<unk>  may or may not actually exist as a clinical phenomenon. Its proponents claim it is a biological change experienced by men during their mid-life, and is often inaccurately compared to the female menopause. It would perhaps be more reasonable to speak of a steady age-related decline in testosterone levels in men, since men's reproductive systems slowly and gradually decline with age, but do not stop working altogether in mid-life, as women's do. It is also not clear how much this supposedly universal male phenomenon can be related to a psychological mid-life crisis, and to overall negative bodily changes in mid-life due not only to aging, but also to the accumulated effects of a lack of exercise, poor diet and so on.<unk>  is also known as androgen decline in the aging male (ADAM), late onset hypogonadism (LOH) and testosterone deficiency syndrome (TDS). There is no cut off age at which<unk>  starts as there is variability among men in terms of age of onset.
Endocrine Society Guideline and the European Association of Urology Recommendations defines<unk>  as the following: TDS/LOH is a clinical and biochemical syndrome associated with advancing age and characterized by symptoms and a deficiency in serum testosterone levels. It may result in significant detriment in the quality of life and adversely affect the function of multiple organ systems.
Andropause
Dyspareunia
Penis pain
Hyperesthesia
Dysuria
Delayed ejaculation
Testicular pain
Urinary hesitancy