Andropause (or male menopause) is a rather misleading word, and a controversial concept. The word is sometimes used to describe a supposed medical phenomenon in middle-aged men. Proponents believe that it represents the effects of a reduction of the production of the hormones testosterone and dehydroepiandrosterone, and the consequences of that reduction, which is associated with a decrease in Leydig cells.
The term andropause is a misleading choice of terminology (as is the term "male menopause"), because it suggests an equivalence with menopause, a complete and permanent physiological shutting down of the reproductive system, which occurs only in women.
The term "andropause" is however sometimes used in peer-reviewed journal articles, both with and without scare quotes; however, there is on-going professional disagreement about whether or not andropause should be considered a normal "state" (the term used by MeSH), or a disorder. A steady decline in testosterone levels with age (in men and in women) is well documented, but there is disagreement over how exactly a "normal" or "healthy" state should be defined.
Researchers who oppose the use of the term "andropause" may not object to the more limited terms "SLOH" or "ADAM", described in more detail below.
Andropause has been observed in association with Alzheimer's disease.
The term "symptomatic late onset hypogonadism" (or "SLOH") is sometimes considered to refer to the same condition as the word "andropause".
Some researchers prefer the term "androgen deficiency of the aging male" ("ADAM"), to more accurately reflect the fact that the loss of testosterone production is gradual and asymptotic (in contrast to the more abrupt change associated with menopause .) The "D" is sometimes given as "decline" instead of "deficiency". In some contexts, the term "partial androgen deficiency in aging males" ("PADAM") is used instead.
Some of the current popular interest in the concept of andropause has been fueled by the book Male Menopause, written by Jed Diamond, a lay person. According to Diamond's view, andropause 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" may be a misnomer, as 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 concept of andropause is perhaps more widely accepted in Australia and some parts of Europe than it is in the United States.
Others feel that andropause is simply synonymous with hypogonadism or low testosterone levels. Opposition is not limited to the US.
Some clinicians argue that many of the cited symptoms are not specific enough to warrant describing a new condition as the cause. For example, people who are overweight may be misguided into treating a 'new illness' rather than addressing the lifestyle that lead to their being overweight. Similarly, energy levels vary from person to person, and for those people who are generally inactive, energy levels will automatically be lower overall.
While it is true that active and otherwise healthy men could in theory develop andropause-like symptoms, how common and widespread the phenomenon is, and whether genetics, lifestyle, environment, or a combination of factors are responsible, is not yet known.
Several intervention strategies have been found to be effective. These include:
Selective androgen receptor modulators have also been proposed.