Hormone changes are a natural part of aging, but the experience is different for men and women. Unlike the more dramatic plunge that occurs in women during menopause, sex hormone changes in men occur gradually. This is sometimes called male menopause.

For women, menopause marks the end of their menstrual cycles, whether by naturally declining reproductive hormones, surgical removal of the ovaries, changes caused by chemotherapy or radiation therapy, or a conditional called primary ovarian insufficiency. Ovulation ends and hormone production plummets during a relatively short period of time.

In men, production of testosterone and other hormones declines over a period of many years and the consequences aren't necessarily clear. This gradual decline of testosterone levels is called late-onset hypogonadism or age-related low testosterone.

Recognizing low testosterone levels

A man's testosterone levels decline on average about 1% a year after 40. But most older men still have testosterone levels within the normal range, with only an estimated 10% to 25% having levels considered to be low.

Low testosterone levels in older men often goes unnoticed. Testosterone levels can be checked by a blood test, but tests aren't done routinely. And many men who have low testosterone levels experience no symptoms. In addition, the signs and symptoms associated with low testosterone aren't specific to low testosterone. They also can be caused by a person's age, medication use, or other conditions, such as having a body mass index of 30 or higher.

Signs and symptoms suggestive of low testosterone include:

• Reduced sexual desire and activity.
• Decreased spontaneous erections or erectile dysfunction.
• Breast discomfort or swelling.
• Infertility.
• Height loss, low trauma fracture or low bone mineral density.
• Hot flushes or sweats.

Other possible symptoms include decreased energy, motivation and confidence; depressed mood; and poor concentration. It's also possible to experience increased sleepiness; sleep disturbances; mild, unexplained anemia; reduced muscle bulk and strength; and increased body fat.

Experts recommend only testing older men for low testosterone if they have signs or symptoms. If an initial test shows low testosterone, the test should be repeated to confirm the results. If low testosterone is confirmed, further testing of the pituitary gland is recommended to determine the cause and rule out other hormone deficiencies. The pituitary gland is a kidney-bean-sized gland situated at the base of your brain. It is part of your body's endocrine system, which consists of all the glands that produce and regulate hormones.

Treatment

Recommendations on testosterone therapy for men with age-related low testosterone vary. In 2020, the American College of Physicians recommended that healthcare professionals consider starting testosterone treatment in men with sexual dysfunction who want to improve their sexual function, after explaining the risks and benefits. In 2018, the Endocrine Society recommended testosterone therapy for men with age-related low testosterone who have signs and symptoms associated with low testosterone.

Some experts also recommend offering testosterone treatment to men with age-related low testosterone without the presence of signs or symptoms.

If you choose to start testosterone therapy, your healthcare professional will explain the different ways testosterone can be administered, target levels and follow-up testing.

For some men, testosterone therapy relieves bothersome signs and symptoms of testosterone deficiency. For others, the benefits aren't clear, and there are possible risks.

Though further research is needed, testosterone therapy might stimulate growth of metastatic prostate and breast cancer. Testosterone therapy also may increase the risk of heart attack and stroke and contribute to the formation of blood clots in the veins.

Your healthcare team likely will recommend against starting testosterone therapy if your fertility is important in the near future or if you have conditions such as breast or prostate cancer, untreated severe obstructive sleep apnea, uncontrolled heart failure, or thrombophilia, or if you've recently had a heart attack or stroke.

If you think you might have low testosterone, talk to your healthcare team about your signs and symptoms, testing, and possible treatment options. They can help you weigh the pros and cons of treatment.

Connect with other men talking about healthy aging in the Men's Health Support Group on Mayo Clinic Connect, an online patient community moderated by Mayo Clinic.

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DEAR MAYO CLINIC: My wife is 52 and just beginning menopause. We were talking about the changes she's been experiencing, and I was wondering if there is such a thing as male menopause. I am 58.

ANSWER: Hormone changes are a natural part of aging. Unlike the more dramatic reproductive hormone plunge that occurs in women during menopause, however, sex hormone changes in men occur gradually.

The term "male menopause" has been used to describe decreasing testosterone levels related to aging. But aging-related hormone changes in women and men are different.

