Hormonal changes for both men and women are normal and part of the aging process. For women, menopause is a complete cessation of reproductive ability, which usually starts around age 51. For men, “andropause” is a very gradual decrease in testosterone beginning around age 30 at a rate of about 1% a year. Generally men do not lose total ability for reproduction and can father children late in life, even into their 90’s. Otherwise there are a lot of similarities between menopause and andropause. For some andropause doesn’t cause any symptoms. For others, the symptoms may involve:
• Gynecomastia (male breasts)
• Increased body fat
• Depression and mood swings
• Lack of energy
• Insomnia
• Loss of strength or muscle mass
• Low sex drive
• Hot flashes
• Memory loss
• Osteoporosis
• Hair loss

The word andropause is currently not recognized by the World Health Organization as it is a term of convenience to describe the stage in life when men have symptoms of aging. The concept is more accepted in Australia and parts of Europe. Some clinicians feel the symptoms are not enough to be considered a medical condition and that “andropause” is just low testosterone. But whatever name we give it does not lessen the impact of the symptoms for San Francisco men’s physiological and psychological well being.
A blood test is required to diagnosis low testosterone. One way of treating andropause is with testosterone replacement, but the treatment is controversial as it may increase the risk of prostate cancer as well as other medical issues. The gynecomastia breast is one of the most upsetting symptoms and while testosterone replacement is not an option for many men, male breast reduction surgery is.