Male menopause: andropause and its particularities

Andropause, or menopause in men, is a progressive decline in reproductive function caused by age-related changes. It is not a disease, but a natural aging process that occurs in all men, although its manifestations may vary. Unlike menopause in women, androgen deficiency in men develops more slowly and later, and presents less pronounced symptoms. Andropause can occur prematurely, that is, before the age of 45, which is often associated with the influence of unfavorable external and internal factors.

Age and Andropause in Men

The natural decline in reproductive function in men generally occurs between the ages of 45 and 60. Early andropause occurs before the age of 45, and late andropause after 60. However, in medical practice, there are cases of men who become fathers at the age of 60 and older, indicating the variability of manifestations of androgen deficiency.

Causes of Andropause

The normal functioning of the male reproductive system is closely linked to hormonal context, particularly to the production of androgens, the main one being testosterone. Other androgens, such as dihydrotestosterone, also play an important role in regulating sexual function and maintaining genital health. Testosterone influences the functioning of the sexual glands, the prostate, the seminal vesicles, and the testicular appendages. Testosterone is responsible for the formation and activation of libido, sexual arousal, and the intensity of orgasm. The hormone is also involved in the metabolism of fats and proteins and contributes to the absorption of trace elements.

With age, testosterone production decreases, leading to a gradual decline in libido and reproductive function.

Causes of Premature Andropause

Premature andropause can be caused by:

• Circulatory disorders in the testes (due to sedentary lifestyle or diabetes). Preventive measures include staying physically active and exercising regularly, as well as controlling blood sugar levels;
• Chronic inflammatory diseases of the genital tract;
• Working in harmful conditions (noise, vibrations, ionizing radiation, contact with heavy metal salts, irregular working hours);
• Smoking and alcohol abuse;
• Testicular tumors.

Signs of Menopause in Men

The symptoms of andropause include

Physical Symptoms

• Increased fatigue;
• Slowness of erections;
• Stiffness of the penis during erection;
• Decrease in ejaculation volume;
• Increased sweating;
• Tachycardia;
• Migraine;
• Anemia;
• Increased fat deposits;
• Osteoporosis;
• Decrease in hair growth rate.

Psycho-emotional Symptoms

• Decreased libido and sexual activity;
• Tendency to depression;
• Weakening of memory;
• Drowsiness;
• Feeling of fear.

Cardiological Symptoms

• Hypertension.

Diagnosis and Treatment of Andropause

To confirm the diagnosis, the andrologist or urologist subjects the patient to hormonal tests, Doppler ultrasound, and ultrasound of the penis and scrotum, PSA testing, and other analyses. The treatment of andropause in men aims to eliminate the identified causes and is individualized for each patient.

Treatment may include hormone replacement therapy (for example, testosterone preparations in the form of injections, gels, or patches), lifestyle adjustments, physiotherapy procedures (such as massages and magnetotherapy), as well as medications to alleviate associated symptoms (for example, antidepressants or medications to reduce blood pressure). Timely diagnosis and a comprehensive treatment approach can significantly improve a man's quality of life during this period.

In conclusion: Andropause is a natural physiological state in men. In terms of symptoms, age-related androgen deficiency is very similar to menopause in women. The difference is that in the case of andropause, a man's body continues to produce sperm, which is not the case with the production of estrogens and progesterone in women.

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