I have noticed that older men tend to be closer to their family and are more interested in domestic issues than when they were younger. It is as if the lack of testosterone makes them more "feminine". They take on more homely roles of cooking, cleaning and looking after children. More often than not, they devote much more time and attention to their grandchildren than they had previously to their own children when they were parents themselves. Perhaps it is because they have more time during the andropausal years as they have probably retired by then. They usually also have more disposable income, having saved most of their lives, and are more willing to enjoy little pleasures around them, stopping to smell the roses. Their emotions become less "fiery" and take on a gentler aspect, so in a sense, the decline of testosterone enhances domestication skills.

In the andropausal years the mind becomes less sharp and nimble. The older male becomes less swift in mental calculations and his judgment is not as accurate as before. Perhaps he used to make razor-sharp business deals, but now he makes blatant mistakes and incurs painful financial losses. Oftentimes, he attributes it to aging, but in truth it may be partly due to the decline of testosterone. In more severe cases, the memory gets impaired too, and with time, dementia may even set in.

Although once willing to take risks of all sorts, the andropausal man becomes more conservative and fears treading in unclear waters. They no longer participate in roller coasters and bungee jumping, but rather watch these on TV instead. Most loose courage to take on new ventures and feel it is a time to retire and to "take it easy". However, fear and courage take on a different perspective in the andropausal years, especially in the older age group of the eighties and nineties. A study on fear was done whereby two groups of people were asked what they feared most. The younger group in the twenties said "death", but death was not what the eighty year olds feared most. It was their loss of independence. It is almost as if the elderly chide, "Death, where is thy sting?"

Productivity is at the core of a man's being. He feels happy when he creates something and is being noticed for it. He wants to feel contributory to his family and society. All his life he struggles to be the breadwinner for the family, and to get recognition at work for his efforts. In the days of early man, hunting and providing for his family and society was at the hub of function. For modern man, there may not be a need for barbaric hunting, but the board room still makes the same demands on his skills and abilities, and managing those complex business deals is akin to modern hunting. Andropause is a time of decline, when he is no longer as productive as he was before. Often he makes even less money than when he was younger, and feels threatened by younger more aggressive males biting into his turf. A man's personality may not stay the same over the years of his life. In younger days the fiery younger male is impulsive, intolerant and ambitious. With the passage of time, various experiences and the fall in testosterone, quite a different male may emerge in later years. The red hot male often converts to a mellow yellow version, becoming more "feminine" and "domesticated", and taking on less challenges in the outside world, often preferring the cozy security of family and close friends. He is much less active, prefers his couch to watch television, and becomes weaker from lack of exercise. Deep inside every man is the desire to remain young and be that little boy that he once was. This may become more marked after retirement as usually there is more spare time at hand. The andropausal man may relive his childhood days, often to the amazement of his partner or spouse! The mischief may be an extramarital affair, a new red sports car, a sudden passion for toy train sets, riding a bicycle, which he hadn't done for years, and so on. Sometimes of these childish acts may even be mistaken for Alzheimer's dementia!

Cognitive Challenges in the Andropause
In my research, I found that the third most common reported symptom of Andropause was memory loss. It is not uncommon for patients who undergo the Andropause to report misplacing a key or forgotten important details. Often the memory loss is so minor it does not affect everyday functioning. This memory loss has sometimes been referred to as "age related memory loss" and is not as severe as Alzheimer's disease, (which is accompanied by loss of functioning). Memory loss in the andropausal years has been a research interest of mine. In my clinical studies, I have replaced testosterone in demented hypogonadic men (those low on testosterone) and have demonstrated improvements in their visual-spatial cognitive abilities. Although the study results have been presented at several scientific meetings, more research is needed before recommending testosterone as a possible treatment of certain dementia. Another researcher in Oregon has found similar results and he demonstrated improving cognitive functions with testosterone even in normal older men who did not have hypogonadism.

The Andropause is beginning to be accepted as part of aging. Coping strategies are important. Hormonal therapy for the symptomatic is available today but has to be carefully supervised by a physician.

Robert S. Tan, MD is an internationally recognized Geriatrician who has an interest in Aging Andrology. He teaches at the University of Texas, Houston and is also author of the book: "The Andropause Mystery: unraveling truths about the Male Menopause". More information on purchase of the book can be obtained by calling 1-800-2476553 or by visiting Amazon.com or BN.com

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