Many people have heard the term “male menopause,” commonly referred to as andropause. It is often used to describe physical and emotional changes that some men experience in midlife—but it is not the direct male equivalent of menopause.
What is andropause?
During menopause, ovarian hormone production changes significantly and menstrual periods eventually stop. Men do not experience the same sudden hormonal transition.
Testosterone levels usually decline gradually with age—typically from around the age of 30 to 40. For most men, this natural decline does not cause significant problems.
However, some men develop a medical condition called late-onset hypogonadism, where the body does not produce enough testosterone. This is uncommon and should not be considered an inevitable part of ageing.
Possible signs and symptoms
Men experiencing midlife changes may notice:
- Reduced sex drive
- Erectile difficulties
- Low energy or motivation
- Mood changes or irritability
- Poor concentration
- Difficulty sleeping
- Reduced muscle mass or strength
- Increased body fat
- Lower confidence or enthusiasm
These symptoms are real and deserve attention, but they do not automatically mean that testosterone is low.
It may not be hormonal
Many symptoms associated with “andropause” can have other causes, including:
- Chronic stress
- Anxiety or depression
- Poor-quality sleep or sleep apnoea
- Relationship or work pressures
- Excessive alcohol consumption
- Smoking
- Inactivity
- Poor nutrition
- Obesity or type 2 diabetes
- Thyroid or other medical conditions
- Side effects from medication
Erectile difficulties can also be connected with cardiovascular problems. Men should therefore avoid assuming that changes in sexual function are simply part of ageing.
How is low testosterone diagnosed?
Late-onset hypogonadism cannot be diagnosed from symptoms alone or through an online questionnaire.
A healthcare professional will consider symptoms, medical history, medication and lifestyle before arranging appropriate blood tests. Testosterone is normally measured in the morning, when levels are highest, and an unexpectedly low result may need to be confirmed with another test.
Further investigation may be required to determine whether the problem originates in the testes, the pituitary gland or another health condition.
Read the NHS guidance on “male menopause”
Can lifestyle changes help?
Lifestyle support can make a meaningful difference, particularly when symptoms are connected with stress, sleep or metabolic health.
Helpful foundations may include:
- Regular resistance and cardiovascular exercise
- Sufficient sleep and assessment for possible sleep apnoea
- A balanced diet containing adequate protein, fibre and healthy fats
- Reducing excessive alcohol
- Stopping smoking
- Managing stress
- Maintaining supportive relationships and social connection
- Seeking help for anxiety, depression or persistent low mood
- Having blood pressure, blood sugar and cholesterol checked
These measures support overall wellbeing, but they should not be promoted as guaranteed ways to “boost testosterone.”
What about testosterone replacement therapy?
Testosterone replacement therapy, or TRT, may be offered when a specialist confirms testosterone deficiency alongside relevant symptoms.
It is available in forms such as gels and injections, but it is not a general anti-ageing, bodybuilding or energy treatment. TRT requires an individual risk assessment and ongoing medical monitoring.
It may affect fertility by reducing sperm production and is not suitable for everyone. Blood count, prostate health, cardiovascular risk and treatment response may need to be monitored. Current guidance recommends diagnosing hypogonadism only when compatible symptoms occur alongside consistently low testosterone levels.
Read the Endocrine Society’s clinical guidance
Be cautious with “testosterone-boosting” supplements
Herbal or nutritional products marketed as natural testosterone boosters are not automatically effective or safe.
Evidence varies greatly between ingredients and products. Supplements may interact with medicines or be unsuitable for people with prostate conditions, heart disease, diabetes, liver or kidney problems.
Men should speak with a pharmacist or healthcare professional before combining supplements with prescribed treatment.
The whole-person approach
Midlife changes in men can involve hormones, but they may also reflect sleep, stress, relationships, mental wellbeing, nutrition and wider physical health.
The best approach is not to dismiss symptoms as “just ageing” or assume that testosterone is always the answer. Men deserve the same opportunity to discuss their changing health openly, receive an appropriate assessment and access evidence-informed support.
Andropause may be a popular term, but the individual behind the symptoms should always come first.
This article is for general education and does not replace personalised medical advice, diagnosis or treatment.