In women, ovulation ends and hormone production plummets during a relatively short period of time. This is known as menopause. In men, production of testosterone and other hormones declines over a period of many years, and the consequences aren't necessarily clear. This gradual decline of testosterone levels is called late-onset hypogonadism, or age-related low testosterone.

A man's testosterone levels decline on average about 1% a year after age 40. But most older men still have testosterone levels within the normal range, with only an estimated 10% to 25% having levels considered to be low.

Low testosterone levels in older men often go unnoticed as many men who have low testosterone levels experience no symptoms. In addition, the signs and symptoms associated with low testosterone aren't specific to low testosterone. They also can be caused by a person's age; medication use; or other conditions, such as having a body mass index of 30 or higher.

Testosterone levels can be checked by a blood test, but tests aren't routinely done. That said, if you are experiencing certain signs and symptoms suggestive of low testosterone, it may be worthwhile to ask your health care provider to check your levels.

Some signs and symptoms suggestive of low testosterone include:

• Reduced sexual desire and activity.
• Decreased spontaneous erections or erectile dysfunction.
• Breast discomfort or swelling.
• Infertility.
• Height loss, low trauma fracture or low bone mineral density.
• Hot flushes or sweats.

Other possible symptoms include decreased energy, motivation and confidence; depressed mood; and poor concentration. It's also possible to experience increased sleepiness, sleep disturbances, mild unexplained anemia, reduced muscle bulk and strength, and increased body fat.

Experts recommend only testing older men for low testosterone if they have signs or symptoms. If an initial test shows low testosterone, the test should be repeated to confirm the results. If low testosterone is confirmed, further testing of the pituitary gland is recommended to determine the cause and rule out other hormone deficiencies. The pituitary is a gland the size of a kidney bean situated at the base of your brain. It is part of your body's endocrine system, which consists of all the glands that produce and regulate hormones.

Treatment recommendations for men with age-related low testosterone vary. In 2020, the American College of Physicians recommended that health care providers consider starting testosterone treatment after explaining the risks and benefits in men with sexual dysfunction who want to improve their sexual function. In 2018, the Endocrine Society recommended testosterone therapy for men with age-related low testosterone who have signs and symptoms associated with low testosterone. Some experts also recommend offering testosterone treatment to men with age-related low testosterone without the presence of signs or symptoms.

If you choose to start testosterone therapy, your health care provider will explain the ways to administer testosterone, as well as target levels and follow-up testing.

For some men, testosterone therapy relieves bothersome signs and symptoms of testosterone deficiency. For others, the benefits aren't clear, and risks are possible.

Though further research is needed, testosterone therapy might stimulate growth of metastatic prostate and breast cancer. Testosterone therapy also can increase the risk of heart attack and stroke, and contribute to the formation of blood clots in the veins.

Your health care provider likely will recommend against starting testosterone therapy if your fertility is important in the near future or if you have conditions such as breast or prostate cancer, untreated severe obstructive sleep apnea, uncontrolled heart failure or thrombophilia, or if you've recently had a heart attack or stroke.

If you think you might have low testosterone, talk to your health care provider about your signs and symptoms, testing and possible treatment options. Your health care provider can help you weigh the pros and cons of treatment. — Compiled by Mayo Clinic staff

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Related Articles

• Mayo Clinic Minute: Lifestyle changes to manage menopause symptoms published 5/3/21
• Mayo Clinic Minute: Low testosterone levels can affect men published 6/10/19

The post Mayo Clinic Q and A: Male menopause — myth or reality? appeared first on Mayo Clinic News Network.

So much of a man's physical characteristics are affected by testosterone levels. And Dr. Landon Trost, a Mayo Clinic urologist, says a drop in testosterone level can cause a long list of side effects.

In this Mayo Clinic Minute, Dr. Trost explains what is considered a low testosterone value, how low testosterone can affect men's bodies, and why treating low testosterone does not always produce the results some men hope for. Ian Roth reports.

Watch: The Mayo Clinic Minute

Journalists: Broadcast-quality video pkg (0:59) is in the downloads. Read the script.

Testosterone is the hormone most associated with masculinity.

"Everything from a deepening of voice, to muscles, to different characteristics on the jaw and so on, often are related to testosterone," says Dr. Trost.

