Male Menopause


- Clif Arrington M.D.

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One of the best kept secrets is that men go through a male form of menopause called andropause. While menopause occurs in all women and is accompanied by cessation of monthly periods and an almost complete shutdown of ovarian estrogen, the male version is not universal and the decline in testosterone is much more gradual. The average healthy male in his late forties has one-third to one-half the level of testosterone that he had in his twenties. An even greater drop occurs in unhealthy men.

The male menopause does similar things to men as menopause does to women, although to a lesser extent. Some men, for instance, experience hot flashes, sweating, aches and pains, loss of energy, dry skin, and depression. The decline in testosterone also contributes to signs of aging such as increase body fat ("pot belly"), decreased muscle mass, loss of sex drive, and erection failure.

Equal rights for men is on its way. Because male menopause was not taken seriously until very recently, there have been few double-blind trials of testosterone replacement therapy compared with estrogen replacement therapy (ERT) in women. The studies that have been done tend to bear out that testosterone replacement therapy (TRT) is as potent in its anti-aging effects as estrogen and progesterone replacement in women. Contrary to previously held belief that testosterone increases risk of heart disease and prostate problems in men, new studies show that testosterone replacement therapy lowers the risk of heart disease and prostate cancer as well as decreasing insulin resistance in diabetes.

While testosterone has yet to enjoy the popularity with older men that estrogen has with women, some physicians are starting to use it in their practice on a regular basis. There are various methods of hormone replacement including injections, tablets, patches, transdermal creams, suppositories, and pellets implanted under the skin. There are possible adverse effects so hormone replacement therapy should be done under the supervision of a knowledgeable physician.