Male menopause: is it a real clinical syndrome?

The association between aging-related testosterone deficiency and late-onset clinical hypogonadism in men remains a controversial concept. Several descriptive names, such as andropause, male menopause, partial androgen deficiency of the aging male and late-onset hypogonadism, have been suggested in an attempt to connect the age-related decline in androgen production and symptoms of aging in men. However, despite many studies, no clear correlation has been established and, as a result, there is also a debate over the use of androgen replacement therapy in this clinical set-up. Nevertheless, new data from large-scale studies have been recently published, which shed more light on this complicated issue. A recent New England Journal of Medicine article demonstrated that only a minor fraction (2%) of elderly men suffer from this clinical syndrome and gave serum testosterone level thresholds that support it.