Fatigue, decreased libido, and sleep problems. Is this already andropause?

Fatigue, decreased libido, and sleep problems can appear in middle age, but they alone do not confirm testosterone deficiency. “Andropause” is a colloquial term, and the diagnosis of hypogonadism requires symptoms and repeatedly low test results. Find out when it’s worth consulting a doctor.

What is andropause?

Andropause is a colloquial term for ailments experienced by some men in middle and older age. This term is sometimes referred to as “male menopause,” but both phenomena do not proceed in the same way. During andropause, there is no cessation of hormone production (in women – the cessation of ovarian function), but rather gradual age-related changes [1,2].

With age, testosterone production decreases in some men. This process is individual and does not lead to the occurrence of ailments in everyone. Diagnosis requires the simultaneous presence of characteristic symptoms (e.g., decreased muscle mass, libido problems, increased body fat, and mental health disorders) and reduced testosterone levels measured in morning blood tests [1,2].

The development of andropause symptoms is also influenced by coexisting diseases, including obesity, type 2 diabetes, chronic stress, sleep deficiency, and certain chronic diseases. Age alone is therefore not a sufficient criterion for diagnosing hypogonadism.

Symptoms of andropause – what should you pay attention to?

The first symptoms of so-called male menopause can be non-specific. They may develop over many months, making them easy to attribute to overwork. The most frequently reported symptoms include:

• chronic fatigue,

• decreased libido,

• erectile dysfunction,

• worsened sleep quality,

• low mood,

• difficulty concentrating,

• increase in body fat, especially around the abdomen,

• decrease in muscle mass [1-3].

The occurrence of these symptoms does not automatically mean the necessity of hormonal treatment. If the ailments persist, worsen, or affect daily functioning, they should be consulted with a doctor to determine their cause.

How is andropause diagnosed?

A gradual decrease in testosterone levels in men is a natural stage of the body’s aging process. However, it is worth remembering that if physical symptoms and mood changes begin to negatively affect a man’s quality of life, diagnosis is necessary.

The basis for diagnosis is a medical history, physical examination, and measurement of morning total testosterone levels. If necessary, the doctor may also order free testosterone, LH, FSH, prolactin, TSH, or tests evaluating metabolic status. Such a procedure allows for the exclusion of other causes of similar symptoms, including depression, thyroid disorders, or obstructive sleep apnea [2-5].

Treatment of andropause – how to alleviate symptoms?

The course of action depends on the cause of the ailments. Not every man experiencing fatigue, decreased libido, or worsening well-being requires hormonal therapy.

In the case of symptomatic and confirmed testosterone deficiency, the doctor may consider testosterone therapy. Before starting it, an assessment of possible benefits, contraindications, and risks is necessary. Treatment also requires regular clinical and laboratory monitoring [6,7].

Does supplementation matter?

Dietary supplements are not intended for the treatment of hypogonadism and do not replace diagnosis. They can supplement the diet with specific vitamins or minerals if their use corresponds to individual needs.

The foundation remains a healthy diet, physical activity, adequate sleep duration, and weight reduction for overweight individuals. Some fatigue supplements can replenish vitamin and mineral deficiencies (e.g., BestMag with an innovative day and night formula), if they have been previously confirmed by tests or a specialist’s assessment. One should not expect a dietary supplement to independently increase testosterone levels in a healthy man. Before starting supplementation, it is worth evaluating one’s diet, health status, and medications taken.

When to see a specialist?

Low testosterone levels combined with the natural aging process can resemble andropause. So when should symptoms be an alarm signal for a man?

It is advisable to consult a doctor if fatigue, sleep disturbances (and other mental symptoms), or decreased libido (often along with impaired other sexual functions) persist for several months, worsen, or negatively affect daily functioning. Early diagnosis allows for detecting not only hormonal disorders but also diabetes, cardiovascular diseases, or depression, which can also cause similar ailments.

FAQ – frequently asked questions

How to treat andropause in men?

Treatment depends on the cause of the symptoms. After confirming testosterone deficiency, the doctor may consider hormonal therapy. Simultaneously, physical activity, an appropriate diet, weight reduction, and treatment of coexisting diseases are recommended.

How long does andropause last in men?

Andropause is not a stage with a defined beginning and end. Symptoms can have various causes, so their duration depends, among other things, on health status, lifestyle, and applied treatment. In the case of confirmed hypogonadism, the course also depends on its cause.

What are the psychological symptoms of andropause?

The most common observations include low mood, irritability, decreased motivation, difficulty concentrating, and impaired memory. However, these are non-specific symptoms that can also result from stress, depression, insomnia, or chronic diseases. Hypogonadism should not be self-diagnosed based on these symptoms.

What are the effects of andropause?

Untreated testosterone deficiency can be associated with a worsened quality of life, decreased bone mineral density, reduced muscle mass, and impaired sexual function. The type and severity of consequences depend on the cause and degree of testosterone deficiency.

Are there tests for andropause?

Screening questionnaires, such as ADAM, exist, but they are not used to make a diagnosis. The final diagnosis is based on the assessment of symptoms and the results of hormonal tests performed in accordance with current guidelines.