The Ageing Male
Androgen Deficiency in Ageing Men (ADAM) / Andropause
What is Andropause (ADAM)?
As men age, their bodies undergo gradual hormonal changes, particularly a decline in testosterone levels. This process, known as Androgen Deficiency in Ageing Men (ADAM) or andropause, affects many aspects of men’s health, sexual function and overall well-being.
Unlike menopause, which occurs suddenly in women, testosterone levels decline gradually, typically starting in a man’s 30s or 40s, at a rate of around 1% per year. For some men, this process is subtle, but for others, it can lead to significant physical, emotional, and sexual changes that impact their quality of life.
ADAM is often overlooked or misattributed to “just getting older.” However, testosterone plays a critical role in energy levels, sexual function, mental clarity, and physical health. Low levels can lead to fatigue, reduced libido, difficulty maintaining erections, weight gain, and loss of muscle mass—all of which can have a profound effect on confidence, relationships, and overall health.
The good news? There are effective treatments available that can help restore balance and improve quality of life.
How ADAM Affects Men’s Health, Sexual Health & Urological Function
Testosterone is essential for more than just sex drive—it plays a role in cardiovascular health, penile health, bone density, metabolism, and even mood regulation.
Low testosterone can intersect with various aspects of men’s health, sexual health, and urology, leading to:
1. Erectile Dysfunction & Sexual Health Challenges
Low testosterone doesn’t directly cause ED, but it makes it harder to achieve and maintain an erection because of its crucial role in sexual arousal and regulation of erectile tissue response to nitric oxide (essential for blood flow to the penis).
Men with ADAM often experience reduced morning erections, weaker erections, or difficulty sustaining them.
Loss of libido (sex drive) is one of the most common complaints in men with low testosterone.
2. Prostate & Urinary Health
While testosterone is essential for prostate function, its relationship with urinary symptoms, BPH (benign prostatic hyperplasia), and prostate cancer risk remains complex and not fully understood.
Urinary function is influenced by multiple factors, including age, prostate size, metabolic health, and hormone levels. Men experiencing urinary symptoms should undergo a comprehensive assessment rather than assuming testosterone levels are the sole cause.
ADAM and BPH often coexist in ageing men, as both conditions can impact urinary function. While BPH results from prostate enlargement, some evidence suggests that men with lower testosterone may experience more severe urinary symptoms.
Testosterone replacement therapy (TRT) may improve lower urinary tract symptoms (LUTS) in some men, but effects vary based on individual health factors.
If you're experiencing persistent urinary symptoms, a thorough evaluation is recommended to determine the best treatment approach.
3. Cardiovascular & Metabolic Health
Low testosterone is linked to an increased risk of heart disease.
It plays a role in maintaining healthy cholesterol levels and blood vessel function.
Testosterone helps regulate insulin sensitivity, meaning men with low testosterone are at a higher risk of developing type 2 diabetes and metabolic syndrome.
4. Mental Health & Cognitive Function
ADAM can lead to brain fog, difficulty concentrating, memory issues, and irritability.
Many men with low testosterone feel unmotivated or emotionally flat, affecting their productivity and relationships.
There is a strong link between low testosterone and depression, especially in ageing men.
5. Muscle, Bone & Body Composition
Testosterone is crucial for muscle strength, bone density, and metabolism.
Men with ADAM experience muscle loss, increased body fat (especially around the abdomen), and weaker bones, increasing the risk of osteoporosis and fractures.
A decrease in energy levels often makes exercise and weight management harder, creating a cycle of declining fitness.
Symptoms of ADAM / Andropause
The symptoms of testosterone deficiency can vary in severity. Some men notice only mild changes, while others struggle significantly with fatigue, low sex drive, and mood shifts.
Physical Symptoms:
✔ Persistent fatigue / low energy
✔ Loss of muscle mass & increased belly fat
✔ Weaker bones (higher fracture risk)
✔ Hot flushes or excessive sweating
✔ Reduced endurance & slower recovery from exercise
Sexual Symptoms:
✔ Reduced libido (low sex drive)
✔ Weaker or less frequent erections
✔ Loss of morning erections
✔ Decreased orgasm intensity
✔ Decreased penile sensitivity
Mental & Emotional Symptoms:
✔ Depression or low mood
✔ Irritability or increased stress levels
✔ Brain fog / difficulty concentrating
✔ Lack of motivation or drive
Many men assume these symptoms are just part of ageing, but testosterone deficiency is treatable, and early intervention can significantly improve quality of life.
What causes Andropause?
Testosterone levels naturally decline with age, but some men experience a faster or more significant drop due to underlying health conditions or lifestyle factors.
Common causes include:
✔ Ageing: Testosterone levels decline by about 1% per year after the age of 30-40.
✔ Obesity & Poor Metabolic Health: Excess fat, especially around the belly, leads to higher estrogen levels and lower testosterone production.
✔ Chronic Illnesses: Conditions like diabetes, high blood pressure, and sleep apnoea can worsen testosterone deficiency.
✔ Stress & Poor Sleep: High cortisol levels (the stress hormone) and sleep disturbances interfere with testosterone production.
✔ Medications & Lifestyle Factors: Long-term use of opioids, steroids, excessive alcohol, or drug use can contribute to low testosterone.
Understanding the cause is key to finding the right treatment.
How is Andropause treated?
The best treatment depends on your symptoms, overall health, and personal goals. Treatment may involve a combination of lifestyle changes, hormone therapy, and targeted medical support.
1. Lifestyle & Natural Approaches
✔ Weight loss & exercise: Losing excess weight and engaging in resistance training (lifting weights) naturally boosts testosterone.
✔ Better sleep: Restoring 7-9 hours of quality sleep per night improves hormone balance.
✔ Reducing stress: Managing stress through meditation, relaxation techniques, and reducing workloadhelps regulate testosterone production.
✔ Improved diet: Eating protein-rich foods, healthy fats, and reducing sugar intake can support testosterone levels.
2. Testosterone Replacement Therapy (TRT) (When Medically Indicated)
For men with clinically low testosterone and significant symptoms, testosterone replacement therapy (TRT) can be life-changing.
Options include:
Gels & Creams: Absorbed through the skin, applied daily.
Injections: Longer-acting, given every few weeks for steady testosterone levels.
Implants: Slow-release formulations for consistent hormone delivery.
⚠️ TRT is only prescribed after thorough testing and evaluation, as it is not suitable for all men. Dr. Ross will assess your symptoms, medical history, and bloodwork before determining if testosterone therapy is right for you. Referral to an endocrinologist may be required in select cases.
When should I see a doctor?
Many men ignore the signs of low testosterone, assuming they’re just part of ageing. However, if symptoms are affecting your energy, mood, confidence, or sex life, it’s time to seek help.
Book a consultation with Dr. Ross if you are experiencing:
✔ Persistent fatigue and low energy
✔ Low libido or changes in erectile function
✔ Unexplained weight gain or muscle loss
✔ Mood changes, anxiety, or depression
✔ Difficulty concentrating or ‘brain fog’
It’s time to get your testosterone levels checked.
Ask Dr Ross.
If you are not ready to make an appointment, but would like to ask a question or get some more information, we are here for you.
BOOK A CONSULTATION WITH DR ROSS
If you feel like you’ve lost your energy, drive, or sexual confidence, you don’t have to accept it as part of ageing.
✔ Comprehensive hormone evaluation
✔ Personalised treatment options
✔ Expert care to restore your well-being
Book an appointment today and start feeling like yourself again