Symptoms of andropause (often known as "male menopause") include low energy, decreased libido or interest in sex, depression, muscle weakness or aches, hot flashes, broken bones due to bone thinning (osteoporosis), and sexual dysfunction.

Symptoms of andropause

  • depression
  • decreased interest in sex (low libido)
  • erectile dysfunction (loss of erections)
  • fatigue/low energy
  • hot flashes
  • increased fat deposits around the abdomen
  • infertility
  • muscle aches
  • osteoporosis (thinning of the bones associated with a risk of broken bones)
  • poor sleep

Andropause may be diagnosed when there is a low level of testosterone in the blood, symptoms of testosterone deficiency, and improvement of those symptoms when testosterone replacement is taken.

As there are many potential causes of testosterone deficiency, it is important to determine the exact cause of testosterone deficiency and determine which therapy is appropriate.

Measuring your testosterone level

Testosterone can be measured by a simple blood test that your doctor can order. However, it is important to measure the level in the morning, as the amount of testosterone in the blood varies throughout the day. Sometimes, low blood levels of testosterone can be found later in the day due to a natural daily rhythm.

Testosterone can be measured in 1 of 3 different ways: total testosterone, "free" testosterone or bioavailable testosterone. Unfortunately, each method can give somewhat different results, which has led to some controversy. Total testosterone measures all of the testosterone in the blood sample. However, because some of this testosterone is not thought to be active due to its attachment to compounds in the blood that increase with age, total testosterone levels give a misleading result in older men.

Free or bioavailable testosterone levels provide a more accurate measurement of the true amount of active testosterone in an older man's body. Your doctor will help you decide whether to have free or bioavailable testosterone measured. However, since the equipment for measuring free and bioavailable testosterone may not be widely available, total testosterone measurement is usually recommended initially.

Should you take testosterone?

The decision regarding whether or not to take testosterone is a personal decision that many men will have to make as they age. Studies done in the last 20 years on testosterone therapy in men with low levels of testosterone have shown positive effects on men's sense of well-being, improved libido, increased muscle bulk and strength, improved bone density, and improved sexual function.

If you think you may be experiencing the symptoms of andropause, ask your physician to measure your morning-time level of testosterone. Every man is unique. It is worthwhile to obtain additional information on andropause and to discuss the different aspects of therapy with your physician.

Richard A. Bebb, MD 
with updates by the MediResource Clinical Team