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Symptoms of male menopause
Medical expert of the article
Last reviewed: 04.07.2025
Absolutely all symptoms of male menopause are associated with a natural age-related decrease in the production of gonadotropins and, first of all, the main male hormone (androgen) – testosterone.
Translated from Greek, klimax means “ladder”, and when applied to human physiology, it defines the biological stage of life at which signs of aging of the body begin to appear.
[ Symptoms of Male Menopause and Hormonal Changes
Let us note right away that we will not consider the decrease in testosterone levels in some pathologies (for example, in diabetes), because the main goal is to understand the hormonal changes that occur over time in healthy men and manifest as signs of andropause or, in a more popular formulation, symptoms of male menopause. Although "signs" is a more correct definition, since "symptoms" immediately lead to alarming thoughts about the disease. Men, remember, this is not a disease, you, too, are just getting old, alas...
In addition, the term "male menopause" is associated with female age-related problems. In principle, this is correct, since age-related problems are also typical for men. But if menopause in women means the final end of the reproductive period of life, then in men during andropause, sperm production continues and there is a possibility of becoming a father even after 70 years. But at the same time, physiological processes caused by age-related involution are still inevitable, they just occur less intensively. Western doctors use the abbreviation ADAM: androgen deficiency in the aging male, that is, a syndrome of decreased androgen levels in aging men.
So, testosterone synthesis begins to decrease in the average man after 30 years of age - about 2% per year, and by the age of 80, testosterone secretion by the testicles (testes) is reduced to the prepubertal level. The main reason for this process during male menopause is considered to be a decrease in the number of special cells in the testes that synthesize testosterone - Leydig cells.
In addition, the symptoms of male menopause are caused by a different ratio and biochemical interaction of other important hormones: GnRH (gonadotropin-releasing hormone) secreted by the hypothalamus; gonadotropins FSH (follitropin) and LH produced by the pituitary gland, as well as the growth hormone somatotropin (STH); progesterone (PG), which is synthesized by the adrenal cortex and testicular cells.
The lower the production of testosterone, the more pronounced the first signs of male menopause depending on age: at 40-45 years (early andropause), at 50-60 (normal age for menopause) or after 60 years (late andropause).
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How do the symptoms of male menopause manifest?
In healthy men in their fifties, despite a gradual but constant decrease in testosterone levels, the concentration of gonadotropin-releasing hormone (GnRH) and luteinizing hormone (LH), which stimulates the synthesis of testosterone by Leydig cells, remains at the same level due to the fact that for some time the hypothalamic-pituitary endocrine tandem functions in a compensatory mode. However, with a further decrease in testosterone, the level of GnRH and LH decreases. And the first signs of male menopause after 40 years are a decrease in libido (sexual desire) and problems with erection.
In addition, most men begin to lose hair faster, which leads to alopecia (baldness). The beard and moustache grow worse and more slowly.
Reduced testosterone synthesis causes the pituitary gland to produce less follitropin (FSH). These changes explain such symptoms of male menopause as decreased sperm volume and decreased number of mature spermatozoa. Also, a decrease in FSH, which controls testicular tissue, causes changes in the functioning of the Sertoli cells located in the testicular tubules. Therefore, at the beginning of menopause, the level of estradiol (which is synthesized by these cells) increases in men. And this gives the following symptoms of male menopause:
- increase in body weight due to fat accumulation;
- deposits of fatty tissue in the mammary glands, waist and abdomen;
- rush of blood to the head and neck;
- increased sweating and increased heart rate.
The ratio of testosterone and estradiol (as well as FSH and LH) continues to change, and eventually estrogen begins to dominate. And then the symptoms of male menopause after 50 years can be expressed in benign hyperplasia (enlargement) of the prostate gland, problems with urination, decreased bone density ( osteoporosis ).
With age, the secretion of somatotropin (STH) gradually decreases, which causes changes in protein metabolism and, in turn, a decrease in muscle mass and physical strength.
It should be noted separately that all hormonal changes taken together have a major impact on the central nervous system and psyche.
Mental changes during male menopause
The most common mental changes during male menopause include:
- sleep disorders (insomnia or excessive sleepiness);
- rapid fatigue, decreased performance and a feeling of complete loss of strength;
- sudden mood swings;
- anxiety and depression;
- increased nervousness and irritability;
- deterioration of cognitive function of the brain;
- difficulty concentrating and forgetfulness;
- decreased motivation or self-confidence.
Obviously, mental changes during male menopause also occur due to a decrease in progesterone levels. The fact is that not only testosterone is synthesized from progesterone, but also the neurosteroid allopregnenolone, which is a substance that binds to the receptors of the main neurotransmitters of the central nervous system (gamma-aminobutyric acid and glycine). And where something is disrupted in the transmission of nerve impulses, mental problems always arise.
Of course, medicine does not ignore the problems of aging men. For example, everything is very clearly and reasonably presented in the popular book "Male Menopause" written by American doctor Jed Diamond in 1997. According to the author, every man will experience hormonal, physical, psychological, interpersonal, social, sexual and even spiritual changes with age. And this cannot be avoided...
In the life of every man there will come (or has already come) a stage of life when the body undergoes age-related restructuring and complex biochemical processes occur. They are accompanied by symptoms of male menopause. Treat them adequately and be healthy as long as possible.