Women may not be the only ones who suffer the effects of changing hormones. Some doctors are noticing that their male patients are reporting some of the same symptoms that women experience in perimenopause and menopause.

The medical community is currently debating whether or not men really do go through a well-defined menopause. Doctors have reported that male patients receiving hormone replacement therapy (testosterone) have reported relief of some of the symptoms associated with so-called male menopause.

What Is Male Menopause?
Since men do not go through a well-defined period referred to as menopause, some physicians refer to this problem as androgen (testosterone) decline in the aging male. Men do experience a decline in the production of the male hormone testosterone with aging, but this also occurs with some disease states such as diabetes. Along with the decline in testosterone, some men experience symptoms such as fatigue, weakness, depression and sexual problems. The relationship of these symptoms to the decreased testosterone levels is still controversial.

Unlike menopause in women which represents a well-defined period in which hormone production stops completely, male hormone (testosterone) decline is a slower process. The testes, unlike the ovary, does not run out of the substance it needs to make testosterone. A healthy male may be able to make sperm well into his eighties or longer.

However, as a result of disease, subtle changes in the function of the testis may occur as early as 45 to 50 years of age, and more dramatically after the age of 70 in some men.

How Is Male Menopause Diagnosed?
To make the diagnosis, the doctor will perform a physical exam and ask about symptoms. He or she may order other diagnostic tests to rule out any medical problems that may be contributing to the condition. The doctor will then order a series of blood tests which may include several hormone levels, including a blood testosterone level.

Can Male Menopause Be Treated?
If testosterone levels are low, testosterone replacement therapy may help relieve such symptoms as loss of interest in sex (decreased libido), depression and fatigue. But, as with hormone replacement therapy in women, testosterone replacement therapy does have some potential risks and side effects. Replacing testosterone may worsen prostate cancer, for example.

If you or a loved one is considering androgen replacement therapy, talk to a doctor to learn more. Your doctor may also recommend certain lifestyle changes, such as a new diet or exercise program, or other medications, such as an antidepressant, to help with some of the symptoms of male menopause.

Edited by Milton M. Lakin, M.D., Cleveland Clinic Glickman Urological Institute, January 2006