Andropause

Andropause may or may not actually exist as a clinical phenomenon. Its proponents claim it is a biological change experienced by men during their mid-life, and is often inaccurately compared to the female menopause. It would perhaps be more reasonable to speak of a steady age-related decline in testosterone levels in men, since men's reproductive systems slowly and gradually decline with age, but do not stop working altogether in mid-life, as women's do. It is also not clear how much this supposedly universal male phenomenon can be related to a psychological mid-life crisis, and to overall negative bodily changes in mid-life due not only to aging, but also to the accumulated effects of a lack of exercise, poor diet and so on.

Overview
Much of the current interest in this alleged phenomenon has been fueled by the book Male Menopause, written by Jed Diamond. It should be noted that Diamond is neither an MD nor a PhD. According to the book's author, andropause (another term for "male menopause") is a change of life in middle-aged men, which has hormonal, physical, psychological, interpersonal, social, sexual, and spiritual aspects. Diamond claims that this change occurs in all men, generally between the ages of 40 and 55, though it can occur as early as 35 or as late as 65.

The term "male menopause" is a misnomer, as men don’t have menstrual periods, and therefore cannot stop having them. Unlike women, men's reproductive systems do not cease to work completely in mid-life; some men continue to father children late into their lives (at age 90 or older ). But Diamond claims that, in terms of other life impacts, women’s and men’s experience are somewhat similar phenomena.

The impact of low levels of testosterone has been previously reported. Heller and Myers identified symptoms of what they labeled the "male climacteric" including loss of libido and potency, nervousness, depression, impaired memory, the inability to concentrate, fatigue, insomnia, hot flushes, and sweating. Heller and Myers found that their subjects had lower than normal levels of testosterone, and that symptoms improved dramatically when patients were given replacement doses of testosterone.

The concept of andropause is perhaps more widely accepted in Australia and some parts of Europe than it is in the United States. In the U.S., many clinicians believe that, since men can continue to reproduce into old age, and do not show the same dramatic drops in hormone levels characteristic of menopause in women, andropause is nonexistent. Others feel that andropause is real, but is synonymous with hypogonadism or low testosterone levels.

Diagnosis
Morley has developed a ten-item survey to screen for andropause, but emphasizes loss of testosterone as the primary cause. Mintz, Dotson, & Mukai take a broader perspective and believe that other hormones, diet, and exercise are equally important. Diamond believes that depression is one of the most common problems of men going through andropause, and feels it is greatly under-diagnosed in men, with serious consequences.

Treatment
Several intervention strategies have been found to be effective. These include:
 * Hormone replacement therapy,
 * Exercise, dietary changes, stress reduction,
 * Couple counseling, career refocusing, and spiritual support,
 * Chemical dependency treatment, sexual compulsivity treatment,
 * Treatment for depression,
 * Finding and engaging one’s “calling” in the second half of life.