Andropause also known as male menopause[1] is said to be the result of a gradual drop in testosterone, which is an androgen. The medical community is currently debating whether or not men really do go through a well-defined menopause.[1] The condition "andropause" is currently not recognized by the World Health Organization. When andropause occurs, it is considered to be a deficiency state in which the hormone testosterone goes below the normal range for an aging male.[2][verification needed]
Andropause is caused by the reduction of hormones testosterone and dehydroepiandrosterone in middle-aged men. Testosterone assists the male body in building protein and it is crucial for normal sexual drive and stamina. Testosterone also contributes to several metabolic functions including bone formation, and liver function. Andropause is also associated with a decrease in Leydig cells.[3] A steady decline in testosterone levels with age (in both men and women) is well documented.[4]
External factors that can[5] cause testosterone levels to fall include certain forms of medication, poor diet, excessive alcohol consumption, illness, lack of sleep, lack of sex, stress, or surgery. It can also be a symptom of neuroendocrine dysfunction after a mild traumatic brain injury.[6]
Andropause is preceded by a condition called Hypogonadotropic hypogonadism.[7] A downturn in the circulation of testosterone can cause the hypothalamus and pituitary gland to trigger a release of brain hormones that stimulate the testicles to ramp up production of testosterone.[8]
Although, as men age, despite low testosterone the levels of gonadotropin-releasing hormone (GnRH) and luteinizing hormone (LH) will not rise. The luteinizing hormone, gonadotropic releasing hormone, and testosterone all are dropping below what is considered normal. Low GnRH, low LH, low testosterone indicate the syndrome of hypogonadotropic hypogonadism, and it is a downward trend that takes men closer to andropause. This phenomenon typically begins in the early forties.
Eventually, testosterone levels drop to such low levels, the hypothalamus and pituitary kick in and produce high levels of GnRH and LH to compensate. This triggers the production of testosterone, which will generally work for a while, but then will fall again. That's when men enter andropause. They have a low testosterone and a high LH and GnRH, whereas before they had a low testosterone as well as low LH and GnRH.
This shift in hormonal patterns occurs in all men at some point. The female version, a similar hormonal shift that occurs in women happens in a more narrow age grouping, from early forties to late fifties.[9]
Testosterone levels decline gradually with age. Unlike females going through menopause, the decline in testosterone in men is gradual, and there is variation among individuals.[10] Upon reaching 80 years of age, the rate of testosterone secretion has decreased about 50% for men.[10]
The American Association of Clinical Endocrinologists defines hypogonadism as a testosterone level that is below the lower limit of normal for young adult control subjects[11]
Researchers conclude there is no black-and-white cutoff for "low" or "suboptimal" testosterone. Different symptoms show up at different testosterone thresholds: Muscle mass and strength do not decline until testosterone drops quite low (significantly below normal levels) whereas libido may dampen with relatively small decreases in the hormone.[12] According to Joel Finkelstein, associate director of the Bone Density Center at Massachusetts General Hospital in Boston, mens functioning is not impaired solely by a loss of testosterone, but by a loss of estrogen as well.[11]
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Andropause - Wikipedia, the free encyclopedia
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