What Is Late-Onset Hypogonadism?

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Hypogonadism is a syndrome that causes the body to produce insufficient sex hormones. There are several types of hypogonadism, one of them being late-onset hypogonadism (LOH). LOH occurs later on in someone's life.

LOH is also sometimes known as "male menopause" or "andropause" because it often occurs around the same age that women experience menopause.

Late-onset hypogonadism can cause a variety of symptoms like low sex drive, erectile dysfunction, depression, fatigue, reduced bone density, and more.

LOH is both under-diagnosed and under-treated because there is controversy surrounding LOH diagnosis within the medical community. There are no clear guidelines as to what range defines low testosterone in older men specifically.

This article will explain more about the symptoms, causes, and diagnosis of late-onset hypogonadism, as well as tips for coping with this condition and other potential causes of your symptoms.

older man on the beach

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What Is Hypogonadism?

To understand what late-onset hypogonadism is, it is first important to understand what hypogonadism is in general.

Hypogonadism refers to a group of syndromes that are marked by the body's inability to produce a sufficient amount of sex hormones. In men, the sex hormone is testosterone (androgen). In women, the primary sex hormone is estrogen.

Testosterone is important for many bodily functions and processes in men, and this hormone decreases by approximately 1% per year starting at age 30. Some examples include:

Late-onset hypogonadism is a type of hypogonadism that only occurs later in a man's life, usually within the late 40s and early 50s.

Late-Onset Hypogonadism Symptoms

There are instances in which late-onset hypogonadism appears with no symptoms at all. That said, if it does appear symptomatically, someone with late-onset hypogonadism may experience the following:

Causes

In the case of LOH, it is the result of a testosterone deficiency that only occurs in older men. There are three main reasons why older men experience changes in their testosterone levels:

  • The aging process
  • Deterioration of hypothalamic-pituitary function
  • Reduced Leydig cell function in the testes

Testosterone can decline for a number of reasons other than those seen in hypogonadism. Lifestyle, psychological, and medical factors such as poor diet and exercise, mental health conditions, and certain medications may also contribute to abnormal testosterone levels.

Diagnosis

While there are a number of direct symptoms that may be the result of low testosterone, the only way to truly determine if someone's testosterone is depleted is through a total testosterone blood test.

Markers for what is considered "deficient" regarding testosterone have not been clearly defined for older men. This is due to a combination of reasons, one being that testosterone is known to dip with increasing age in general.

Because of this, there is some disagreement among researchers about what truly qualifies as LOH.

LOH & Controversy Surrounding Diagnosis

While LOH is common, it often goes underdiagnosed and undertreated because of the controversy in the medical community as to what exactly is low testosterone for older men.

Treatment

LOH is primarily treated through testosterone replacement therapy. Testosterone replacement therapy (TRT) can be administered via patches, topical gels, injections, oral medications, and nasal sprays.

Coping

There are many strategies someone can use to cope with hypogonadism of any type. These include:

  • Attend talk therapy: Therapy can be beneficial for those dealing with LOH's emotional symptoms such as depression.
  • Eat a testosterone-friendly diet: This consists of healthy fats and proteins, as well as reducing salt and sugar intake.
  • Weight loss: Excess weight and obesity can make symptoms of hypogonadism worse, which is why losing excess weight can help restore hormonal balance and function.
  • Exercise regularly: The Centers for Disease Control and Prevention recommends, at minimum, adults get 150 minutes of light to moderate exercise weekly.Additionally, strength training is highly beneficial to boosting testosterone levels.
  • Quality sleep: Eight hours or more is recommended for adults.
  • Communicate with your partner: Being open and honest with your partner about what you're experiencing can make coping with low testosterone that much easier for both parties.

Summary

Late-onset hypogonadism, also known as male menopause, is a type of hypogonadism that only occurs in older men. It is caused by a testosterone deficiency.

There is controversy and disagreement within the medical community regarding LOH's diagnosis and treatment, specifically in regards to what is defined as low testosterone in older men.

A Word From Verywell

Late-onset hypogonadism can cause a variety of distressing symptoms, from fatigue to low sex drive to erectile dysfunction. These symptoms can affect someone's self-esteem as well as their relationships.

Talk to your healthcare provider if you or your loved one are experiencing symptoms of LOH. Despite diagnostic difficulties, if you are experiencing symptoms of low testosterone at an older age, do not ignore them. Instead, talk to your healthcare provider about your concerns because if these symptoms aren't the result of LOH, they could be a sign of another medical issue that requires attention.

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9 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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