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Jamaican men are quietly slipping into a midlife health crisis, one that robs them of vitality, focus, and even sexual function.

For many, the first sign is something they're reluctant to admit - no erections.

"They don't see any erections at all, and they say, 'Wow, this is just strange,'" said urologist Dr Elon Thompson. "Some men may just say they're getting older, and this is just one of the effects of life. Some men may not be sexually active at all, and they just overlook it and think it's nothing." But the real issue, he said, might be something few men have even heard of - andropause, sometimes called male menopause.

"Essentially, it is a decrease in men's testosterone levels, which is related to the increase in age," Thompson said.

He noted that similar to menopause in women, andropause doesn't happen at the same age for every man. Symptoms typically start showing up in a man's late 40s to early 50s, but the condition remains poorly understood and even more poorly addressed, both by patients and some doctors.

"When testosterone levels are low, there are various things that can happen outside of sexual problems. Reduced erection, reduced libido, which is the urge for sex, those are the things that can happen."

"It [also] comes with mood swings and depression and headaches, low energy, lack of focus, muscle loss ... insomnia and weight gain, and in some cases osteopenia (lower than normal bone mineral density)," he said. Though often misunderstood as a sexual disorder, andropause is a hormonal shift that affects the entire body.

"Testosterones are what develop male characteristics and be attracted to the opposite sex. It helps with erection. It helps with all cognitive functions. Testosterone does increase your muscle mass, erectile function, your energy, and your focus," he said. Instead of seeing a doctor, however, many Jamaican men turn to what's familiar.

"They seek advice from friends, or try remedies: the rum, the Boom, the Guinness, blended oats, Supligen and Dragon. They may try black market drugs."

He called on health professionals to sharpen their awareness and screening for the condition. One potential treatment is testosterone replacement therapy, which, he says, can help "for the appropriate patient".

But Thompson pointed to a larger issue - that men's health, especially hormonal and sexual aspects, is rarely prioritised in Jamaica.

"Women and children tend to get a lot more attention when it comes to various conditions," he said.

"It's just a fact, compounded by the fact that men have worse health-seeking behaviour than women," he said. "We have to encourage our women to encourage men to push health when they are experiencing these problems, but it cannot only be the responsibility of the men."