Andropause: Psychological Symptoms such as Depression

Andropause and depression have more in common than you might imagine.

First of all we have to clarify that the term andropause, or also known as menopause in men It is not an equivalent to the term female menopause. We only use it figuratively to refer to refer to the deficiency of free testosterone that occurs in adult men.

Second we must distinguish the depression, of the dysthymia. Although both are affective disorders, they differ in severity and the length of time they occur. Major depression is the more serious of the two.

Depression and dysthymia: what are they and how are they different?

La depression, Depression is a psychiatric/psychological diagnosis in which a marked mood disorder is experienced. This may be temporary or permanent, but is usually characterized by the patient experiencing feelings of depression, unhappiness and/or guilt. Depression also causes a total or partial inability to enjoy everyday life.

La dysthymia, on the other hand, is a chronic mood disorder that has characteristics similar to those of depression, although these are less severe.

How does andropause affect you emotionally?

Andropause does not have a fixed duration or standardized period, as it varies considerably between men. In general, andropause is a gradual process that occurs over several years. Here are some key aspects about its duration:

1. Gradual Start: Andropause usually begins around the age of 40-50, although it can vary depending on the individual. Symptoms and the decrease in testosterone do not occur abruptly, but develop slowly over time.
2. Duration of Symptoms: Symptoms associated with andropause, such as mood swings, decreased libido, and reduced muscle mass, can persist for several years. The intensity of these symptoms can vary, with some men experiencing more severe symptoms in the early stages and others feeling more affected in later stages.
3. Prolonged Process:Unlike female menopause, which is a defined and relatively short phase, andropause is a continuous process that can last from a decade to more, depending on individual hormone levels and the man's overall health.
4. Individual Variability: The duration and severity of andropause can be influenced by factors such as genetics, lifestyle, general health, and the presence of additional medical conditions. Each man may experience andropause differently, with significant variability in the duration of symptoms.
5. Management and TreatmentWith proper treatment and lifestyle changes, many men can experience a reduction in the intensity of symptoms over time. Hormone therapy, regular exercise, a balanced diet, and stress management can help mitigate the effects and improve quality of life during this phase.

Andropause, also known as “male menopause” or “male climacteric,” is a phenomenon that occurs in men as they age, usually from the age of 40-50, and is characterized by a gradual decline in testosterone levels. This process can have various emotional effects, including:

1. Mood Changes: Decreased testosterone levels can lead to mood changes, including feelings of sadness, irritability, or anxiety. Men may experience a general feeling of emotional distress and have difficulty managing their emotions effectively.
2. Depression: Some men may experience depressive symptoms during andropause. Low testosterone levels have been associated with an increased risk of depression, and a lack of energy and motivation may contribute to feelings of hopelessness or discouragement.
3. Anxiety and Stress: Andropause can increase anxiety and stress levels, in part due to concerns about aging, sexual performance, and potential health implications. Adjusting to these changes can be stressful and negatively affect emotional well-being.
4. Changes in Self-Esteem: Decreased testosterone can affect body image and self-esteem. Men may feel less confident about their physical appearance, their ability to maintain an active sex life, or their overall performance. This can lead to a reduction in self-confidence.
5. Problems in Relationships: Emotional changes associated with andropause can affect interpersonal relationships. Irritability and mood swings can create tension in relationships with partners, friends, and family, and sexual problems can impact intimacy and emotional connection between couples.
6. Lack of motivation: Loss of interest in previously enjoyable activities or lack of motivation to undertake new projects can be an emotional symptom of andropause. Decreased energy and enthusiasm levels can contribute to a general feeling of apathy.
7. Sleeping problems: Sleep problems, such as insomnia or difficulty getting restful sleep, are common during andropause. Lack of good rest can exacerbate emotional problems and negatively affect overall well-being.

It is important for men experiencing symptoms of andropause to seek medical and emotional support. Treatments may include hormone therapy, lifestyle changes, and psychological therapy to address the emotional aspects. A comprehensive approach can help mitigate the emotional effects and improve quality of life during this time.

How long does andropause last in men?

Andropause does not have a fixed duration or standardized period, as it varies considerably between men. In general, andropause is a gradual process that occurs over several years. Here are some key aspects about its duration:

1. Gradual Start: Andropause usually begins around the age of 40-50, although it can vary depending on the individual. Symptoms and the decrease in testosterone do not occur abruptly, but develop slowly over time.
2. Duration of Symptoms: Symptoms associated with andropause, such as mood swings, decreased libido, and reduced muscle mass, can persist for several years. The intensity of these symptoms can vary, with some men experiencing more severe symptoms in the early stages and others feeling more affected in later stages.
3. Prolonged Process:Unlike female menopause, which is a defined and relatively short phase, andropause is a continuous process that can last from a decade to more, depending on individual hormone levels and the man's overall health.
4. Individual Variability: The duration and severity of andropause can be influenced by factors such as genetics, lifestyle, general health, and the presence of additional medical conditions. Each man may experience andropause differently, with significant variability in the duration of symptoms.
5. Management and TreatmentWith proper treatment and lifestyle changes, many men can experience a reduction in the intensity of symptoms over time. Hormone therapy, regular exercise, a balanced diet, and stress management can help mitigate the effects and improve quality of life during this phase.

The antidepressant properties of the hormone testosterone

It has long been known that the main male hormone testosterone, (or androsterone) It has antidepressant properties, Although the mechanisms by which this occurs were unknown until recently, it has recently become known that there is a region located in the hippocampus, which is an area related to memory, especially episodic and spatial memory.

