Male menopause is a commonly used term for physical, sexual or emotional changes that some men experience as they age. However, it is not the male equivalent of female menopause. Testosterone does not suddenly stop being produced. Instead, levels may decline gradually with age, and only some men develop clinically significant testosterone deficiency.
Symptoms can include reduced sexual desire, erectile difficulties, low energy, reduced muscle mass, sleep problems and mood changes.
The terms men menopause and men and menopause are therefore useful for describing the topic in everyday language, but medically, persistent symptoms accompanied by consistently low testosterone may be evaluated as hypogonadism.
Correct diagnosis matters because similar symptoms can also result from obesity, diabetes, sleep problems, depression, medicines and other health conditions.
What is Andropause (Male Menopause)?
Andropause is an informal term used to describe age related hormonal and health changes in men, particularly those associated with declining testosterone.
Unlike female menopause, there is no sudden biological event when male reproductive hormone production stops. Testosterone levels generally decline gradually with age, beginning from approximately the third or fourth decade of life. The NHS notes that the average decline is gradual rather than abrupt, which is why the phrase “male menopause” can be misleading.
Some men develop symptoms together with consistently low testosterone. This may be described as testosterone deficiency syndrome, hypogonadism or, in some contexts, late onset hypogonadism.
Because low testosterone can sometimes occur alongside sexual or reproductive concerns, men experiencing persistent symptoms may also benefit from a broader assessment of their reproductive health through male fertility services rather than assuming that ageing alone is responsible.
Current Endocrine Society guidance stresses that symptoms alone are not enough to diagnose testosterone deficiency. Low libido, fatigue and changes in mood can have several causes, so clinicians should confirm low testosterone and investigate the underlying reason.
This distinction is important when discussing male ageing and hormonal imbalance in men. Age related testosterone decline can occur without causing a medical problem, while clinically significant deficiency requires proper evaluation.
What are the Symptoms of Andropause?
Symptoms associated with andropause vary widely and usually develop gradually rather than appearing at one specific age.
Some men notice mainly sexual symptoms, while others first experience changes in energy, strength, sleep or mood. Many of these complaints can also occur with depression, chronic illness, thyroid disorders, obesity or sleep apnoea.
Possible male menopause symptoms therefore need to be interpreted alongside testosterone testing and a broader health assessment. Since reproductive ageing can also affect sperm health over time, men concerned about fertility may benefit from understanding how age can influence IVF and male fertility outcomes rather than assuming every reproductive change is caused by testosterone deficiency alone.
What Are the Physical Symptoms of Andropause?
Possible physical men menopause symptoms include reduced energy, loss of muscle mass, reduced strength, increased body fat and sleep disturbance.
Long standing testosterone deficiency may also affect bone density.
These symptoms are not specific to low testosterone, so other metabolic, sleep related and medical causes should be considered during evaluation.
What Are the Sexual Symptoms of Male Menopause?
Sexual signs of male menopause may include reduced libido, erectile difficulties, fewer spontaneous erections and lower sexual satisfaction.
Low testosterone can also be associated with reproductive concerns, but erectile dysfunction has many possible cardiovascular, psychological and medical causes.
A sexual symptom alone does not confirm testosterone deficiency.
What Emotional and Cognitive Changes Can Occur During Andropause?
Some men report irritability, reduced motivation, low mood, anxiety, difficulty concentrating or problems with short term memory.
These symptoms can overlap substantially with depression, chronic stress and sleep problems.
Persistent emotional or cognitive changes deserve medical attention rather than being assumed to result automatically from ageing or low testosterone.
What Causes Andropause?
The most recognised biological change associated with ageing is a gradual decline in circulating testosterone.
The commonly searched male menopause age is therefore not one fixed number. Testosterone begins to decline gradually from around the age of 30 to 40 in many men, while noticeable symptoms may not occur at all or may appear much later.
Ageing alone does not explain every case of low testosterone in men.
Factors that may contribute to or worsen testosterone deficiency include:
- Obesity
- Type 2 diabetes
- Testicular disorders
- Pituitary or hypothalamic disorders
- Chronic illness
- Poor sleep or obstructive sleep apnoea
- Certain medicines, including opioids or corticosteroids
- Previous testicular injury or treatment
- Significant lifestyle and metabolic factors
The Endocrine Society’s July 2026 statement emphasises that clinicians should distinguish true hypogonadism from potentially reversible contributors such as obesity or medication effects.
This is why male menopause causes should not be reduced to ageing alone.
How is Andropause Diagnosed?
Diagnosis requires more than recognising symptoms.
A doctor first reviews sexual symptoms, energy levels, medical history, medicines, sleep, weight, metabolic health and other possible causes of testosterone deficiency.
Physical examination may assess body composition, testicular findings and other relevant signs.
The Endocrine Society recommends diagnosing hypogonadism only when compatible symptoms or signs occur together with consistently and unequivocally low testosterone levels. A low result should generally be confirmed with a repeat morning testosterone measurement using an appropriate laboratory assay.
