Health. What is “andropause”, a common but little-known male menopause

First night sweats. Then a slight depression, complete loss of libido and erection problems. Like Remy Burkel, many men over 60 experience a phenomenon called andropause, which is common but little known.

“At the age of 55, I started having hot flashes at night. My wife, who was going through menopause, was going through the same thing,” says the director, now 62. When he then felt tired, depressed and, above all, completely lacking in sexual desire, the anxiety intensified. “But like many men, it was the fact that I could no longer exert myself that made me realize there was a problem.”

He then did some research, discovered the term “andropause” and consulted his GP, who prescribed him pills to “start everything back like it was at 40.” Intrigued by this phenomenon, Remi Burkel began filming a documentary (Andropause, la grande débandade?, soon to be broadcast on French television). He finds that many men suffering from the same symptoms choose to remain silent about them. “I had a feeling of some kind of shame,” he describes.

Androgen reduction

“We usually talk about andropause to draw a parallel with menopause, but it is not the same clinical picture,” explains Dr. Pierre Devaux, andrologist and head of the department of sexology at the Faculty of the Paris Center.

While menopause in women around the age of 50 is characterized by the cessation of production of ovarian hormones (estrogen and progesterone), in men there is a gradual decrease in testosterone levels. But even with a decrease, reproductive functions are preserved.

“Instead of andropause, it is more correct to talk about an age-related decrease in androgen levels (dala) or testosterone deficiency,” emphasizes Dr. Deveau. “We believe that after age 60, about 20% of men are deficient in testosterone, but production never stops completely unless chemical castration has been performed, for example due to prostate cancer,” he continues.

Not all men suffer from this. The clinical manifestations of this variable decline in hormones are usually grouped under the expression of the famous “old age”: “we feel more tired, we have a little brioche, less libido, less frank ejaculations…”, the doctor lists.

Daniel Golyar, a 68-year-old retiree from Drôme-Provençal, calls it “the adventure of a lifetime.” “It took me some time to realize this phenomenon. Loss of sexual appetite may be associated with aging of both the man and the couple,” he analyzes.

Taboo topic

But one thing is for sure: this topic remains “taboo”. “When I say the name andropause, people look at me funny,” he smiles. “The men I talk to about this usually respond with dirty jokes,” also notes 75-year-old Valentin Husser, who “took a long time to admit what was happening.”

“When I found a relationship again, around 60-65, after a rather ascetic life, I realized that the things that fascinated me in my youth were no longer present,” he says. Therefore, he shares “something else” with his last companion: tenderness, humor…

There are solutions to reduce symptoms. To make a diagnosis of age-related testosterone deficiency, the doctor, after interviewing the patient and conducting a clinical examination, may prescribe a replacement dosage of this hormone. He may combine medications to treat erectile dysfunction.

“Care needs to be global: if something is wrong in the head, it won’t be right in the body,” warns Marc Galliano, a Paris-based andrologist who advocates educating boys about sexual health from a very young age. “Starting in your twenties, testosterone levels naturally decline every year, 40% of men over 40 have erection problems… a man who knows how it works will pay attention,” he assures.