Andropause or Male Menopause

Dr. Philip Werthman, FACS
Director, Center for Male Reproductive Medicine
Summary: Dr. Philip Werthman is the most recognized vasectomy reversal surgeon and male fertility specialist in the world. After serving as the chief of urology at Century City Hospital, Dr. Werthman founded the Center for Male Reproductive Medicine and Vasectomy Reversal. Dr. Werthman has lectured around the globe, written numerous books and articles and is a clinical assistant professor of Urology at USC School of Medicine.

What is "andropause"?

Andropause is the name we give to what is commonly known as male menopause, or the male biological clock. As men get older, their level of testosterone decreases. Their level of sperm decreases. It probably reaches a peek in the teens and early twenties and then in the late twenties or early thirties, there is a gradual decline in the level of testosterone and testicular function. So as men experience this decrease in testosterone, they start undergoing some changes such as decreased desire, decreased drive, decreased lean body mass, decreased energy, decreased ability to focus, lack of mental concentration that go on with normal ageing.

Do all men experience andropause?

Andropause is experienced by different men to different degrees. I have met young men in their thirties who have a drop in their testosterone level as they've gotten older and I've seen men in their seventies and eighties who have absolutely no drop in their testosterone, they're vigorous, they're vital. Those are usually men who take very good care of themselves, who exercise regularly, who continue to work. So while all women experience menopause by the age of 45 to 50, not all men will experience andropause.

How is andropause treated?

Andropause is treated by replacing the male hormones that are now low. And that usually means giving testosterone supplementation. This can be done through a shot of testosterone on a monthly basis. It can be done through a patch that goes on the skin. It can be done through creams or jells that are applied to the hands. It's important for men to know that if they want to have children in the future, they can't take testosterone on a long term basis because it will lower their sperm counts. For those men, there are other ways of increasing testosterone. There are taking shots of the precursor to testosterone, HCG. And that causes the testicle to make more testosterone. There are also other ways of doing this using pills, although those are not really great for long term treatment of this problem.

What are symptoms of andropause?

The symptoms of andropause vary, but the most concerning to men is a symptom of descreased sex drive -- a low libido. It can also result in problems with erection. It can cause depression. It can be a lack of energy or a lack of a sense of well-being. Andropause can be lack of mental acuity or inability to focus at work or doing difficult tasks. So all these things can be due to low testosterone. It can also manifest as low lean muscle mass, or men can put on weight in the midsection and decrease their lean muscle mass in their upper body. This will happen as men go through andropause.