The Male Menopause

Andropause ­­– The Male Menopause

Andropause is a potentially lethal disorder as it may increase the risk of developing conditions like diabetes, stroke, metabolic syndrome, stroke, heart disease, frailty syndrome, and certain cancers.

The onset of andropause in men is less sudden than the female menopause, however, the symptoms can be just as life-altering and severe in its long-term consequences. The cause of andropause is a decrease in the hormone testosterone in the male body as part of the ageing process

Half of healthy men between the ages of 50-70 years will have blood testosterone levels well below the lowest level seen in that of healthy men who are 20-40 years of age.

Andropause Symptoms

A testosterone deficiency will lead to both subtle and more pronounced symptoms and signs such as fatigue, tiredness, depression, irritability, bad temper as well as the loss of memory and concentration. Reduction in libido on all levels is a major source of concern for men with andropause. Not only does sexual desire decrease but, morning erections become less and less with decreased erectile tension and intensity in orgasm.

Men who experience andropause tend to lose their drive and competitiveness with falling levels of fitness. They experience decreased effectiveness in their workouts followed by longer periods of muscle and joint stiffness and delayed time to recover for the next workout.

On a more visible level, muscle loss takes place and more fat accumulates in the areas classically known for its ‘flab’ and if the andropause continues for a long enough period, it may lead to osteoporosis and even anaemia.

What tests can be used to determine if a man has andropause?

Blood tests done in the morning reflects very well and in a reliable way what the status of the testosterone level is. The total testosterone level is a very good measurement to establish the presence of deficient levels of testosterone and also provides good follow up data when testosterone supplementation is used.


Testosterone replacement therapy (TRT) is used to treat andropause. TRT may also assist in decreasing a man’s chances of developing Alzheimer’s disease and decline in cognitive functions like memory and concentration. It’s been shown to reduce the incidence of angina and lower the risk for coronary artery disease.


Today injections with testosterone cypionate or testosterone enanthate, are a popular replacement method that can be administered on a two-weekly to monthly basis. The levels on injectable testosterone tend to fluctuate and have roller coaster effect which hampers the effectiveness and monitoring. It also has a high degree of conversion into oestrogen in males, which can be very harmful on many levels.


A very convenient alternative way of replacing testosterone is by using transdermal gels that are applied to naked skin area like the inside of the forearm. The gel is compounded by a pharmacy according to the specific need of the male involved. It is well absorbed in most men with serum levels that prove it afterwards. It reaches a steady-state soon and can be monitored and tweaked to the individual needs of the affected male.

Testosterone Implants

A very useful way of replacing testosterone in men which do not absorb the transdermal testosterone well or who do not wish to be injected every two to four weeks is the use of testosterone pellets implanted under the skin. This is a minor surgical procedure. The testosterone levels remain stable for even up to five months. This is becoming increasingly popular at the Longiva Healthy Ageing Institute where Dr Gys du Plessis regularly does this small procedure for andropausal males with great efficacy afterwards.

Whatever the method of replacement of testosterone used, it’s imperative to do this under the supervision of an experienced medical doctor competent in the field of hormone therapy. The doctor involved will examine and scrutinise for other medical conditions that may affect the effectiveness of TRT and vice versa. Follow up blood levels of testosterone, estrogen and other biomarkers has to be done regularly and replacement adjusted according to the results and clinical status of the male in need of TRT.

For more information on TRT or hormone replacement therapy for women, please contact Longiva Healthy Ageing Institute today.


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Longiva Medical Institute is an integrative health and wellness clinic designed with the modern individual in mind.


152 Western Service Road, 
Woodmead, Johannesburg, 
South Africa