Low sex drive, low energy, and trouble sleeping. Sound familiar? If so, it could be a sign of andropause, also referred to as "male menopause”.
*All images feature a model portrayal
(unless otherwise noted).
Low sex drive, low energy, and trouble sleeping. Sound familiar? If so, it could be a sign of andropause, also referred to as "male menopause”. Andropause refers to the symptoms of low testosterone that develop as part of the aging process.
The word andropause has Greek origins, with “andro” referring to male and “pause” meaning stop.
Other names for andropause include:
Androgen deficiency in the aging male or ADAM
Late-onset hypogonadism
In women, menopause is the period when menstruation stops due to hormonal changes, including a significant drop in estrogen. In men, andropause is characterized by a slow decline in the hormone testosterone over many years.
If your testosterone levels dip below the normal range for adult males, you may develop symptoms that disrupt your daily life.
Effectively, all men will see a drop in their testosterone levels as they age unless they receive testosterone replacement therapy. This treatment involves taking a synthetic form of testosterone to replenish your natural supply of this important sex hormone.
Not all men will develop testosterone levels low enough to cause health problems. In fact, only about 20 percent of men over 65 have testosterone levels below the normal range for young men.
The normal range for testosterone in men measured with a blood sample can vary slightly between labs but is often considered between 300 and 1,000 ng/dL (nanograms per deciliter).
More testosterone isn’t always better. For some men, being at the bottom of the normal range might be sufficient to support optimal health, whereas other men might need to be near the high end.
Having testosterone levels higher than normal can also cause health problems such as prostate cancer, high blood pressure, and baldness. This is sometimes seen in men with tumors on certain glands.
Medically, low testosterone is known as hypogonadism. Not every man with low testosterone develops noticeable symptoms.
Symptoms of andropause are the same as the symptoms of testosterone deficiency from other causes. You may only have a few of these symptoms or many of them.
Typical symptoms include:
Physical Symptoms
Reduced muscle mass and strength
Increased body fat
Decreased bone density, which increases osteoporosis risk
Reduced energy levels and fatigue
Sexual Symptoms
Erectile dysfunction
Reduced sperm production and fertility issues
Other problems with sexual function
Psychological Symptoms
Mood swings and irritability
Cognitive decline, including memory loss and difficulty concentrating
Many of these symptoms have causes other than low testosterone levels. It’s important to see your healthcare provider if you’re concerned you may have a hormone imbalance for proper testing.
Andropause, by definition, is the age-related decline of testosterone. Testosterone levels naturally decline with age, even if you have healthy lifestyle habits.
Changes to your testosterone levels throughout your life occur due to factors such as changes to your testicle function in response to luteinizing hormone (LH). LH is a hormone produced by your pituitary gland that stimulates the release of testosterone.
In women, menopause generally occurs between the ages of 45 and 55. However, andropause is a more gradual process caused by small decreases in your testosterone levels over many years.
Testosterone loss generally starts around 35. The decline in total testosterone levels is roughly 1 percent per year, but the drop tends to be even greater for the form of testosterone your body can use called free testosterone. By age 75, testosterone levels are roughly half those of men in their 20s.
Your lifestyle habits and underlying medical conditions can also play a role in your testosterone levels, including how they change throughout your life.
It’s normal for your testosterone levels to decline with age. Many factors determine how much testosterone your body produces, including your lifestyle habits, your genetics, and any underlying medical conditions you may have.
Your genetics are out of your control, but taking care of your body with healthy habits can optimize your body’s capacity to produce testosterone.
Low testosterone levels are particularly common in people who have obesity. In fact, obesity is often considered the single greatest risk factor for low testosterone in men. Losing weight if you have obesity may help support your hormonal health.
Low testosterone also appears to be very common in men with type 2 diabetes.
Other factors that may increase your risk of low testosterone include:
Excessive alcohol consumption
Malnutrition
Some infections, like HIV
Certain medications, such as corticosteroids or opioids
Chronic stress
Previous misuse of anabolic steroids
Andropause doesn’t have a strict standard medical definition and isn’t a medical diagnosis itself. Some doctors diagnose andropause based on your testosterone levels measured with a blood test, whereas some may diagnose you based on the presence of symptoms of low testosterone.
