Is 'male menopause' real?

What is ‘male menopause’?

Conversations around female menopause are growing, and awareness is reaching levels we haven’t seen before. While there’s still a long way to go, progress is being made. But as we continue to improve our understanding of women’s hormonal health, should we also pay attention to how men’s hormones change with age?

Dr Mohammad Bakhtiar, Clinical Lead at Medical Express Clinic, explains that ‘male menopause’ - sometimes called 'andropause' - is not a recognised medical diagnosis. Instead, it’s a popular term used to describe symptoms some men experience in midlife. However, it can give the misleading impression that men go through a hormonal transition equivalent to women’s menopause.

“Women’s menopause marks the end of menstrual periods as ovarian function declines,” he says. “Men do not go through an equivalent transition, and testosterone does not usually fall abruptly at a particular age.”

That said, Bakhtiar emphasises that symptoms commonly associated with ‘male menopause’ shouldn’t be dismissed. They may be a sign of testosterone deficiency or another underlying health condition, which could benefit from medical assessment and treatment.

Dr Mohammad Bakhtiar

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What are the symptoms of ‘male menopause’?

While women experience changes in oestrogen, progesterone, and testosterone levels during perimenopause and menopause, men tend to see a more gradual decline in testosterone. This can begin in their thirties or forties.

Bakhtiar notes that this pattern varies considerably from person to person and can be influenced by several factors, including age, body weight, and overall health. Many older men may continue to maintain normal testosterone levels.

There is no specific age at which every man develops symptoms of testosterone deficiency. However, Bakhtiar highlights several common signs that may indicate low testosterone.

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• Reduced sex drive and fewer spontaneous or morning erections.

• Reduced muscle mass or strength.

• Increased body fat.

• Tiredness, low mood, and difficulty concentrating - although these symptoms can also have other causes.

Unlike women’s menopause, there is no defined period of ‘male menopause’ that lasts a set number of years.

“How long symptoms last depends on their cause,” Dr Bakhtiar explains. “Persistent testosterone deficiency may require ongoing care.”

What is late-onset hypogonadism?

Hypogonadism occurs when the communication between your brain and your ovaries or testicles is disrupted, affecting the production of sex hormones. This can lead to the testicles producing less testosterone or the ovaries producing less oestrogen.

The condition is often present from birth, but it can also develop later in life. When it develops in men as they get older, it may be referred to as late-onset hypogonadism (LOH).

Hypogonadism can cause a range of symptoms in both men and women. In men, these can overlap with symptoms commonly associated with low testosterone.

“LOH is one possible explanation for symptoms attributed to the ‘male menopause’, but it is not an inevitable part of getting older,” says Bakhtiar. “It is more common with increasing age, obesity, type 2 diabetes, and poor general health.”

Your doctor will usually start by asking about your medical history and symptoms, followed by a physical examination. If they suspect LOH, they’ll arrange blood tests to check your testosterone levels. However, low testosterone on its own isn’t enough to confirm a diagnosis. You’ll also need to have symptoms of LOH and consistently low testosterone levels confirmed by blood tests.

How is low testosterone treated?

Treatment for low testosterone depends on what’s causing it, your overall health, and whether you’re planning to have children.

Making a few lifestyle changes can also help support your general and sexual health. Staying active, getting enough sleep, eating a balanced diet, and cutting back on alcohol if you drink too much can all make a difference.

“In men with obesity, losing weight may help improve testosterone levels,” he says. “Underlying conditions such as depression or sleep apnoea should also be treated, and any possible effects of medication should be reviewed. Erectile issues may need treatment in their own right, too.”

If you have symptoms alongside consistently low testosterone levels, testosterone replacement therapy (TRT) may be an option. It can help improve your sex drive and some aspects of sexual function, although its effects on energy levels and mood are less predictable.

While ‘male menopause’ isn’t directly comparable to female menopause in terms of symptoms or how quickly changes occur, men can experience hormonal changes as they get older. For some, these changes can lead to symptoms associated with lower testosterone levels and affect their overall wellbeing.

Although these effects typically happen more gradually, they can still have a real impact on everyday life. Understanding what’s happening and recognising that it's ok to seek help can empower men take better care of their health and wellbeing - just as women are increasingly encouraged to do during menopause.