He says, as men age, their testosterone levels tend to drop, causing a long list of possible symptoms, including decreased energy and sexual function, weight gain and muscle loss. But exactly what level is considered low testosterone, commonly referred to as "low T," depends on a lot of factors, including age. In general, Dr. Trost says a testosterone value of less than 300 nanograms per deciliter is considered below normal.

There are plenty of treatment options, from alternative agents to testosterone compounds, but all of them come with a risk of side effects, such as blood that is too thick. Dr. Trost says men who think they might have low testosterone should see their primary care provider to be tested, but it's important to remember there's only so much testosterone therapy can do.

"It won't improve all men," says Dr. Trost. "And it'll be a modest improvement in those that it does improve. So it's not a miracle cure or miracle drug."

The post Mayo Clinic Minute: Men and testosterone appeared first on Mayo Clinic News Network.

On this week's Mayo Clinic Radio program, Dr. Landon Trost, a urologist at Mayo Clinic, will discuss two common men’s health topics: prostate cancer screening and what can be done about low testosterone. Also on the program, Dr. Bobbit Pritt, a parasitologist at Mayo Clinic, will cover common tick-borne diseases and how to prevent them. And Dan Gaz, an exercise specialist with the Mayo Clinic Healthy Living Program, will explain how knowing your numbers can help you get the whole picture on your health.

To hear the program, find an affiliate in your area.

Miss the show?  Here's your Mayo Clinic Radio podcast.

Use the hashtag #MayoClinicRadio, and tweet your questions.

Mayo Clinic Radio is on iHeartRadio.

Access archived shows or subscribe to the podcast.

Mayo Clinic Radio produces a weekly one-hour radio program highlighting health and medical information from Mayo Clinic.

The post Mayo Clinic Radio: Men’s Health Month / tick-borne diseases / know your numbers appeared first on Mayo Clinic News Network.

Everything from deepening of voice, to jaw line, to muscles are all affected by testosterone levels. But Dr. Landon Trost, a Mayo Clinic urologist, says, as men age, their testosterone levels tend to drop. That drop can come with a long list of side effects.

In this Mayo Clinic Minute, Dr. Trost explains what is considered a low testosterone value, how low testosterone can affect men's bodies, and why treating low testosterone does not always produce the results some men hope for. Ian Roth reports.

Watch: The Mayo Clinic Minute

Journalists: Broadcast-quality video pkg (0:59) is in the downloads. Read the script.

The post Mayo Clinic Minute: All about testosterone appeared first on Mayo Clinic News Network.

On the next Mayo Clinic Radio program, Dr. Landon Trost, a urologist at Mayo Clinic, will discuss common men's health concerns, including vasectomy and testosterone therapy. Also on the program, Dr. Joseph Murray, a gastroenterologist at Mayo Clinic, will explain why what you eat before bed can affect your sleep. And Dr. Ahmed Mohamed, a Mayo Clinic resident, will share his journey from Somalian refugee to medical school.

To hear the program, find an affiliate in your area.

Follow #MayoClinicRadio, and tweet your questions.

Mayo Clinic Radio is on iHeartRadio.

Mayo Clinic Radio produces a weekly one-hour radio program highlighting health and medical information from Mayo Clinic.

Access archived shows.

The post Mayo Clinic Radio: Men’s Health Week appeared first on Mayo Clinic News Network.

On the next Mayo Clinic Radio program, Dr. Landon Trost, a urologist at Mayo Clinic, will discuss common men's health concerns, including vasectomy and testosterone therapy. Also on the program, Dr. Joseph Murray, a gastroenterologist at Mayo Clinic, will explain why what you eat before bed can affect your sleep. And Dr. Ahmed Mohamed, a Mayo Clinic resident, will share his journey from Somalian refugee to medical school.

To hear the program, find an affiliate in your area.

Miss this show?  Here's your Mayo Clinic Radio podcast.

Follow #MayoClinicRadio, and tweet your questions.

Mayo Clinic Radio is on iHeartRadio.

Mayo Clinic Radio produces a weekly one-hour radio program highlighting health and medical information from Mayo Clinic.

Access archived shows.

