What Is Andropause and What Are the Symptoms?

Andropause is the male equivalent of menopause. During this time in a man’s life, hormone levels—like testosterone—dramatically decline, resulting in increased risk of diseases such as heart disease and a host of unpleasant and very uncomfortable symptoms.  Many men don’t recognize they are in andropause and accept their current state as “ facts of aging.”

At the age of 35, most men will produce 1% to 2% less testosterone every year. By the time a man reaches his 70’s, he will be creating a fraction of the testosterone he did in his youth. This drop in hormones is the culprit behind andropause—and there’s no reason men have to accept suffering.

Bioidentical hormone replacement therapy (BHRT) and testosterone therapy provide aging men relief from debilitating symptoms and protection from various diseases. Contrary to reports, testosterone replacement therapy (TRT) has a strong safety record in men who have testosterone deficiencies.

If any of the symptoms of andropause look familiar to you, book your initial consultation with PeakPerforMAX Medical Director: Dr. Pamela Tambini, right away. Dr. Pam has worked in the field of aging for many years and has helped clients correct age-related hormone issues and optimized their testosterone levels.

Below are the most common symptoms of Andropause:

of Men
over 40 have some degree of ED
Low Libido and Lack of Interest in Sex

Lack of interest in sex may last for just a short time, or it may become a chronic issue. The prominent symptom of low libido is non-existent sexual interest, which results in less sexual activity and experiencing barely any sexual stimulation. The desire to engage in sex is not present. Optimal testosterone levels are significant for maintaining a healthy libido. Nutrition and exercise are also crucial in keeping your libido in check. Proper-diet and training results in optimal blood flow throughout the body, which is necessary for sexual intercourse. Fat gain is common without proper nutrition and an inactive lifestyle. Aside from affecting your respiratory functions and strength, fat is known to produce estrogen, which in turn can further decrease your libido. So in essence, fat loss, a healthy diet, and vigorous exercise are essential components to keeping your libido.

How can I regain my energy in my 40’s?

Erectile Dysfunction (ED)

Erectile dysfunction is the inability to develop or maintain an erection during sexual performance. Many factors can cause it, but the natural cause is andropause and Low T (Low T means low testosterone levels). Stress, environment, toxins, a poor diet, and lack of exercise can all contribute to erectile dysfunction, as can disease like heart disease and diabetes (many doctors consider erectile dysfunction to be the first symptom of heart or circulatory disease). In many cases, optimizing testosterone levels can completely resolve erectile dysfunction.

Fatigue and Low Energy Levels

I’m always tired, no matter how much sleep I think I got”


Most men will experience fatigue during andropause. “Feeling tired all of the time” is something we hear in almost every case of Andropause. Fatigue brings an onset of many other issues, like decreased motivation to work, which can result in worsening job performance — fatigue results in decreased motivation to exercise, which leads to less exercise. Less exercise means a reduction in heart health, more fat accumulation, increased health risks, and a lower quality of life. Fatigue can also cause frustration, depressed mood, and irritability, along with many other unpleasant symptoms. Low testosterone levels are one of the most common causes of fatigue and low energy levels in men.

Weight Gain

Many aging men notice they start gaining weight, particularly in the mid-section (abdominal fat), despite no changes to their activity level or diet. This unexplained weight gain is caused by hormone imbalance, especially the combination of low testosterone and elevated estrogen. Other hormones may also be involved in andropause-related weight gain. The thyroid, which produces thyroid hormone, is the critical organ in regulating the metabolism. Cortisol is an important hormone that can cause increased appetite and fat gain if there is cortisol imbalance in men.

Muscle Loss

Testosterone plays a significant role in muscle tone and strength. When testosterone levels decrease, the muscle cells atrophy (shrink), which results in reduced muscle mass and tone. Symptoms of muscle loss include musculoskeletal weakness and loss of stamina, which can interfere with physical activity. Lack of physical activity, in turn, further reduces muscle mass. Studies indicate that there is a 20% loss of skeletal muscle in healthy men between 30 to 70 years of age. As with many symptoms of andropause, muscle loss is a symptom that many men assume is “ a natural part of aging.” In reality, age-related muscle loss is caused by male hormone imbalance. Like other andropause symptoms, muscle loss can be reversed or prevented through treatment.

Mood Swings

“ Irritable man syndrome” is generally a result of high cortisol levels and low testosterone levels. Low testosterone levels may occur due to andropause or cortisol imbalance. Cortisol imbalance can cause unpleasant emotional/mood changes by negatively affecting the functions of other hormones. For example, cortisol imbalance can adversely affect the functions of testosterone, which results in unpleasant emotional/mood changes. Cortisol measurement should be part of your andropause related bioidentical hormone replacement therapy if blood tests indicate elevate cortisol.

