The Silent Shift: Understanding the Male Menopause
- Dr. Nazanin Safaei, ND, MS
- Jun 27
- 3 min read
In recent years, there has been growing awareness of a condition that affects men as they age—andropause, often referred to as the “male menopause.” While it’s not as widely discussed as menopause in women, andropause can have a significant impact on a man’s health, well-being, and quality of life.
What Is Andropause?
Andropause refers to a gradual decline in testosterone levels in men, typically beginning in the late 40s or early 50s. Unlike the sudden hormonal changes in female menopause, andropause occurs more slowly, often over several years. The medical term for this condition is late-onset hypogonadism or age-related testosterone deficiency.
Common Symptoms of Andropause
Men experiencing andropause may notice physical, emotional, and mental changes, including:
Low energy or fatigue
Decreased libido or erectile dysfunction
Mood swings or irritability
Loss of muscle mass and strength
Increased body fat, especially around the abdomen
Difficulty concentrating or memory lapses
Sleep disturbances
Reduced motivation or confidence
These symptoms can vary widely in intensity and may be mistaken for natural aging or stress.
What Causes Andropause?
The primary driver of andropause is the gradual decline in testosterone production. Testosterone levels in men typically peak in their late teens and early twenties and decrease by about 1% per year after the age of 30–40. Other contributing factors may include:
Chronic stress
Poor diet
Lack of exercise
Obesity
Diabetes or metabolic syndrome
Certain medications (e.g., opioids, steroids)
Diagnosis of Andropause
A proper diagnosis involves a combination of clinical evaluation and laboratory testing, including:
Total and free testosterone levels (measured in the morning)
Luteinizing hormone (LH) and follicle-stimulating hormone (FSH)
Comprehensive metabolic panel
Screening for other potential causes of symptoms and low testosterone
It's essential to work with a licensed healthcare provider to rule out other conditions and confirm a testosterone deficiency.
Common Treatment Options for Andropause
If andropause is diagnosed, treatment options may include:
Testosterone Replacement Therapy (TRT) – prescribed when testosterone levels are consistently low and symptoms are significant.
Lifestyle Changes – diet, regular exercise, stress reduction, and sleep optimization can naturally support testosterone levels.
Nutritional Support – key nutrients play a role in hormone balance.
Psychological Support – counseling or therapy may help men cope with mood changes and emotional symptoms.
Is Andropause Inevitable?
Not all men experience significant symptoms of andropause, and many maintain adequate testosterone levels into old age. Genetics, lifestyle, and overall health play a big role in determining how (or if) andropause affects you.
Takeaway
Andropause is a real and often underrecognized condition that affects many men as they age. Understanding the signs and exploring both medical and lifestyle-based treatment options can lead to better health, improved energy, and a greater sense of well-being.
Disclaimer: The information provided in this article is for informational and educational purposes only and is not intended as medical advice, diagnosis, or treatment. Always consult with a qualified healthcare provider before making changes to your diet, lifestyle, or health care regimen.
References
Bhasin S, Cunningham GR, Hayes FJ, et al. Testosterone Therapy in Men With Hypogonadism: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2018;103(5):1715-1744. doi:10.1210/jc.2018-00229
Wu FCW, Tajar A, Beynon JM, et al. Identification of Late-Onset Hypogonadism in Middle-Aged and Elderly Men. N Engl J Med. 2010;363(2):123-135. doi:10.1056/NEJMoa0911101
Snyder PJ, Bhasin S, Cunningham GR, et al. Effects of Testosterone Treatment in Older Men. N Engl J Med. 2016;374(7):611-624. doi:10.1056/NEJMoa1506119
Handelsman DJ. Global Trends in Testosterone Prescribing, 2000–2011: Expanding the Spectrum of Prescription Drug Misuse. Med J Aust. 2013;199(8):548-551. doi:10.5694/mja13.10166
Basaria S. Male hypogonadism. Lancet. 2014;383(9924):1250-1263. doi:10.1016/S0140-6736(13)61126-5
©2025 by Nazanin Safaei, ND, MS
