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Testosterone Hormone Replacement and Andropause

Andropause or "male menopause" is a recognized medical condition brought about by declining testosterone or male hormone levels with. The World Health Organization reports that testosterone levels progressively decline with age. By age 70 they are about 10 percent of what they were at age 25. It is estimated that 30 percent of men in their 50s will have testosterone levels low enough to be causing symptoms or putting them at risk.

Although andropause, or the decline of testosterone levels, also known as hypogonadism or hypogonadal, is a normal part of aging, it may be accompanied by a gradual decline in sexuality, mood, and overall energy and can cause serious health risks. By the time men are between the ages of 40 and 55 they can experience andropause.

Men experience gradual physical changes such as loss of muscle mass and increased fat mass which may be accompanied by changes in attitude and mood, the onset of fatigue and loss of energy, sex drive and physical agility. Often concentration and sleep are adversely affected as well.

This decline in testosterone can also put men at risk for other health problems like cardiovascular disease and osteoporosis. This timing of andropause can also coincide with a mid-life crisis and make matters worse psychologically.
Unlike menopause, which generally occurs in women during their mid-forties to mid-fifties, testosterone decline in men may be much more gradual.

Many factors can contribute to the development of andropause including mental attitude, degree of psychological stress, alcohol use, trauma or surgery, prescription and over the counter medications, obesity, and infections. Although with age, a decline in testosterone levels will occur in all men, there is no way of predicting who will experience andropausal symptoms or at what age symptoms will occur.


Andropause has been underdiagnosed until recently. Andropause was first described in medical literature in the 1940's but was not commonly diagnosed until more sensitive tests for testosterone were available. With increasing life spans in general there is more interest in andropause and in improving quality of life.

Another reason why andropause has been underdiagnosed over the years is that symptoms can be vague. Also some men find it difficult to admit that they have a problem. In addition physicians didn't always think of low-testosterone levels as a cause of men's symptoms so patients were often told they were depressed or just getting older. It is unfortunate when this happens since these symptoms can impact their quality of life and may expose them to other, longer-term risks of low-testosterone.

New blood testing methods are available and there is increased interest in men's' aging among medical researchers. In fact, so much attention is being focused on andropause that major efforts are underway to quickly share emerging scientific information with physicians worldwide.

Testosterone is an important hormone that has powerful effects on a man's body. Produced in the testes and in the adrenal glands, testosterone helps build protein, is essential for normal sexual behavior, and affects many metabolic activities such as production of blood cells, bone formation, lipid metabolism, carbohydrate metabolism, liver function and prostate gland growth.

There is great variability in testosterone levels among healthy men so not all will experience the same changes to the same extent. But typical responses to low bioavailable testosterone levels include:


Bone tissue is constantly being broken down and rebuilt. In an individual with osteoporosis, more bone tissue is lost than is regenerated. Testosterone is thought to play a role in helping to maintain this balance in men. Between the ages of 40 and 70 years, male bone density falls by up to 15 percent. Approximately one in eight men over age 50 actually have osteoporosis.

The incidence of hip fractures rises exponentially in aging men. About 20-30 percent of osteoporotic fractures occur in men and the incidence of fractures has been increasing.

Low bone density puts one at risk of frequent fractures, associated pain, and in many cases, loss of function. Wrists, hips, spine and ribs are most commonly affected.

Consequences of osteoporosis include a slow but progressive rounding of the shoulders as well as a loss of height and back pain. When a hip fracture occurs, up to one third of patients never seem to regain full mobility.

Cardiovascular Disease

It is now well accepted that women's risk of atherosclerosis increases after menopause and that estrogen replacement therapy reverses this trend.

A similar phenomenon occurs in men as their testosterone levels diminish with age. Clinical research suggests an association between low testosterone levels and an increase in cardiovascular risk in men.


There are several conditions in which you should never use testosterone replacement therapy. These include:

In some other cases testosterone replacement therapy may not be right for you. If one of the conditions below is applicable to you, your doctor will decide whether testosterone replacement therapy is the right solution.

To help your doctor determine your best treatment plan, you should also discuss the following:

Benefits of Testosterone Replacement

Testosterone replacement in men with andropause can be highly effective and beneficial. Clinical studies have shown benefits including:

Most men have a better attitude and more confidence, feel more vigorous, experience improved energy levels, better mood, concentration, cognition, libido, sexual performance and sense of well being. Other potential benefits include improvement in bone density, body composition, muscle mass, and muscle strength.

In addition lifestyle changes are helpful to reduce the symptoms and risks of andropause such as a low glycemic index diet, appropriate dietary supplements, regular exercise, stress reduction.

Articles on Testosterone and Andropause

1. Andropause - Male Menopause

Hormonal health is a great contributor to determining a person’s overall sense of well-being. Hormonal supplementation and modulation have been proven to successfully diminish the negative consequences of aging brought on by menopause and andropause. This article clearly explains to men and women the benefits of human growth hormone (hgh), testosterone, estrogen, progesterone, and DHEA supplementation for the successful treatment of menopause and andropause.

2. Outcomes of Long Term Testosterone Replacement in Older Hypogonadal Males A Retrospective Analysis.

3. Risks of testosterone replacement therapy in ageing men.


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