Perceptions of and risk factors for andropause

There has been some controversy about whether males undergo andropause (male equivalent of a menopause). This study seeks to describe how older males perceive and understand this entity. It also explores the possibility of an association between the age of onset of andropause and risk factors such as ethnic origin, smoking, alcohol, hypertension, and cerebrovascular disease. A nonexperimental, cross-sectional study was conducted at the outpatient clinic at a Veterans Affairs Medical Center. Subjects were interviewed by a single investigator and answered a questionnaire consisting of 22 items, including information on patient demographics, patient understanding of andropause, patient understanding of possible interventions with hormonal therapy, medical and drug history, and social habits such as smoking and drinking. Altogether 302 male patients were recruited: 71% of the survey population were above the age of 60 years, and 87% were white, 6% Hispanic, and 5% black. Patient knowledge of andropause was lacking, though the majority (70%) expressed an interest in getting further knowledge. The most frequent age for onset of symptoms related to andropause was 51-60 years, and patients reported symptoms such as impotence, weakness, and memory loss. The next most common age associated with onset was 61-70 years. Multivariate regression analysis revealed that smoking more than 10 cigarettes a day was independently associated with an earlier onset of andropause symptoms bringing down the age of onset to below 50 years (p = .01, OR = 2.5, CI = 1.2-5.3). We found no association with risk factors such as ethnicity or alcohol. Andropause is experienced by many older males but knowledge of the entity is nonuniform. Smokers are at risk for an earlier onset of andropause. This is the first study to look at risk factors for andropause and the results are consistent with studies in females on smoking and menopause.