Memory Loss

Memory loss is more than just occasionally being forgetful. It can negatively affect your job performance and safety. Memory loss is the decreased ability to focus, along with difficulty recalling information. As with many symptoms of male hormone imbalance, memory loss is often assumed to be “ a natural part of aging.” In many cases, however, the memory loss associated with aging is directly due to decreased testosterone levels and hormone imbalance, including estrogen, DHEA, pregnenolone, cortisol, and thyroid hormone.

Hot Flashes

Most people know that hot flashes are a common symptom of menopause for women. It is a surprise to many men, however, to learn that hot flashes are also a common symptom of male hormone imbalance, particularly andropause. Fortunately, if you are a man experiencing hot flashes, you are not alone, and treatment is available. Hot flashes occur when the body suddenly feels warm despite no change in the room temperature. In men, hot flashes are directly related to sudden cessation of hormone production, particularly estrogen and testosterone. Low testosterone levels result in false signals sent to the hypothalamus (in the brain), which indicates that the body is overheating and needs to cool down. The hypothalamus responds by increasing blood flow in an attempt to cool the body, resulting in sudden sweats, clamminess, and hot flashes.

Night Sweats

Night sweats refer to excessive sweating at night. They are primarily male hot flashes that occur at night and cause sweating. It is more common among men who are 40 years of age or older. Like menopause in women, andropause is a common cause of night sweats in men.
Optimizing hormone levels with bioidentical hormone replacement therapy in conjunction with an exercise, diet, and supplementation program will relieve night sweats.

Urinary Problems

As men age, three different types of urinary conditions can be caused by male hormone imbalance: urinary incontinence, painful bladder syndrome and benign prostate hyperplasia (BPH).

What is Urinary Incontinence? Urinary incontinence is defined as any involuntary leakage of urine. It is a common and distressing problem that may have a profound impact on a man’s quality of life. An underlying and treatable medical condition almost always causes urinary incontinence. Testosterone replacement therapy for men has been shown to improve bladder control in men with urinary incontinence Painful Bladder Syndrome. Interstitial cystitis (painful bladder syndrome) is a chronic, often severely debilitating disease of the bladder. The cause of this urinary condition is unknown. Its characterized by bladder pain, painful urination, urinary frequency/urgency (as often as every 10 minutes), and pressure in the bladder and pelvis. There are studies linking painful bladder syndrome in men to low testosterone levels.

Testosterone replacement therapy for men has been shown to help relieve the symptoms of interstitial cystitis Benign Prostate Hyperplasia (BPH). Benign prostate hyperplasia is an enlargement of the prostate caused by an elevated number of prostate cells — this prostate enlargement results in the formation of large nodules around the urethral area of the prostate. If the nodules become large enough, they can compress the urethral canal to cause partial and sometimes complete obstruction of the urethra, which interferes with the normal flow of urine. This can lead to the development of urinary hesitancy, frequent urination, dysuria (painful urination), urinary retention and increased risk for UTIs (urinary tract infections). PSA (prostate specific antigen) levels are typically elevated in individuals with BPH. Luckily, BPH does not lead to cancer and does not increase the risk of cancer.

Unfortunately, during andropause, testosterone levels decline, and estrogen levels increase. Some evidence suggests that this relative increase in circulating estrogen may strengthen the effect of the testosterone derivative dihydrotestosterone (DHT). DHT promotes cell growth, which results in glandular enlargement of the prostate gland. The development of the prostate gland requires the conversion of testosterone into DHT in the presence of a specific enzyme called 5-alpha reductase. As aging occurs, the amount of DHT in the prostate gland remains high even though the circulating testosterone level drops.

Metabolic Syndrome

Metabolic syndrome is defined as the combination of the following medical problems: obesity, high blood pressure (aka hypertension), unhealthy cholesterol levels and insulin resistance. The prevalence of metabolic syndrome has been shown to increase with age. It’s estimated that 25% of Americans have metabolic syndrome, and this number continues to grow as the rate of obesity increases. Many studies have shown a link between metabolic syndrome and many health problems, including cardiovascular disease and diabetes. Men with metabolic syndrome should focus on reducing their body fat percentage to less than 15% by incorporating daily aerobic exercise (30 minutes per day) and eating a healthy diet. Prevention or reversal of metabolic syndrome will significantly reduce the risk of developing cardiovascular complications and diabetes.

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