Often called male menopause, andropause is characterized by a gradual decrease in testosterone levels. “It affects men around the age of 50 but not everyone is affected in the same way.”, explains Dr. Marc Galiano, urologist and andrologist. Biologically, the diagnosis of andropause, and therefore androgen deficiency, is made when the bioavailable testosterone level (i.e. uncorrelated with the patient’s weight and possible liver damage) is less than 1 ng/ ml twice.
Andropause: what are the symptoms?
The symptoms of andropause affect several areas and vary greatly from one man to another. “Men may present with mood disorders (sadness, withdrawal), memory problems, sleep problems. Some also have hot flashesnight sweats, without forgetting of course sexual disorders”, explains the urologist. Among the other symptoms, we observe hair removal on the front of the legs, a reduction in muscle strength but also a different distribution of fat.
Dr. Galiano points out, however, that for some men, as is the case with menopause in women, andropause goes almost unnoticed. “An 80 year old man may have decent testosterone levels while, conversely, a 47 year old man may already have difficulties and very present symptoms.”, he explains. Andropause also has a global impact on the body, with a risk of hyperglycemia, hypercholesterolemia but also osteoporosis.
Andropause may cause low libido in some men
Testosterone influences arousal and libido, and andropause therefore has an indirect impact on erection. In addition to this drop in desire, an erection can logically be more difficult to obtain and we also sometimes observe a reduction in morning erections. But, as with other symptoms of andropause, not all men are affected in the same way by these sexual difficulties. It is important not to hesitate to speak to the attending physician who can then refer the patient to a specialist. Treatments exist.
Hormonal treatment for andropause: for sexual disorders but not only
In France, there are two ways to replace this drop in testosterone. “Medication by mouth does not work well, so patients are offered either injections (every fortnight) or gel to use every day”, explains Dr. Galiano. “These are tedious treatments to which patients become addicted. We really need to warn them of this. But they are very effective and allow a real transformation. Patients feel much better in their head and body, and therefore also better in their sexuality.”, adds the andrologist.
The latter, however, reminds us that these treatments can have side effects: salt and water retention, increase in hematocrit (and therefore increased risk of heart and vascular problems), increase in the size of the prostate and therefore PSA. They therefore require regular clinical and biological monitoring.
Thanks to Dr. Marc Galiano, urologist and andrologist.