There are a number of symptoms consistent with andropause, but most men focus on their declining libido (sex drive). There are a number of other signs, but this is the one that concerns most men as it strikes at their masculinity and is perceived in a very personal manner. Of course that is understandable, but there are other important factors associated with andropause that most men and many doctors don’t recognize. For example, many of my female patients speak to me about their spouses or boyfriends and whether or not they should be evaluated because of low energy, depression, loss of sex drive, lack of stamina, weight gain, loss of muscle mass, loss of strength and moodiness. All the above are symptoms of andropause, but the most important factor is the one that is never mentioned and unknown to most doctors. Testosterone has a cardiovascular protective effect! In other words, higher levels of testosterone have a protective effect on the heart and brain as the result of preventing atherosclerotic vascular disease (hardening of the arteries). Testosterone is also important in maintaining healthy bones. Proper levels (optimal) help maintain proper mineralization and add to the strength of bones. When bones are stronger, they are much less likely to fracture with minimal trauma.
When most men become aware of the cardiovascular and skeletal protective effect of testosterone, they strive to never let their blood levels fall to previously accepted “normal” levels. That brings up the point of what doctors consider normal. As an example, if we were to study 1,000 men, age 60, their levels would prove to be much lower than a sample of 1,000 men at 25 years of age. When a doctor tells a male patient, over the age of 45, that his levels are normal, what he/she is really saying is that compared to everyone else in that age group, their levels are about the same. Apparently it never occurs to most doctors that if everyone in a particular age group is low, then a low level will be considered “normal” as well. Normal does not mean that it’s healthy, it’s just a mathematical number computed from averages in a particular age group. This illustrates something very important and something lost in doctors’ training programs. Normal values do not necessarily mean “optimal.”