Aly S. Abdulla, BSC, MD, LMCC, CCFP, DipSportMed(CASM)
Faiza Abdulla, CDA
Contributing Authors,
Geriatrics & Aging.

Introduction
Unlike female menopause, which has been at the forefront of the medical community for over a decade, male menopause has been ignored and its very existence contested. This article will review this controversial topic in terms of its definition, mechanisms, evidence, symptoms, diagnosis, treatment options and follow-up.

Definition
Andropause is a clinical condition characterized by a partial deficiency of circulating androgens in blood and/or a decreased sensitivity to testosterone or its active metabolites in target tissues. This state of hypogonadism leads to a decline of energy, an altered sense of well-being, sexual dysfunction and various metabolic alterations. These issues may have effects on muscle mass, bone density, lipid profile and eventually cognitive function.^1,2 This syndrome tends to begin around age 50. Its insiduous onset can predate the finding or suspicion of symptoms by ten years.1 There is large overlap between andropause and other entities like neuro-vegetative dystonia, sleep disorders, mood disorders (anxiety and depression being the predominant two), hypothyroidism, drug abuse including alcoholism, medications, anemia, diabetes, obesity, hyperprolactinemia and erectile dysfunction due to non-hormonal factors (i.e. stress).