The post Mayo Clinic Radio: Men’s Health Week / worst things to eat before bed / from refugee to physician appeared first on Mayo Clinic News Network.

DEAR MAYO CLINIC: I’m a 56-year-old man without any health problems. Recently, I’ve noticed I don’t have the energy for physical activities that I used to. Working in the yard, riding my bike and even just doing jobs around the house all wear me out much faster now than even five years ago. My sex drive is lower, too. I see ads all the time for testosterone therapy and what a difference it can make for men my age. Should I give it a try? Is it safe?

ANSWER: Recent research shows that testosterone therapy can be useful in some cases, but it’s not right for all men. To see if it could be helpful for you, start by making an appointment with your doctor to have your testosterone level checked.

Testosterone is a hormone produced primarily in the testicles. Testosterone helps maintain men’s bone density, fat distribution, muscle strength and mass, red blood cell production, sex drive and sperm production. For most men, testosterone peaks during adolescence and early adulthood. Then, as men get older, testosterone levels gradually fall.

If testosterone drops below a certain level, it can cause symptoms. Fatigue and low sexual interest are common. Some men also see changes in beard and body hair growth. Muscle wasting and a decrease in muscle strength can be a result of low testosterone, too.

Your doctor can use a blood test to check your testosterone level. Even if your testosterone level is found to be low, though, testosterone therapy is not automatically the answer. It’s also important to determine any potential causes or associated conditions of low testosterone before moving forward with treatment.

In some cases, medical conditions can contribute to low testosterone, including thyroid problems, obesity, obstructive sleep apnea, depression and excessive alcohol use. Some medications may cause testosterone levels to drop, as well.

As part of your evaluation, your doctor should review your current medications and check for underlying medical problems that could be contributing to your symptoms. If your testosterone is low and a medical condition is identified, treatment for that disorder may be all you need to bring your testosterone level back into the normal range. A change in medications also could make a difference.

If low testosterone isn’t due to medication or a medical problem, then taking prescription testosterone replacement may be beneficial. Numerous studies have found that testosterone may be helpful for men experiencing symptoms as a result of low testosterone. In many cases, however, the effects are modest. In men with normal levels of testosterone, taking prescription testosterone generally has no effect for most symptoms.

In addition to easing symptoms of low testosterone, prescription testosterone may have other benefits, including reducing fat mass, improving lean muscle mass, strengthening bones and improving insulin sensitivity.

Taking prescription testosterone does have risks. It may cause production of more red blood cells (a condition known as polycythemia); increase prostate-specific antigen, or PSA, in the blood; enlarge breasts; or reduce sperm production. Testosterone therapy does not cause cancer, including prostate cancer. If your doctor recommends that you take testosterone, you need regular blood tests to make sure the prescribed dose is correct, as too much testosterone potentially can lead to other medical problems.

Although most studies suggest that testosterone therapy does not increase the risk of heart attacks or stroke, and that it may even be protective in some cases, there is not enough information to prove its safety conclusively among elderly men with cardiovascular risk factors.

To see if testosterone therapy may be right for you, make an appointment to see your doctor and assess your symptoms. He or she can do a thorough evaluation and help you decide what, if any, treatment you may need. — Landon Trost, M.D., Urology, Mayo Clinic, Rochester, Minnesota 

The post Mayo Clinic Q and A: Testosterone therapy? Maybe appeared first on Mayo Clinic News Network.

In this Mayo Clinic Minute, reporter Jeff Olsen speaks with urologist Dr. Landon Trost about the role of testosterone in the body and symptoms that may indicate your level is too low.

Watch: The Mayo Clinic Minute
https://youtu.be/JyLaWFeNR6s
Journalists: Broadcast-quality video pkg (1:03) is in the downloads. Read the script.

The post Mayo Clinic Minute: Low Testosterone Symptoms appeared first on Mayo Clinic News Network.

Myth or Matter-of-Fact: The type of obesity you have may determine which treatment is most effective.

Mayo Clinic Radio is available on iHeartRadio.

Click here to listen to the program at 9:05 a.m. CT Saturday, September 26, and follow #MayoClinicRadio.

To find and listen to archived shows, click here.

Mayo Clinic Radio is a weekly one-hour radio program highlighting health and medical information from Mayo Clinic.

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