Additional tests may include LH and FSH to help distinguish testicular causes from pituitary or hypothalamic causes.
Doctors may also investigate thyroid disease, diabetes, depression, sleep apnoea or other chronic illnesses when symptoms overlap.
For men with fertility concerns, a semen analysis may be appropriate because testosterone levels alone do not show whether sperm production is normal.
Treatment & Management
Andropause treatment depends on the cause of symptoms rather than the label itself.
Some men benefit primarily from weight management, better sleep, treatment of diabetes, reducing excessive alcohol, stopping smoking or addressing an underlying medical or psychological condition.
Men with confirmed hypogonadism may be considered for testosterone replacement therapy, but only after appropriate evaluation.
Current Endocrine Society guidance recommends testosterone therapy for appropriately diagnosed hypogonadism while stressing that symptoms, blood results, contraindications and treatment goals must all be reviewed first.
Fertility goals are especially important. Exogenous testosterone can suppress the hormonal signals needed for sperm production and may cause very low sperm counts or azoospermia. When sperm are absent from the ejaculate, further assessment is needed to determine the cause, and men can learn more about the evaluation and management of azoospermia.
What Lifestyle Changes Can Help Manage Andropause Symptoms?
Regular exercise, resistance training, healthy weight management, adequate sleep and balanced nutrition can support men’s hormonal and metabolic health.
Stopping smoking, limiting excessive alcohol and treating sleep problems may also help.
If obesity is contributing to testosterone deficiency, the Endocrine Society recommends addressing weight as an important first line strategy in appropriately diagnosed cases.
When Is Testosterone Replacement Therapy Recommended?
Male menopause treatment with testosterone may be considered when a man has compatible symptoms and repeatedly confirmed low testosterone after the cause has been evaluated.
Treatment requires medical monitoring and review of potential risks.
It is not appropriate for every older man with fatigue and should generally be avoided in men planning fertility because it can suppress sperm production.
When Should You See a Doctor for Andropause Symptoms?
Seek medical evaluation for persistent low libido, erectile difficulties, unexplained fatigue, significant loss of strength, mood changes or other symptoms affecting daily life.
Assessment is also important when fertility is a concern. If a couple has been trying to conceive without success, the evaluation should consider both partners because hormonal symptoms in the man may coexist with other Infertility factors.
Do not start testosterone or hormone supplements based only on age or symptoms without confirming whether testosterone deficiency is actually present.
Frequently Asked Questions
What is Andropause?
Andropause is an informal term for age related changes sometimes associated with declining testosterone.
It is not a true male equivalent of menopause because testosterone production does not stop suddenly.
When symptoms occur together with repeatedly low testosterone levels, doctors may diagnose hypogonadism after assessing possible testicular, pituitary, metabolic or medication related causes.
What Are the Symptoms of Male Menopause?
Possible symptoms include reduced libido, erectile difficulties, fatigue, reduced muscle mass, increased body fat, sleep disturbance, irritability, low mood and difficulty concentrating.
These symptoms are not specific to low testosterone.
Thyroid problems, depression, obesity, sleep apnoea and other medical conditions may produce similar symptoms and should be considered.
At What Age Does Andropause Start?
There is no fixed male menopause age.
Testosterone levels can begin declining gradually from around age 30 to 40, while some men never develop troublesome symptoms.
Symptoms commonly associated with “male menopause” may become noticeable later in life, but age alone is not enough to diagnose testosterone deficiency.
Is Testosterone Therapy Safe?
Testosterone therapy can benefit appropriately diagnosed men, but it requires medical supervision and monitoring.
It is not suitable for everyone, and risks and contraindications must be reviewed before treatment.
The Endocrine Society specifically advises against starting testosterone in men planning near term fertility and in several other clinical situations.
Does Andropause Affect Fertility?
Ageing can influence male reproductive health, but testosterone level and fertility are not interchangeable.
Low testosterone may occur alongside impaired sperm production or sexual dysfunction.
Importantly, taking external testosterone can itself suppress sperm production. Men concerned about male infertility should therefore discuss fertility goals before starting hormone treatment.
Conclusion
Andropause is best understood as a term describing symptoms that may occur alongside age related hormonal changes rather than an inevitable male version of menopause.
Persistent low libido, erectile difficulties, fatigue or changes in strength and mood should be evaluated because many conditions can produce similar symptoms.
When testosterone deficiency is confirmed, treatment may involve lifestyle measures, management of underlying conditions or carefully supervised hormone therapy.
For men concerned about aging and male fertility, fertility goals should always be discussed before testosterone treatment because external testosterone can reduce sperm production.
At Motherhood Fertility & IVF, men and couples can undergo fertility evaluation when reproductive concerns are present, with options such as IVF Treatment considered only when clinically appropriate.
For personalised fertility guidance, call 080 6723 8900 or book an appointment with Motherhood Fertility & IVF.