The idea of a hormonal change when the body enters a specific age isn’t strictly a female issue.

mens health andropause

Yes, in terms of general awareness, menopause is a staple in the common vernacular. However, one must not dismiss the aging process that affects men and that they, too, go through changes that can affect their physical and mental well-being.

What is Andropause?

Interestingly enough, the World Health Organization (WHO) hasn’t recognized andropause yet as an offcial condition, but due to the increase in awareness via mainstream medical research, it has recently received a lot of focus. Dr. David Borenstein, MD, a New York-based physician in practice for more than 15 years has been treating andropause cases for over a decade and explains it as a gradual depletion of male testosterone that occurs over a period of time. Testosterone maintains vital aspects of development, including male sex organs, muscle mass, bone strength and fat metabolism. Unlike menopause, where the change is felt quite drastically during a specific window of age, andropause can start as early as your 30s (“It’s a small number, but they are certainly there”) and 40s. According to Dr. Borenstein’s patients, he sees testosterone levels declining three per cent per year and gradually increasing once you hit your mid-40s and early 50s, with drastic declines taking place after the 50-year mark. In some cases, the decline can take place before symptoms even present themselves.

Sypmtoms of Andropause

Dr. Borenstein notes that the symptoms of andropause are remarkably similar to those of menopause and can include the following:

  • Irritability
  • Low stamina
  • Memory loss
  • Weight gain
  • Trouble sleeping
  • Depression
  • Low sex drive

Unlike women, who tend to be more proactive when it comes to health care, men often take a wait-andsee approach before entering the doctor’s office. And, yes, men tend to Google it fi rst (“Men Google stuff, women don’t”) before consulting a medical professional. When presented with these symptoms, sometimes men just chalk it up to the unpleasant part of the natural aging process. The standard medical examination starts with thorough blood tests, checking the kidney and liver functions, thyroid and vitamin profiles, thereby eliminating any other possibilities. Once those are clear, then the focus is on testosterone levels.

So are patients surprised by an andropause diagnosis? “Sure, there are patients who are surprised,” Borenstein explains, he notes “but there is a lot more awareness in men now than a few years ago.” He notes the increase in men who are specifically asking about their testosterone levels and how that may be an indicator of their sluggish feeling.

The Stigma

Dr. Borenstein feels that the stigma still exists but not nearly as much compared to how andropause was viewed just a decade earlier. He still gets patients who are pushed through his door at the insistence of their partners, but when it comes to a general awareness of andropause (as compared to menopause), he feels that it still has a long way to go. Of course having a celebrity a liation when it comes to medical conditions is a surefi re way to spread awareness among the masses, but the reality of the sensitivity of andropause among men puts the idea of a male celebrity wanting to announce his declining testosterone levels to the world in doubt. And there lies the Catch 22.

The Cause

Beyond of it being just a natural part of the aging process, there are instances where certain common drugs may also a ect testosterone levels. The sex hormone comes from a main molecule, cholesterol. Often, cholesterol-lowering drugs may lower testosterone. Similar challenges are seen for women, where the birth control pill, which increases estrogen, also decreases testosterone levels, thereby leaving women with similar symptoms of a lower sex drive and depression.


There are a number of treatment options available to patients. That’s not to say that it’s an easy sell, though. “Men are very scared to take testosterone,” says Dr. Borenstein. “They hear ‘prostate cancer’ and ‘heart attack.’ The problem is that they only hear half the story. If you do [treatment] improperly, there can be an increase in these problems. But if you do it properly, there is certainly no greater risk than if you aren’t taking it.” The common fi rst step is a topical application of a transdermal cream once a day. There is also the option of taking a testosterone injection once or twice a week. There are Clomid pellets (Clomiphene citrate or “CC” pills), which cause the testicles to make their own testosterone while preserving the size of the testicle and sperm count—a common treatment for younger patients who still want children. And how quickly does the treatment take hold? Dr. Borenstein says that after the usual tweaking of meds to ensure that the correct levels are in place, it’s just a matter of a “couple of weeks” before patients “see improvement.” At the end of the day, Dr. Borenstein feels it’s very important to be proactive when it comes to your health. When you aren’t feeling your 100 per cent best, you have to “be your own advocate and think outside the box.” Sure, it’s the natural aging process, but it shouldn’t be unpleasant. “Don’t su er. You don’t have to live like this. There is treatment.”