Testosterone is more than just a sex hormone. Its role goes beyond giving pubescent boys growth spurts, and its effects on the male body are lifelong. But talk of a male menopause, marked by reduced testosterone from middle age, is often met with controversy.

Here are a few things you might not know about men and testosterone:

Testosterone plays a part in maintaining muscle mass, physical energy and mental alertness, as well as libido and sexual stimulation . Since these characteristics are associated with youth, it's no surprise that men produce gradually less testosterone as they age. The rate of decline varies, but levels typically drop by around 20 to 50 per cent between early adulthood when they are at their peak and when a man reaches his 80s .

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The medical term for low testosterone in men is 'male hypogonadism'. It can be caused by problems with the testicles, for example resulting from infection, chemotherapy, certain autoimmune conditions and some tumours.

It can also signal a condition affecting the pituitary gland, which sits at the bottom of the brain stem. If the function of the pituitary gland becomes impaired through a head injury, tumour or using anabolic steroids, for example it has a knock-on effect on certain hormones, which in turn means the testicles don't make as much testosterone.

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Professor Mike Kirby, a GP and visiting professor to the Prostate Centre, says that as they get older, men develop more long-term conditions "such as diabetes, metabolic syndrome and cardiovascular disease and all those things impact on testosterone levels".

Being overweight or obese, also more common in older than in younger men, is also linked with hypogonadism.

So, although it's normal for testosterone levels to fall a certain amount as men get older, the ageing process itself doesn't ordinarily cause testosterone to dip beneath the lower end of normal range. Other health problems are responsible for almost all cases of reduced testosterone in older men, and that, says consultant endocrinologist Dr Richard Quinton, negates the concept of a male menopause. He says:

"For a tiny minority, there is a slightly similar phenomenon to the female menopause, but it's mild and partial rather than complete and absolute."

When a man's testosterone levels are low, he'll often get quite vague symptoms. As well as a change in the sex department loss of libido and erectile dysfunction he might experience difficulty concentrating, insomnia, mood disturbances, weight gain and loss of muscle bulk.

These signs are all-too-easy to ignore, but Dr John Chisholm CBE, a GP and chair of the Men's Health Forum, urges men to get them checked:

"Erectile dysfunction in particular should be looked into because it can be a symptom of serious underlying disease."

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Low testosterone levels can be confirmed by a blood test, and the standard treatment is testosterone replacement by way of a tablet, patch, gel, implant or injection . Evidence suggests that with regular monitoring, testosterone treatment is safe, effective and relatively free of side effects when it's prescribed appropriately .

The problem is that experts disagree about who should be prescribed testosterone. Professor Kirby argues that men with the lowest levels of testosterone level will "almost certainly benefit from treatment regardless of the cause" and that in men whose levels are at the lower end of normal, "it may well be worth addressing the cause first, but some would still benefit from testosterone treatment".

But others, including Dr Quinton, dispute this. He supports treatment only in men who are "genuinely hypogonadal" in other words, those who have consistently low testosterone but aren't obese and have no underlying illness.

"Giving testosterone to men who are either normal, or just have hypogonadism due to chronic ill health including obesity cannot be justified on the basis of available safety and efficacy data."

As well as restoring testosterone levels, testosterone treatment slows the production of certain hormones, switching off sperm production in the testicles. Alternative hormone treatments can work for younger men and those who want to maintain their fertility.

The clear message is that if you're worried about anything, talk to your doctor. The chances are symptoms are nothing to worry about and any problems can be easily rectified

"We'd also recommend they seek help if they're experiencing mental health disturbance. It's better to talk than to avoid issues and conceal symptoms."

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8 things you need to know about testosterone and 'the male menopause' - Netdoctor

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