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Menopause in men: the signs!


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Martina Feichter studied biology with an elective in pharmacy in Innsbruck and also delved into the world of medicinal plants. From there it was not far to other medical topics that still captivate her today. She trained as a journalist at the Axel Springer Akademie in Hamburg and has been working for NetDoktor since 2007 – first as an editor and since 2012 as a freelance writer.
Does menopause exist in men in a similar way to it does in women? In a way, yes. Read here how menopause manifests itself in men, what happens during it and what men can do then.
Menopause in men: symptoms
Menopause in men is a slang term for the fact that hormonal changes occur in some men as they age – just as they do in all women.
About half of all men over 50 are said to experience «menopausal symptoms.» These are considered to be the following symptoms:
decreased sexual function, decreased sexual desire (libido), erection problems
decreased muscle strength, decrease in muscle percentage in relation to fat tissue
increase in abdominal fat
Decrease in bone density, bone and joint problems
Changes in skin and hair such as skin dryness, decreasing elasticity of the skin
Decline in performance, decreasing memory, lack of concentration, stress intolerance, depressive moods
Menopause in men: definition
When a man enters menopause, the amount of the male sex hormone testosterone decreases, while at the same time sex hormone-binding globulin (SHBG) increases.
In addition, levels of DHEA (dehydroepiandrosterone) and DHEAS (dehydroepiandrosterone sulfate) decrease. These are also two sex hormones. Finally, the concentration of the growth hormone somatotropin is also reduced.
However, these hormonal changes are subject to enormous individual differences. Some men, for example, show a quite significant drop in testosterone, while others hardly notice any. Many men are still capable of reproduction and sexually active at an advanced age.
Menopause in men: Other terms
The decrease in male sex hormones in old age is also called menopause in men, analogous to the decrease in sex hormones in women. Other names are:
male menopause
climacteric virile
Andropause (in analogy to menopause in women)
PEDAM (Partial endocrine deficit of the aging male)
PADAM (Partial androgen deficit of the aging male)
The term andropause for menopause in men is unfavorable: for one thing, it translates as «death of the man» (menopause = death of the period). For another, men do not experience a drastic drop in hormones within a relatively short period of time as women do, but rather very gradual changes:
Very slowly, over decades, testosterone levels decrease while SHBG levels increase. This eventually results in a discrete deficit rather than a near-total hormone deficiency, as is the case with estrogen in women. Therefore, the term «partial androgen deficit in the aging male» (PADAM) seems more appropriate.
Menopause in men is controversial
By no means all experts agree that menopause can affect men as much as women. Some consider the climacteric virile rather an invention of the pharmaceutical industry:
Lack of desire, sleep disturbances, depressive mood, erection problems and other complaints that many aging men undoubtedly experience are then not attributed to the natural aging process, but are regarded as a (pathological) consequence of gradual androgen deficiency – a medical diagnosis that is supposed to be treatable with medication.

Many physicians, on the other hand, do not question the hormonal changes and the associated complaints, but speak out against the term menopause in men.
Menopause in men: treatment options
The deficit of male sex hormones may be compensated with hormone preparations. However, such hormone replacement therapy should only be undertaken if there is evidence of a clear hormone deficiency and this can be held responsible for the symptoms.
The administration of male sex hormones is contraindicated in the case of hormone-sensitive prostate carcinoma, i.e. a malignant tumor of the prostate gland.
If necessary, the doctor can also prescribe potency-enhancing drugs. Under no circumstances should men obtain these on their own and use them without medical supervision, because the preparations can have serious side effects, especially on the heart and circulation.
In addition, education and couples counseling are recommended for (possible) menopausal symptoms: The man and woman are informed by the doctor about the physical changes and their possible effects, for example on their sex life.

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