TESTOSTERONE HAS ANTIDEPRESSANT PROPERTIES, POSSIBLY THAT IS WHY WOMEN SUFFER MORE FROM THE EFFECTS OF MENOPAUSE

The response to stress It occurs in this area located inside the temporal lobe, connected to the cerebral cortex, where the positive effects of this hormone, act as mediators.

Compared to men, Women are twice as vulnerable to suffer from mood disorders such as depression. One explanation could be that the amount of testosterone in women is 20 to 30 times lower than in men.

Relationship between andropause and depression; depressive events in adult men

In Adult Free Testosterone Deficiency (hypogonadism), it is also common for depressive and anxiety events to increase, and a molecular marker has even been found that is essential for the male hormone to have the proper effect on mood, thus combating the recurring sadness that can occur in these cases.

Testosterone levels decrease by 1,6% annually after age 40; however, individual differences may exist. Total testosterone levels decrease by 35% in men aged 20 to 80, while free testosterone (Tl) decreases by 50%, with the latter having the greatest effect on mood.

Some medical facts:

It has been shown that with age there is a loss of the circadian (night-day) rhythm of testosterone secretion, in the elderly, as well as an elevation of SHBG. Most circulating testosterone is bound to SHBG and constitutes the non-biologically active fraction. Only 2% circulates in free form to be used by the body's cells.

SHBG levels increase with age, so when there are higher concentrations of circulating SHBG there is less circulating Tl. Great clinical value has been given to the determination of the free androgen index (FAI). When FAI values ​​decrease by 50%, the clinical manifestations of andropause are generally observed.

Dihydrotestosterone (DHT) is a metabolic product of testosterone. It contributes to the development of benign prostatic hyperplasia. DHT is produced in the brain, skin and adrenal glands. It is the most abundant steroid hormone in the body. As men age, DHT concentrations decrease. At 45 years of age, DHT production is half of what it was at 20.

Hormonal changes after maturity

Dihydroepiandrosterone (DHEA) also decreases with advancing age in men. Decreased levels of GH, insulin-like growth factor 1 (IGF-1), and melatonin are also affected.

Leptin levels (a hormone that controls hunger and satiety) are increased in men with hypogonadism. This could partly explain the changes found in body fat distribution.

Some researchers have hypothesized that increased adipose tissue, particularly abdominal adipose tissue, in older men is associated with increased activity of the aromatase enzyme. This converts T into estradiol (E2), resulting in decreased T levels and increased E2 levels.

Symptoms of depressive disorders

This whole complex cascade of biochemical events will lead us to a situation of decreased bioavailable hormone, with the subsequent psychological consequences, which if they become chronic can lead to or facilitate a mood disorder that may or may not be hidden, if some of the symptoms are clearly manifested.  The symptoms will be as follows:

• Dysphoric mood or loss of interest or pleasure in almost all usual activities.
• Sadness, hopelessness or apathy, lack of initiative and irritability.
• Decreased sexual motivation, loss of energy and fatigue.
• Feelings of worthlessness, self-reproach, or excessive or inappropriate guilt.
• Decreased ability to concentrate and indecision.
• There may be weight loss and poor appetite or increased appetite with weight gain.
• As for sleep, there may be insomnia or hypersomnia.
• In some patients, it will depend on their personality and tolerance to stress, traits of insecurity and feelings of guilt, the degree of environmental dependence and the way they relate socially. All these factors can act as a catalyst to trigger pathological sadness.

What should I do if I think I'm experiencing depression?

Generally The patient is reluctant to consult, for fear of being stigmatized, or thinking that their self-esteem will be further affected, all of which It leads to a vicious circle and everything gets worse, if it's not carefully diagnosed with a blood test.

It is also important to mention here that some medications, such as antihypertensives and some psychotropic drugs, can have effects on libido and sexual performance. This can worsen the problem if an adequate differential diagnosis is not made. If treatment with a medication is required, one should be selected that does not have this type of undesirable side effect.

Finally, we must highlight that the effects of male hormones are significant on mood, affectivity, entrepreneurship, sleep quality and mental processes in general.

Can it be confused with other diseases?

On Congress of the Andalusian Association of Urology (AAU), the President of the Spanish Association of Andrology and urologist at the Reina Sofía Hospital (Córdoba) has explained that patients with deficit of testosterone They may have a higher mortality rate than other men.

They also reported in Congress that on many occasions, a patient goes to his or her primary care physician with symptoms similar to those of depression, such as: mood swings, loss of libido/sexual desire, desire to cry... and is automatically prescribed antidepressants. For this reason, Dr. Rafael Prieto has warned that the primary care physician, "You should be alert to this type of symptoms because they are not always depressions.", given that "There are several diseases that share these symptoms and require other treatments.", like the testosterone deficiency, a disease that is still rarely diagnosed.

Prieto assures that if the testosterone deficiency If not diagnosed, it can be a problem, because men with low testosterone have a higher mortality rate.Much higher because this disease is related to metabolic disorders, diabetes, hypertension and obesity.«.

The President of the Spanish Association of Andrology also referred to a study that was published in New England Journal of Medicine A few years ago, a study revealed very striking figures regarding the survival of patients with testosterone deficiency.

From the age of 40, testosterone levels in blood begin to decrease, although in some cases, this process accelerates and begins earlier. So when you start to feel its symptoms: fatigue, irritability, mood swings, insomnia, lack of libido, loss of muscle mass... ask for complete tests to check your testosterone level in blood before you are given a wrong diagnosis, and therefore an incorrect treatment. We recommend you read: low testosterone symptoms.

What to do in case of hormonal deficiency?

In case of deficit, we have as our main tool, the TRT. This treatment is generally harmless and there is no point in postponing its use when the case warrants it.

As you see, the andropause and depression have an important relationship to take into account. If you think you could be affected by either of these two conditions, don't think twice: APPOINTMENT.