A.D.A.M., or Androgen Deficiency in the Ageing Male, has been equated to the male version of menopause. However, there are quite a few differences between A.D.A.M. and menopause. For example, menopause is often sudden, typically within the first 12 months after the end of ovulation and an almost immediate drop in estrogen after perimenopause, where estrogen loss is more gradual. Whereas A.D.A.M. is a more gradual reduction of testosterone over time due to an imbalance in the hypothalamic-pituitary-testicular axis, the part of the brain and related system that regulates male reproductive function.

Generally speaking, testosterone levels in males fall about 1% every year after 40, an incidence which is also known as late-onset hypogonadism. However, most men still have normal testosterone levels for their age. In the case of A.D.A.M., only around 10-25% of men have testosterone that’s considered low. Other factors that may cause low testosterone besides age are obesity, obstructive sleep apnea, stress from serious injury or surgery, and some medications.

Although they are different, A.D.A.M. may reflect some common symptoms of menopause. This can include hot flashes due to changes in the circulatory system, changes in mood and mental function, sexual dysfunction or diminished sexual function, and changes in metabolism. Men may also experience changes in energy and muscle strength, and with their physical appearance (such as weight gain, loss of height, loss of hair, etc.). Some men may feel depressed or experience more sleep disturbances.

In terms of sexual health and functioning, A.D.A.M. can cause problems with libido (sexual desire), erectile dysfunction (ED), which is the inability to sustain an erection long enough for satisfactory sex, and some ejaculatory disorders. However, these sexual function issues are not always directly related to low testosterone levels. They may instead be related to other symptoms of A.D.A.M. such as sleep issues, lack of exercise due to muscle weakness, or depression. Sexual dysfunction can also be caused by external factors such as poor diet, smoking, and the overconsumption of alcohol.

Suggested treatments for A.D.A.M. include testosterone replacement therapy or ED medications. Testosterone replacement therapy is recommended for men who wish to improve sexual function, or those with symptoms related to low testosterone. However, there are risks associated, such as blood clots, and potentially an increased risk of prostate or breast cancer. Always speak with a healthcare provider before starting a new treatment or medication. For testosterone deficiencies caused by an outside factor, behavioral or lifestyle changes may be suggested. These may include diet, quitting smoking, less frequent alcohol consumption, and exercise.

Conclusion

A.D.A.M. is a condition in which males’ natural testosterone levels are far below what’s considered normal for individuals over 40. This and other similar conditions are a part of the umbrella term “andropause.” Typically, testosterone-related conditions will be tested via blood work, and it may be suggested that patients make some lifestyle changes prior to being recommended testosterone replacement therapy. If you are experiencing any symptoms related to A.D.A.M. or andropause, it’s important to speak with a healthcare provider.

References:

• Male menopause (androgen deficiency in the ageing male). The British Association of Urological Surgeons Limited. (n.d.). https://www.baus.org.uk/patients/conditions/7/male_menopause_androgen_deficiency_in_the_ageing_male  
• Mayo Foundation for Medical Education and Research. (2025, March 26). Understanding aging and testosterone. Mayo Clinic. https://www.mayoclinic.org/healthy-lifestyle/mens-health/in-depth/male-menopause/art-20048056 
• Nandy, P., Singh, D., Madhusoodanan, P., & Sandhu, A. (2008). Male andropause : A myth or Reality. Medical Journal Armed Forces India, 64(3), 244–249. https://doi.org/10.1016/s0377-1237(08)80105-0
• NHS. (2022, October 13). The “male menopause.” NHS choices. https://www.nhs.uk/conditions/male-menopause/