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The female menopause is well recognised and documented. Women go into their forties and fifties well aware that they will spend several months or years experiencing hot flushes, sweating, mood changes, and weight changes as their level of the sex hormone oestrogen falls. Their periods become erratic before eventually stopping altogether, signalling the end of their reproductive life.

Men also experience a decline in the production of the sex hormone androgen but it is much more gradual, taking place across decades rather than months or years. Men may experience mental and physical changes but they are much more subtle than the changes than women experience so they could be missed in the early days.

Androgen and male menopause

Androgens are a group of steroid hormones that have specific effects on tissue growth and brain function. They play a vital role in both men and women, but are produced in much larger quantities in men. After a man has been through puberty the majority of androgens are produced by the testicles, mainly in the form of testosterone.

Unlike the female menopause which happens relatively quickly, the male menopause, or andropause, occurs as a result of a slow and gradual depletion of androgen later in a man’s life, and it may not affect all men, so the following terms are also used to describe it: ADAM – Androgen Decline in the Ageing Male, and PADAM – Partial Androgen Deficiency in the Ageing Male.

What are the symptoms of male menopause?

Men suffering from the male menopause may exhibit the following symptoms:

  • Circulatory and nervous system: hot flushes, sweating, insomnia, and nervousness.
  • Mood and cognitive function: irritability, tiredness, depression, low self-esteem, lack of motivation, difficulty with short-term memory, low mental energy.
  • Masculinity and virility: diminished muscle strength, decreased vigour and physical activity.
  • Sexuality: erection problems, reduced volume of ejaculate, weaker ejaculation, reduced orgasm quality, loss of desire and interest in sexual activity.
  • Physical symptoms: diminished muscle mass, loss of hair, increased fat around the abdomen.

Andropause and fertility

It seems to be widely believed that the age of the male partner has no bearing on his ability to father children, whilst women have a clear end to their reproductive years in the form of the menopause. However, as we have discussed above, the male menopause or andropause is a very real phenomenon.

Time waits for no man – here’s what happens as a man ages:

  • After the age of 35 testosterone levels fall by around 1% each year.
  • After the age of 40 a man’s age is equal to the probability of erectile dysfunction; i.e. 60% of 60 year olds will suffer.
  • Sperm motility decreases by 1% each year after the age of 40.
  • Ejaculate volume and frequency of ejaculation both decrease with age.

These age-related changes in men’s sexual health happen rather slowly and gradually, until around 70 to 80 years of age when testosterone levels begin to drop off more dramatically. Andropause may not be the best term to describe the process a man’s body goes through on its journey to end its reproductive abilities, but the main thing to draw from this is that age is an unavoidable and irreversible factor for both men and women when it comes to fertility problems.

Androgen depletion and hypogonadism

Androgen depletion is a natural part of the male ageing process; by the time a man reaches the age of 60, his body is producing just two thirds to one half of the testosterone that it was producing when he was 20 years old. However, low levels of testosterone can sometimes be seen in younger males. This is usually due to a condition known as hypogonadism, which can be present from birth, presenting symptoms such as small testes, delayed puberty, reduced body hair, loss of muscle, and sexual difficulties.

Whether your androgen depletion is the result of the natural male ageing process or hypogonadism, there is an effective way to treat the problem by replacing the hormones that your body is not producing.

Androgen replacement therapy

Androgen replacement therapy (ART), also known as testosterone replacement therapy (TRT), is a type of hormone replacement therapy in which androgens, usually testosterone, are replaced in order to lessen the affects or delay the onset of the male ageing process. Androgen depletion is perfectly normal, but as we discussed above, it can have a negative impact on fertility so many men opt to undergo ART. Androgen replacement therapy involves the administration of testosterone either via injection or the use of creams or gels applied topically to the body.

Every man is different and will react differently to ART, but many men report an improvement in energy level, libido, and quality of erections. Testosterone also helps to increase bone density and muscle mass in some men, while others report an improvement in mood.

However, as with most treatments, ART is not without some risks. There are a number of health conditions that some experts believe could actually be worsened by ART, including benign prostatic hypertrophy, prostate cancer, sleep apnoea, blood clots, and congestive heart failure.

Here at TCM HealthCare we have 15 years of experience in treating men with fertility problems and hormonal imbalance with an excellent track record. We will help you to understand the pros and cons of androgen replacement therapy, and explore all of the possible fertility options available to you and your partner. Please don’t hesitate to get in touch with us if you’d like to know more.

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