Male andropause refers to a gradual decline in a man's testosterone levels. Testosterone is the male sex hormone that is responsible for creating and releasing sperm, initiating sex drive and providing muscular strength.

Hormone levels tend to peak around the ages of 15 to 18 in most males. In the mid to late 20s, testosterone levels will begin to drop slowly, and by age 50, half of all men will experience a significant reduction in testosterone levels, causing a variety of uncomfortable ailments.

Unlike female menopause, where the oestrogen levels decrease and then disappear, causing acute symptoms and the complete loss of fertility, men will never lose their fertility completely. Testosterone will continue to be produced, as will sperm, permitting a man to have children well into his 80s.

Causes
Male menopause can occur naturally in some men. It may triggered by illness, depression, dementia and obesity.  Some heart and lung diseases, autoimmune diseases and cancer may affect the production of testosterone.

Symptoms

Men and women have similar symptoms but in men they are much less intense.

These include hot flushes, night sweats, fatigue, muscle and joint aches. Emotional symptoms include mood swings, irritability, depression and restlessness.

The most common symptom experienced by men with low testosterone is a diminished sex drive. 80% of men with documented andropause complain of low libido and an inability to maintain a strong erection.

Treatment options

Men often do not seek treatment for andropause.  

A lot of men feel uncomfortable speaking about their symptoms and, in the past, doctors have not taken men's menopause seriously.

Signs of menopause in men can also be difficult to diagnose, but recently doctors have become more aware of this problem realise the importance of treatment.

The primary treatment is testosterone replacement therapy (TRT). Like oestrogen replacement in women, testosterone replacement aims to bring hormonal levels back up to a healthy level. Once testosterone levels are increased, most men begin to experience fewer symptoms.

 Unfortunately, testosterone replacement does not always work well to improve erectile dysfunction. In such cases patients need more targeted and specific treatment.

It is important for men to understand what is happening to their bodies as they age. Andropause does not affect all men and its symptoms have varying degrees of severity.