Do You Have Low Testosterone? Are You Experiencing Andropause?

What is Andropause?

As we age, it is not only women do have changes in their hormones. Men also have significant hormonal changes as they age. The hormonal changes in women are called perimenopause and menopause.

As men age, their levels of testosterone dropped significantly with each passing decade. This change has been called “andropause”. This name reflects that the primary changes associated with this process are due to declining levels of the androgen steroid hormone called testosterone.

Andropause is not the only cause of low testosterone. Other problems such as type II diabetes, obesity, pituitary gland disorders, tumors, testicle injuries, radiation therapy, chemotherapy, and steroid medications can cause low testosterone levels. It is important to have a thorough evaluation by a physician experienced in diagnosing and treating these problems if you are experiencing the symptoms of low testosterone.

What are the symptoms of Andropause?

There are a wide variety of symptoms associated with the hormonal changes of andropause. The number and severity of the symptoms vary from man to man. Some of the more common symptoms reported include:

  • Erectile Dysfunction
  • Decreased Libido (Sex Drive)
  • Decreases in size of testicles
  • Fatigue
  • Weakness
  • Depression
  • Loss of body hair
  • Loss of body height
  • Increased Body Fat
  • Decreased Muscle Mass
  • Slower Healing from Injuries
  • Decreased Bone Density/Osteoporosis
  • Decreased Motivation
  • Infertility/Low Sperm Count
  • Difficulty Concentrating
  • Gynecomastia (Development Of Breast Tissue)


Is Andropause the male version of menopause?

Andropause has been compared to female menopause. There are however several differences. Obviously, men do not been straight or release ova (eggs) every month. Unlike women, men do not experience a complete shutdown of their reproductive ability as these age-related hormonal changes occur.


What is the age range of Andropause?

During childhood, testosterone levels are low. At puberty, however, testosterone levels start rising through young adulthood. These changes bring on the typical male secondary sexual characteristics such as growth of body hair, lowering his voice, increase in muscle mass, increasing sex drive, and maturing of the sexual organs.


After age 30, however, testosterone levels in men naturally start dropping at approximately 1% per year.  Several factors can cause this decline to accelerate.


Some of these factors include:

  • High levels of stress
  • Poor sleep quality
  • Overweight/obesity
  • Unhealthy diet
  • Lack of regular exercise
  • Medication side effects


It is very common for men with chronic pain to have significantly decreased levels of testosterone. The simple fact that someone has a chronic painful injury that affects their lifestyle, ability to work, and ability to physically function can cause high levels of stress, poor sleep quality, and decrease in exercise activity which can lead to becoming overweight or obese.


Additionally, many medications such as antidepressants and nerve pain medications can have side effects of weight gain as well as hormonal changes. Chronic opiate pain medication commonly causes significant decreases in testosterone levels.



How is Andropause / Low T Diagnosed?


If you are experiencing the symptoms of low testosterone or have risk factors for abnormally low testosterone levels, your doctor may recommend checking your testosterone levels. After ruling out the other potential  lifestyle and/or pathological causes of low testosterone described above, the diagnosis of andropause can be determined.


The normal range for testosterone in adult me in is 300-1000 ng/dL. Your doctor will probably want to run this test more than once to confirm the diagnosis and assure against lab error. While this range  (300-1000 ng/dL)is classified as normal, this includes both young and elderly men. Many experts feel that the optimal level to correct the symptoms listed above is in the upper third of this range of normal values. This upper third range represents the normal values for young adult men at the peak of their health and vitality.


How is Andropause Treated?

Not all cases of andropause require treatment with hormone supplementation. Lifestyle an medical changes such as stress reduction, increased exercise, dietary changes, losing excess body fat, changing medication to minimize side effects, and improving sleep quality can often significantly improved testosterone levels as well as decrease the symptoms associated with low testosterone.


For those men who still have low testosterone after optimizing medical and lifestyle factors, testosterone replacement therapy may be indicated. This involves giving supplemental testosterone to replace the hormone that your body is not producing naturally. Some studies indicate that replacing low levels of this hormone can have significant benefits such as:


  • Improve sex drive
  • Improve erectile dysfunction
  • Improve mood
  • Boost energy levels
  • Protect bone density
  • Help prevent loss of muscle mass


Testosterone supplementation is only indicated for men with symptoms of having low testosterone.


Testosterone supplementation can be accomplished in many forms. The most common forms are shots, patches, gels, dissolving tablets, and implanted time released pellets.  The patches, jails, and tablets required administering the medication one or more times daily. The injections have to be given every 2-4 weeks.


The implantable pellets are considered by many to be the most convenient method since they require only about 10 minutes to insert in your doctor’s office but the last 3-4 months. When the blood testosterone levels start to drop again, new pellets are inserted.


Are there risks associated with Testosterone replacement therapy?

There are risks associated with testosterone replacement. Close monitoring by your doctor is required to minimize the risks and treat them appropriately. Some of these risks include the development of too many red blood cells, sleep apnea, enlarged prostate, and acne. Some research has suggested that there maybe an increased risk of cardiovascular events such as heart attack or stroke. There is also concern that testosterone replacement therapy may increase the risk of prostate cancer.  Regular monitoring  by your doctor is required to look for early signs of prostate cancer. Men with prostate cancer, breast cancer, untreated sleep apnea, too many red blood cells, blood clotting disorders, or poorly controlled heart disease generally should not take testosterone.

Since low testosterone is such a common problem in our patients with neurological problems and/or chronic pain, we now provide evaluation and treatment for low testosterone and andropause.

At Jackson Neurosurgery Clinic, our goal is to treat our patients from a comprehensive standpoint.

If you are a man experiencing some of the symptoms of andropause, please contact us for an evaluation.



“Andropause” The Documentary – Jennifer Burton






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