What is Andropause?

Andropause is supposedly the male equivalent to menopause. Instead of losing estrogen, men lose their vitally important testosterone as they age. Testosterone is literally what makes a man a man. Without it, a male fetus will be born looking a like a female.

Rising testosterone levels at adolescence causes the growth of facial hair and pubic hair, deepens the voice, enhance muscle development, and furthers the development of the secondary sexual characteristics. In other words, turns the boy into a man.

Testosterone levels continue to rise until the mid-twenties and then a slow, inexorable decline occurs over decades to the point where at age 90, it is not uncommon to see levels that are a fifth of the level seen in healthy 25 year olds. When testosterone levels decline to a certain point (and this varies from man to man), the extremes of andropause are expressed (see symptoms of low T above).

But andropause is not a distinct event and there is no clear physiological sign that defines pre- and post-andropause. This is not the case in menopause where a pre-menopausal woman has periods and is fertile and post-menopausal woman doesn't have periods and is infertile (the transition is not so clear in menopause either and it cantake years. But even so, for every woman there comes that last period. Six months after which a woman earns the label "post-menopausal").

So, andropause is not a "pause" at all. It is more like a slow fade. Turning the volume down REALLY slowly over decades. So slowly that day-to-day, month-to-month, and even year-to-year, the change is almost imperceptible. But what is happening in the body? A slow loss of muscle (often accompanied by more abdominal fat), the voice gets higher, depression sets in, the brain slows, and, the scariest thing - the erection goes away (okay, I am man after all).

What is this most reliable indicator of clinical significant decline in testosterone? The loss of the early morning erection. I can almost always predict which of my clients have low testosterone by the absence of "early morning wood". Other clues are loss of muscle mass, higher voice, abdominal fat, lack of interest in sex, depression, fatigue, "brain fog", erectile dysfunction, gynecomastia ("man boobs") and lack of a healthy glow.

With appropriate lab tests and any of the symptoms above, a diagnosis of low testosterone can be made and appropriate treatment can be started.

The amazing thing is that most symptoms of "low T" can be reversed (at least partially) with testosterone supplementation. Erections can be restored, depression can be lifted, energy comes back, muscle mass can be restored with appropriate exercise. Testosterone supplementation can be truly transformational in some men. And all that was done was restore them to the levels that they had in their mid- twenties.