Testosterone levels below the 2.5th percentile for adult males (meaning that you’re lower than 975 out of 1,000 adult men) have been suggested as a cut-off definition.
If your doctor suspects you have low testosterone levels based on the presence of symptoms likelow sex drive, they’ll likely perform initial tests such as the following:
Conduct a physical examination to assess your general health, muscle mass, and signs of hormonal deficiency.
Review your medical history to see if you have a personal or family history of risk factors such as chronic illness, medication use, or particular lifestyle habits.
Ask you about your symptoms to see if you have any characteristic signs of low testosterone, like low sex drive and fatigue.
If your doctor suspects you might have low testosterone levels after these initial tests, they might send you for a blood test to measure your hormone levels. A blood test can show how much testosterone is in your blood and look at levels of other hormones, such as luteinizing hormone, that can influence testosterone levels.
Your doctor may also refer you to a specialist in urology to help treat symptoms such as erectile dysfunction or an endocrine specialist if you need hormone treatment.
If your testosterone levels are low, you may need additional tests to monitor for complications. For example, you might need a bone scan if you are at high risk of osteoporosis.
The best way to manage andropause depends on the severity of your symptoms and whether you have any underlying health conditions. You can work together with your healthcare provider to figure out which treatments may be best for you.
If you don’t have any concerning problems, you might not require any treatment. However, if you do notice changes in your health, you may benefit from the following.
TRT may be an option for men with low testosterone levels. TRT is a type of hormone replacement therapy, or HRT for men, that involves taking a synthetic form of testosterone. It can be administered through:
Injections. Intramuscular testosterone injections given every few weeks.
Gels and patches. Applied to the skin for consistent absorption.
Pellet implants. Slow-releasing testosterone pellets placed under the skin.
Oral medications. Pills or tablets taken by mouth.
While TRT can be effective, it carries the potential risk of some side effects, including:
Increased risk of blood clots and cardiovascular issues
Suppression of natural testosterone production
Enlargement of the prostate
Mood swings and aggression
Your healthcare provider can share more information about the potential benefits and risks of hormone therapy.
Andropause can affect mood and mental well-being. Psychological support may be helpful for many people. Men experiencing depression, anxiety, or cognitive decline may benefit from:
Counseling and therapy. Cognitive behavioral therapy (CBT) can help manage mood changes and anxiety.
Support groups: Connecting with others facing similar challenges can provide emotional relief.
Relationship counseling: Addressing intimacy issues with a partner can improve relationships and sexual health.
Some men prefer natural approaches for increasing their testosterone levels. However, there are few supplements or remedies proven to be safe and effective at increasing testosterone levels. Many products marketed as “testosterone boosters” contain ingredients that have no or little research to back their use.
It’s also important to be cautious when using supplements because they aren’t regulated by the FDA as strictly as prescription medications. This can result in contamination and mislabeling.
The following are some of the most common supplements used to increase testosterone levels.
Vitamin D and zinc. Vitamin D and zinc are essential nutrients for testosterone production. In a 2019 study in the Journal of Sexual Medicine, researchers found vitamin D and zinc supplementation improved erection quality in men ages 54 to 84 who had a vitamin D deficiency.
Ashwagandha. Some research suggests this herbal remedy helps the body manage stress and supports testosterone levels. More studies are needed to assess ashwagandha’s long-term effectiveness and safety.
Fenugreek. This plant may provide a small benefit for testosterone levels, but more research is needed.
Unfortunately, there’s no way to undo the aging process. Your genetics play a large role in determining how your testosterone levels will change as you age. What you can do is support your health as you age to reduce the number of factors that may contribute to suppressed testosterone levels.
Some lifestyle habits you can adopt include:
Eating a balanced diet filled with plenty of fruits, vegetables, and whole foods
Exercising regularly
Minimizing stress in your life
Getting adequate sleep
Achieving or maintaining a healthy weight
Decreasing your alcohol intake
You may also want to talk to your doctor about whether TRT may be a good treatment option for you.
Want to learn more about increasing your testosterone levels? Read our guide.
Hims & Hers has strict sourcing guidelines to ensure our content is accurate and current. We rely on peer-reviewed studies, academic research institutions, and medical associations. We strive to use primary sources and refrain from using tertiary references. See a mistake? Let us know at blog@forhims.com!