Andropause: Real or Not Real?

No one has doubts about menopause. Female body decides it has had enough opportunities to ovulate, the hormonal tap is turned off with all sorts of consequences to the metabolism, physiology and mood.  Menopause jokes have their space at dinner parties and family reunions. Sometimes women will bite back and ask about andropause, but that is usually part of the teasing exchange, as people are not sure if it really exists. Someone actually asked me that question and… I did not know the answer myself. It was time to pull up the sleeves and find out.

First answer is:


And it is not only psychological due to life passing by, but a real thing that affects most men to a certain extend. It is much more subtle than in women, as the hormonal tap is not just turned off, but it simply starts to tighten the valve only ever  so slightly. Androgens (the most well-known of them is testosterone) start dropping by around 2% per year when men turn 40 and about 15-25% of all men over the age of 50 years will experience testosterone levels well below the level considered normal.

Here are some consequences of low testosterone levels:

1. Decreased libido, decreased performance
2. Poor response to PDE-5 inhibitors (drugs used to treat erectile disfunction)
3. Decline in muscle mass and strength
4. Cognitive decline particularly visuospatial memory
5. Negative thinking
7. Mood changes – increased irritability / anger, depression
8. Decreased bone mineral density resulting in osteoporosis
9. Increased visceral fat (the one that gets between internal organs and creates the beer belly effect)
10. Chronic fatigue and sleep disturbances


Testosterone Replacement Therapy (TRT) is somewhat controversial as there is not enough data yet to announce it completely safe on long term. There is a lot of doubt whether it has some connections with increased cardiovascular risk or that there might be interactions with prostate cancer growth. As the same time studies show that TRT does improve the quality of life significantly and as our human race on overall is getting older, I guess it will make even more impact in the coming years.

Even though the symptom is recognized as a proper medical term a lot of clinicians do not treat it seriously, because it is not clearly defined, does not have a clear starting point and a lot of symptoms could be caused by completely different conditions. The fact that most of men – in contrast to women – can still reproduce into old age does not help either.

Now looking at the data it seems that maybe buying a red Porshe at certain stage of life, when logically it might not make sense, actually does help lift the spirits up, and get the blood flowing a bit quicker, as in the older days 😉


  1. This made me laugh out loud.
    Could you edit the second paragraph to read ” start to close the valve ” ?
    Nob / knob is slang for penis 🙂

    Otherwise – good article.


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