The male menopause (also called andropause) is thought to be due to a reduction in the hormone testosterone as men grow older.

Andropause is a medical phenomenon, similar to the female menopause, that can affect men between the ages of 40 and 55. Unlike women, men do not have a clear-cut signpost such as the cessation of menstruation to mark this transition. Both, however, are distinguished by a drop in hormone levels--oestrogen in women, testosterone in men. The bodily changes occur very gradually in men and may be accompanied by changes in attitudes and moods, fatigue, a loss of energy, sex drive and physical agility.

Studies show that this decline in testosterone can put men at risk for other health problems such as heart disease and weak bones.

Unlike menopause, which generally occurs in women during their mid-forties to mid-fifties, men's "transition" may be much more gradual and expand over many decades. Attitude, psychological stress, alcohol, injuries or surgery, medications, obesity and infections can contribute to its onset.

Although with age, a decline in testosterone levels will occur in virtually all men, there is no way of predicting who will experience andropausal symptoms of sufficient severity to seek medical help. Neither is it predictable at what age symptoms will occur in a particular individual. Each man's symptoms may also be different

Symptoms can include erectile dysfunction, loss of muscle mass, irritability, generalized fatigue, sleep disturbacne and even problems with memory and cognition.

Andropause routinely escapes diagnosis because symptoms can be vague and can vary greatly among individuals. Furthermore, while the female analogue of this life change has a distinctive and sudden onset, production of the male hormone begins to decline as early as age 30 and proceeds over the next three, four or five decades until death.

While the creeping symptoms of andropause are often dismissed by both patients and professionals as "what happens as we age" some have begun to consider them as signs of a disease state of which premature aging is merely another symptom. A diagnosis of hypogonadism (also seen in younger men) often serves as a gateway to consideration of the broader condition.

Once the condition is discovered, it is a straightforward (although somewhat involved) process of replacing the missing testosterone by injection, locally applied hormone gel, trans-dermal patch or implanted cartridge.

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