What Is Andropause? Symptoms, Diagnosis, and Treatment of Andropause in Men

As men age, their testosterone levels naturally decline. While this condition causes no symptoms in some men, it can lead to complaints such as loss of energy, decreased sexual desire, reduced muscle strength, and mood changes in others. This condition, commonly known as “male menopause,” is called andropause. However, andropause is a different process from menopause in women and does not manifest the same way in every man.

AsProf. Dr. Volkan İzol, when patients come to me with suspectedandropause, I do not limit myself to simply checking their testosterone levels; instead, I evaluate the patient’s symptoms, lifestyle, medications, and comorbid conditions together to develop the most accurate diagnosis and treatment plan.

What Is Andropause?

Andropause is a set of symptoms that arise due to a decline in testosterone levels associated with advancing age. In medical terms, this condition is more accurately referred to aslate-onset hypogonadism (LOH).

Testosterone levels typically decline by about 1% per year after the age of 30–40. However, not every case of low testosterone requires treatment. To make a diagnosis, both the low testosterone level and any accompanying symptoms must be evaluated together.

What Are the Symptoms of Andropause?

Symptoms of andropausecan vary from person to person. The most common complaints are as follows:

  • Decreased sexual desire (libido)
  • Deterioration in erection quality
  • Decrease in morning erections
  • Fatigue and loss of energy
  • Decrease in muscle mass, increase in body fat percentage
  • Difficulty concentrating and forgetfulness
  • Sleep Disorders
  • Irritability, lack of motivation, and a depressed mood
  • Decrease in bone density (increased risk of osteoporosis)

These symptoms may not be caused solely by andropause. Thyroid disorders, diabetes, depression, obesity, and certain medications can also cause similar symptoms.

Who Is More Likely to Have It?

The risk of andropause is higher in the following situations:

  • Men aged 50 and older
  • Obesity
  • Type 2 diabetes
  • Metabolic syndrome
  • Hypertension
  • Chronic kidney or liver diseases
  • Sleep apnea
  • Long-term use of corticosteroids or opioid medications

Healthy lifestyle habits can help maintain testosterone levels.

How Is Andropause Diagnosed?

A low testosterone level in a blood test alone is not sufficient todiagnose andropause.

The following assessments are made during diagnosis:

  • The patient's detailed medical history and symptoms
  • Physical examination
  • Total testosterone level measured in the morning
  • Measurement of free testosterone as needed
  • Hormone tests such as LH, FSH, and prolactin
  • PSA test and prostate evaluation (in appropriate patients)

The decision regarding treatment should be made by evaluating laboratory results and clinical findings together.

Can Andropause Be Treated?

Yes. Treatment is planned based on the underlying cause and the patient's needs.

The main treatment options are as follows:

  • Regular exercise and weight management
  • Healthy and Balanced Nutrition
  • Ensuring a healthy sleep routine
  • Quitting smoking and reducing excessive alcohol consumption
  • Treatment of Comorbidities
  • Testosterone replacement therapy in appropriate patients

Testosterone therapy is not suitable for every man. This treatment should be carefully evaluated, particularly in cases of suspected prostate cancer, uncontrolled heart disease, or certain other conditions.

Is Testosterone Therapy Safe?

When the right patients are selected and regular follow-up is conducted, testosterone therapy can be safe and effective.

During treatment, be sure to:

  • PSA level
  • Complete Blood Count (Hematocrit)
  • Liver Functions
  • Testosterone level
  • Clinical symptoms

It should be followed.

Treatment must be administered under the supervision of aurologistor an endocrinologist.

Can Andropause Be Prevented?

Age-related hormonal changes cannot be completely prevented. However, the following habits may help alleviate symptoms:

  • Engaging in regular physical activity
  • Maintaining a healthy weight
  • Eating a protein-balanced diet
  • Getting enough sleep
  • Managing chronic conditions
  • Make sure not to skip your regular health checkups

Conclusion

Andropause is a natural process that can occur due to a decline in testosterone levels with age. However, not every instance of fatigue or loss of sexual desire indicates andropause. AsProf. Dr. Volkan İzol, I recommend that my patients undergo a detailed evaluation of their symptoms and have the necessary hormone tests performed. Once an accurate diagnosis is made, quality of life can be significantly improved through lifestyle changes and, for eligible patients, planned treatments.