, while it would be tempting to talk about andropause as the male version of menopause, the symptoms and consequences of the two disorders are not really the same. Indeed, for many experts andropause does not even exist.
Literally, andro means man and pause comes from pausis for cessation. This definition is problematic for scientists because andropause does not correspond to an interruption of male fertility: the man, unlike the menopausal woman, will be fertile until the end of his life. Menopause is usually more brutal than the symptoms experienced by men, and it affects all women. This is not the case for andropause, which some men will never know.
Andropause, as it is described today, really is nothing more than a progressive decrease in testosterone production in men. The main symptoms are a decreased sexual desire, erection problems, general fatigue, sometimes accompanied by weight gain, insomnia and hot flashes.
In 2010, the New England Journal of Medicine published a study on the subject. Conducted by researchers from the University of Manchester and Imperial College London, it is based on data from 3369 participants aged 40 to 79 years. The three most important sexual symptoms of andropause are, according to their findings, a decrease in the frequency of morning erections, an increase in erectile dysfunction and a decrease in sexual desire.
There would also be physical symptoms (difficulty performing certain activities) and psychological symptoms (loss of energy, sadness, etc.). All these symptoms are not associated with a decrease in testosterone production, which is why, for researchers, the diagnosis can only be made if the three sexual symptoms are associated with a total testosterone level of less than 11 nanomoles per liter and a free testosterone level of less than 220 picomoles per liter. According to their results, only 2.1% of men would be concerned and mainly men from 60 to 80 years.
As for menopause, it is possible to cure some of the symptoms through hormonal treatment. A study conducted in 2016 shows that testosterone supplementation can partially solve sexual problems by improving libido, erectile function and therefore sexual activity. In some patients, treatment has also reduced mood disorders. But the long-term consequences of this treatment are not certain, some studies have shown that it could also increase the risk of blood clot or coronary heart disease.