At around the same time as females enter menopause in their late 40s or early 50s, males are experiencing their own hormonal decline, called andropause. As part of the normal aging process, a man’s testosterone levels decrease by about 1% a year after age 40.
Low testosterone by itself is not concerning, but with symptoms, may indicate a more serious issue called male hypogonadism. Men may notice changes in body such as decreased muscle bulk, increased body fat, and fatigue; in mind, including depression, difficulty concentrating and disturbed sleep; and reduced libido.
When Should Men Consider Testosterone Therapy
For men diagnosed with hypogonadism, testosterone replacement therapy can help improve libido, energy, muscle mass and bone density. However, for those with low testosterone (low “T”) and symptoms due to aging, if or when testosterone therapy should be recommended is not clear, because:
- Mental health symptoms may be due to other conditions, and there is no evidence to date of improvement from therapy.
- Risks can include acne, sleep disturbances, and blood clots.
- More research is needed: earlier studies pointed to a potentially higher risk of prostate cancer or cardiovascular disease while later ones seemed to allay those concerns but are not yet conclusive.
The best course to pursue? First, consult with our office about your concerns, and we will discuss your individual risks and benefits. Second, be aware that current medical guidelines do not recommend testosterone therapy for men with age-related low testosterone to improve energy, vitality, physical function, or cognition. Third, avoid over-the-counter supplements for boosting testosterone as evidence is lacking regarding their efficacy. Finally, consider natural ways to boost testosterone, such as losing excess weight, increasing muscle mass through resistance exercise, getting quality sleep, and eating a healthy diet.
Sources: Mayo Clinic, Harvard Health Letter.