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Does the andropause exist?

Nature Clinical Practice Endocrinology & Metabolism volume 3, pages 670–671 (2007)Cite this article

Andropause is a syndrome in middle-aged to older men characterized by appreciable 'andropausal symptoms' in association with subnormal serum testosterone levels, and is more appropriately termed 'late-onset hypogonadism' (LOH).1 Many studies have shown that the serum testosterone concentration decreases continuously after 40 years of age. The mean decrease in serum total testosterone levels is small (<1% per year between the ages of 40 and 70 years), and shows considerable individual variation; however, testosterone levels are likely to reach the hypogonadal range in some aging men.2

Aging is also associated with an increased incidence of symptoms known to be caused by hypogonadism in younger men, such as diminished libido, erectile dysfunction, fatigue, depression, decreased lean body mass, increased visceral fat, decreased body hair, and osteoporosis. It has proven difficult, however, to demonstrate causality in the aging-male population: men with a high symptom score often have normal testosterone levels, and vice versa. Moreover, these changes do not occur independently of several other age-related changes (e.g. cardiovascular disease, insulin resistance and the metabolic syndrome) that can cause similar symptoms to hypogonadism. Finally, the levels of hormones other than testosterone also decrease with age. Whether a genuine state of andropause actually exists is, therefore, a highly relevant question. In addition, if the andropause does exist, how common is it and does testosterone replacement have a role in symptom alleviation?

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Authors and Affiliations

  1. A Perheentupa is a Specialist in Reproductive Medicine in the Departments of Physiology and Obstetrics and Gynecology, University of Turku, Finland,

    Antti Perheentupa

  2. I Huhtaniemi is Professor of Reproductive Biology, Institute of Reproductive and Developmental Biology, Imperial College London, UK.,

    Ilpo Huhtaniemi

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  1. Antti Perheentupa
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  2. Ilpo Huhtaniemi
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Correspondence to Antti Perheentupa.

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The authors declare no competing financial interests.

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Perheentupa, A., Huhtaniemi, I. Does the andropause exist?. Nat Rev Endocrinol 3, 670–671 (2007). https://doi.org/10.1038/ncpendmet0623

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