Aging Male Syndrome and Andropause

Unlike women, men do not experience a sudden change in fertility as they age.  Instead, changes occur gradually during a process that some people called andropause. Aging changes in the male reproductive system may include changes in testicular tissue, sperm production, and erectile function. These changes usually occur gradually.

Any aging changes in the male reproductive system occurs primarily in the testes as tissue mass decreases and the level of the male sex hormone testosterone stays the same or decreases very slightly. There may also be problems with erectile function.

The tubes that carry sperm may become less elastic and while testes continue to produce sperm, the rate of sperm cell production slows.  As the prostate gland enlarges with age and   some of the prostate tissue is replaced with a scarlike fibrotic tissue benign prostatic hypertrophy (BPH) results. This affects about 50% of men. This may cause problems with urination as well as with ejaculation.   Prostate function is not closely related to fertility, and a man can father children even if his prostate gland has been removed. The volume of fluid ejaculated usually remains the same, but there are fewer living sperm in the fluid.

Decreases in the sex drive (libido) may occur for some men. and sexual responses may become slower and less intense. There may be a decreased testosterone level.


Erectile dysfunction (ED) –  erections   occur less frequently, ED is most often the result of a medical or psychological problem rather than simple aging, and 90% of ED is believed to be of medical rather than psychological origin.

BPH – The enlarged prostate partially blocks the tube that drains the urinary bladder (urethra). Changes in the prostate gland predispose elderly men to urinary tract infections.

Vesicoureteral reflux (backup of urine into the kidneys) may develop if the bladder is inadequately drained, eventually resulting in kidney failure if untreated.

Prostate cancer becomes more common as men age. It is one of the most frequent causes of cancer death for men. Bladder cancer is also a common cancer in older men. Testicular cancers are possible, but these more often occur in younger men.

Men go through aging male syndrome (AMS) between the ages of 35 and 65 when their hormone levels (especially testosterone) decline. Testosterone is a hormone that helps maintain sex drive, sperm production, pubic and body hair, muscle, and bone.  Men do not lose their fertility. But the hormone change may cause other symptoms. All men have different experiences — some men’s hormone levels go down more than others, and some men have more symptoms than others.

A decline in testosterone can affect a man’s body. AMS has many signs:

  • Feeling fat/weight gain
  • Problems sleeping
  • Less interest in sex
  • Feeling irritable or angry
  • Erection problems
  • Nervousness
  • Problems with memory and concentration
  • Muscle loss
  • Increased urination
  • Depression
  • Loss of energy
  • Bone and hair loss

If you’re having these symptoms of low testosterone, talk to your doctor.

source NIH

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