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Low Testosterone and "Andropause" (Male Menopause) Explained

Are you depressed, fatigued, or tired? Have you lost weight for no apparent reason? Have you experienced a loss in sex drive or a loss of erectile function? Are you suffering from muscle loss or the inability to grow muscle? Low testosterone levels, or hypogonadism, in both men and women may cause any, or all, of these symptoms.

Women may not be the only ones who suffer the effects of hormonal changes. Doctors are starting to notice their male patients reporting some of the same symptoms that women experience in menopause. While the medical community jury is still out on whether or not men really go through “male menopause”, many doctors say that male patients who are receiving hormone therapy with testosterone have reported relief of some of the symptoms associated with this condition.

Unlike a woman's menopause, when estrogen levels plummet over months to very low levels, men's “andropause” is a gradual decline of testosterone levels, approximately 1% to 2% percent per year, over years. The effects of low testosterone can be insidious, and often goes unnoticed because men with low testosterone levels can have symptoms without recognizing them.

Men, and all too often the women in their lives, often mistake their reduced desire for sexual activity as erectile dysfunction (ED), when the lack of desire may actually be a symptom of low testosterone (Low T). In fact, Low T affects 13 million men in the United States ages 45 and older, but it is believed that only half to two-thirds report and/or recognize symptoms, and by some estimates, as few as 12% of men with symptomatic androgen deficiency or low testosterone levels are being treated.

While one of the most prominent symptoms of low testosterone levels in men is a low libido or erectile dysfunction (E.D.), many men may not recognize that they suffer from low testosterone because they may still be somewhat sexually active, not being aware of how much their sexual activity has declined. Don't be fooled, men with symptoms of low testosterone can have significant impairment in their quality of life.

The symptoms of low testosterone include not only low sex drive and erectile dysfunction, but mood problems, fatigue, and sleep disturbances, among the following:

Low T Symptoms

Increased Body Fat / Weight Gain in the Wrong Places

While for some men, gaining weight may be desirable, particularly among the bodybuilding type, weight gain in the wrong places can be a key indicator of low T. If you have gained, or are gaining, weight around your belly, or if fatty tissue is increasing around your breast/upper chest area, you may be experiencing increased estrogen levels, and decreasing testosterone levels.

Testicular Atrophy (Small Testicles)

As with any other drug therapy, there can be side effects from testosterone supplementation. While low testosterone can cause shrinkage of the testicles, or testicular atrophy, so can synthetic testosterone supplementation. Testicular atrophy is fairly common among synthetic testosterone patients, as supplementing the body with testosterone can shut down the body's own production of this hormone.


A study conducted in 2004 indicated that low testosterone levels may cause clinical depression in men. Because some symptoms of low T. are similar to symptoms of depression, the link between the two disorders had been unclear.

In the study, researchers analyzed medical records of 278 men, aged 45 and older, over a period of two years. None of the men were diagnosed with depression before the study time period, but whose test results all indicated either low or normal levels of testosterone.

During the two-year period, the men with low testosterone were four times more likely to be diagnosed with clinical depression than those men who had normal testosterone levels, according to researcher Molly M. Shores, MD, with the Veterans Affairs Puget Sound Health Care System and the University of Washington in Seattle, whose study appeared in the Archives of General Psychiatry.

Fatigue / Lack of Motivation

Another primary symptom of low testosterone is fatigue, a feeling of considerably less energy; one of constantly feeling tired and run down. If it seems that doing a physical activity takes you longer with considerably more effort, or if post-workout or exercise recovery takes longer, you may be experiencing the effects of low T.

Ironically, because of the general feeling of malise, many men may altogether stop working out, which can result in even poorer health and lower energy levels, and as they gain weight, and have more to carry around with less muscle to accomplish it, they more easily experience fatigue and general low energy.

Low Sex Drive / Low Libido / Weak Erections

On average, a male in his twenties will have sex 3-4 times a week, while that frequency declines to approximately once a week or so in his fifties, and 1-2 times a month in his late seventies. As a man ages, along with low sex drive, impotence increases with age and the related lower testosterone levels. Nearly 10% of males over 50 and 40% of males over 70 have impotence problems. This is a primary symptom of low T.

Loss of Muscle Mass

A sedentary male will lose about 10% of his muscle mass every decade, therefore, by the age of 60, he will have lost up to 40% of his lean muscle. Since muscle is an efficient fat burner (5 pounds of muscle will burn calories equivalent to 10-12 pounds of fat per year), as muscle is lost, less muscle and calories are used each day, increasing the likelihood of fat accumulation and weight gain.

Other Symptoms Indicative of Low T

  • Increased risk of breast and prostate cancers
  • Gyneomastia (an abnormal enlargement of one or both breasts)
  • Memory Loss
  • Low Self Esteem
  • Heart Disease
  • Diabetes (High blood sugar)
  • Hypertension
  • Increased risk of stroke
  • Increased heart attack risk
  • Osteoporosis
  • Premature Death

Low Testosterone: How Do You Know If You Have It?

In addition to the any of the symptoms above, if you have noticed an increase in your belly fat and/or a fleshy layer of tissue around the chest/breast area (pre-gyno), if your morning erections have become less frequent or you don't have any at all, or if you have lost motivation and drive, you may be experiencing increased levels of estrogen and decreasing levels of T.

Testosterone is an essential building block for muscle and bone, deepening of the male voice, and revving up sex drive. Throughout a man's life, testosterone maintains his male characteristics, and the decline of this essential hormone is believed to seriously impact these functions. Yet in light of the fact that low testosterone is associated with several chronic medical conditions, including obesity, diabetes, depression, possibly cardiovascular disease, and a condition known as osteoporosis (thinning of the bones), surprisingly little is known about the long-term health effects of low testosterone.

One thing is clear, unless something is done to get your testosterone levels back up to normal levels, more serious symptoms may begin to occur, which for many men means high blood sugar, hypertension, and cardiovascular problems.

Testosterone Replacement or Replenishment: Benefits and Risks

As with many human ailments, the medical society is quick to whip out the prescription pad, which is why prescriptions for testosterone replacement have risen more than 17-fold in recent years. While some experts applaud the increase, others sound a note of caution. Testosterone replacement by oral ingestion, patch, or injection is thought to be generally safe however there just isn't enough data available yet to fully assess the long-term benefits or risks.

One thing that is known is that synthetic testosterone signals the brain that the body has enough testosterone, actually stopping the body from producing its own, which is why men who are on testosterone replacement therapy are periodically cycled off as a precaution to reduce the risk that their bodies will not altogether shut down their own production of testosterone.

This is also one of the main reasons people seek alternative therapies, such as topical testosterone creams, which contain natural testosterone precursors believed to stimulate the body into producing its own testosterone, naturally, and given that bioidentical hormones replicate the very molecular characteristics of the hormones produced in our own bodies, it stands to reason that the human body is better equipped to handle and utilize them safely and effectively than their synthetic counterparts. Though there are relatively few U.S. studies on natural remedies, the few published to date have been promising and seem to affirm an overall emering consensus in people, that natural is better than artificial.

IMPORTANT: According to the Endocrine Society's clinical guidelines, certain men shouldn't take testosterone supplements. Men with metastatic prostate cancer or breast cancer absolutely shouldn't, because testosterone can stimulate cancer growth. Other conditions can potentially be made worse by testosterone therapy, including sleep apnea, severe benign prostatic hypertrophy, severe congestive heart failure, or high red blood cell counts (erythrocytosis).


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