Ageing male syndrome, andropause, androgen decline or mid-life crisis?

Reports of a “male menopause” have been appearing in the literature since the 1930s [1] [2] . The Heller and Myers paper of 1944 was seen by some as a ’landmark paper where symptoms of age-related low testosterone were shown to be reversed by testosterone replacement, but not by placebo [3] . The “male menopause” has been referred to as the andropause, viropause and the male climacteric [1] [4] [5] [6] . The topic is one referred to little in mainstream medical journals. The recent British Medical Journal themed issue, “Men’s Health” [7] made no mention of the subject. It might also be asked if the symptoms are more consistent with a possible mid-life crisis, an “I Don’t Know syndrome”? [4] or the “irritable male syndrome” [8] . The word, climacteric, (from the Greek Klimacter, meaning the rung of a ladder), is a more useful term than menopause, as it suggests a gradual rather than a precipitous fall in hormone levels as occurs in a female.