Men's health

Male menopause a myth

Male menopause a myth Treatment also has side effects

The male menopause does not exist and is no more than a myth, experts say.

And there is no hard scientific evidence to show that men experience a menopause in a similar way to women caused by a drop in hormone production.

This means that the use of testesterone replacement therapy (TRT), to treat symptoms of the male menopause is "questionable," an editorial in to-day's Drugs and Therapeutics Bulletin warns.

The male menopause is also known as the andropause or late-onset hypogonadism. TRT in the form of patches, implants and gels are offered by some private clinics.

Erectile dysfunction, low sex drive, depression and a diminishing strength in older men have all been blamed on falling levels of the male hormone testesterone.

However, unlike the menopause in women, where levels of the female hormone oestrogen fall sharply and production stops almost completely, testesterone levels in men usually only fall by only around one to two per cent from the age of 40 onwards, the editorial states.

And testesterone production does not stop completely. In fact, around 80 per cent of 60 year olds and half of those in their 80s still have levels within the normal range for younger men. Des O'Connor famously fathered a child at age 71!

This means that low testesterone levels are not inevitable with age.

In addition, older men who do have low testesterone may not have any symptoms, and men with symptoms attributed to the "menopause" often have testesterone levels within the normal range.

It's also unclear whether testosterone given to ageing men who have low levels of the hormone see an improvement in sexual function or depression.

Testesterone treatment also has a number of unwanted side effects including a rise in prostate specific antigen (PSA), blockage of the urinary tract, development of prostate cancer and the development of breasts (gynaecomastia).

It can also aggravate heart disease, epilepsy, and sleep apnoea.

The editorial concluded: “Clinicians should not offer testosterone therapy without explicit discussion of the uncertainty about its risks and benefits in this population.”

“There is no place for testosterone therapy in older men without symptoms, or without clearly low testosterone concentrations on more than one occasion.”

This article was published on Thu 3 June 2010

Image © Andrey Ushakov -

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