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“Male menopause” is a popular name, not a diagnosis. Menopause in women is a defined event, and the sources I read describe nothing equivalent in men. They use hypogonadism or low T instead (andropause is another popular term, though none of the sources I read use it), and they require two things together: signs you can feel and a low result on repeat blood tests. I’m not a doctor. This page lays out what the Endocrine Society, the American Urological Association and two large trials say, so you can walk into a healthcare visit with specifics. Menopause is the wrong comparison, and the details matter more than the nickname.
What Are the Symptoms of Male Menopause?
The signs tied to low T fall into three groups: sexual, physical and mood. The list below pulls from the Endocrine Society, MedlinePlus and the European Male Ageing Study, and each item is one that at least one of them names.
Sexual signs
- Lower sex drive. Less interest than is normal for you.
- Fewer morning erections. The European study found poor morning erection among the signs most tied to the hormone.
- Erectile dysfunction. Low T is one possible cause, not the only one.
- Lower sperm count. You would only notice this when trying to have children.
Physical signs
- Low energy and fatigue. Tiredness your body can’t shake, even after sleep.
- Loss of muscle mass. Even when you still train.
- Less ability to do vigorous activity. The European study counted this one too.
- Enlarged breasts.
- Less face and body hair.
- Thinning bones or anemia without a known cause. Both are found through testing.
- Testicular shrinkage.
- Hot flashes. The Endocrine Society ties these to very low levels.
Mood signs
- Depression or mood changes. Depression was one of the signs related to testosterone levels in the European study.
Weight gain is not on these lists as a sign. Obesity and sleep disorders appear as conditions linked to low T. Irritability and trouble concentrating show up on the Endocrine Society’s patient page, and the AUA guideline lists sleep disturbance, but all of these are common and can have other causes, which is the next section.
Is Male Menopause Real?
The hormone drop is real, but it is not a menopause. The Endocrine Society says testosterone falls about 1% a year after age 30. Whether that drop causes problems is a separate question, and it is why the diagnosis needs both symptoms and labs.
The European Male Ageing Study surveyed 3,369 men aged 40 to 79 and measured their testosterone levels in morning blood samples. It found that three sexual symptoms (low desire, poor morning erections and erectile dysfunction) had a clear link to low levels. It defined late-onset hypogonadism as at least three of them plus a low lab result. Fatigue and depression were also related to the level, but not as a cluster.
What Age Does Andropause Start?
There is no set age, because there is no switch that flips. The decline in T production is gradual from your 30s, and the European study looked at ages 40 to 79. If you have several of the signs above, your age matters less than the blood test.
What Else Can Cause the Same Symptoms?
Plenty of other things, and a doctor will check for them. The Endocrine Society lists obesity, sleep disorders and type 2 diabetes among chronic conditions linked to low T, along with kidney and liver disease and certain medications.
Two of those are things you can act on. If you snore, stop breathing at night or wake up wiped out, read our guide to sleep apnea and weight gain. The Endocrine Society guideline also advises against starting treatment with untreated severe sleep apnea. If the scale is stuck, why men over 50 can’t lose weight covers the usual reasons.
How Do Doctors Test for Low Testosterone?
With a morning blood draw, repeated. MedlinePlus says your healthcare provider takes the sample between 7 and 10 a.m., when levels are typically highest. The American Urological Association guideline calls for two total testosterone measurements on separate mornings, with a result below 300 ng/dL as a reasonable cut-off to support the diagnosis.
The Endocrine Society guideline adds two steps. If your testosterone levels sit near the low end of normal, the doctor may check free testosterone. If the diagnosis holds, the next job is finding the cause. Its patient page puts the normal range at about 300 to 1,000 ng/dL, depending on age and lab.
Bring a list of the symptoms you have noticed and how long they have lasted to your healthcare visit. That is a better start than “I just feel off.”
What Can You Do About Male Menopause?
Start with lifestyle and the underlying cause. The AUA guideline says everyone with a T deficiency should be counseled on lifestyle changes as a treatment strategy. The Endocrine Society notes that some causes, such as obesity, can be reversible without treatment.
Common lifestyle steps include working toward a healthy weight, strength training and treating sleep problems. Ask your doctor which of these fit your health before you start. If you decide to train at home, WHATAFIT resistance bands with handles are listed on Amazon as a 150 lb exercise bands set with a door anchor, ankle straps and a carry bag. As an Amazon Associate we earn from qualifying purchases. Our post on how exercise affects testosterone in men covers the training side.
Does TRT work?
For a confirmed diagnosis, it may help some symptoms. The AUA guideline says testosterone therapy may improve erectile function, sex drive, anemia, bone density, lean body mass and depressive symptoms, and calls the evidence inconclusive for energy, fatigue and thinking. The Endocrine Society guideline recommends testosterone replacement therapy (TRT) for symptomatic deficiency after a talk about benefits, risks and monitoring.
What are the risks of replacement therapy?
- Fertility. The AUA says not to prescribe it to anyone currently trying to conceive, and asks the doctor to discuss the effect on sperm production.
- Blood count and prostate. The AUA calls for hemoglobin and hematocrit checks, and a PSA test over age 40, before starting.
- Heart and clots. The TRAVERSE trial followed 5,246 men aged 45 to 80 who had symptoms of low T, two low fasting test results and existing or high risk of heart disease. Major cardiac events occurred in 7.0% of the treated group and 7.3% of the placebo group. Atrial fibrillation, acute kidney injury and pulmonary embolism were higher in the treated group.
Those trade-offs are why this is a decision for you and your healthcare team. For the wider picture, see men’s health after 50.
What should you do if you notice male menopause symptoms?
If you notice male menopause symptoms such as low energy, low mood or a drop in sex drive, the next step is to ask your doctor whether hormone testing makes sense, not to guess. A doctor checks testosterone levels with a blood test and looks at other causes too, because mood swings, tiredness, and weight gain can also come from sleep problems, medicines, and other health conditions.
Doctors usually talk about low testosterone rather than male menopause. If testing confirms low testosterone, testosterone therapy is one treatment option, and the care plan should come from your doctor, with follow-up on your symptoms and your testosterone levels. These symptoms can affect daily life, so it is worth getting a clear answer. Ask your doctor about the treatment options and the risks before you decide on testing or therapy.
Frequently Asked Questions
What are the first signs of male menopause?
The sexual ones tend to track the hormone most closely: lower desire, fewer morning erections and erectile dysfunction. Fatigue is common too, but it has many other causes.
What is male menopause called?
The medical terms in the sources I read are hypogonadism, late-onset hypogonadism and testosterone deficiency. Andropause is another popular name for the same idea, though none of the sources I read use it, and it is not the same thing as menopause in women.
How long does andropause last?
It has no set length. Levels slide gradually with age, and if a doctor confirms low T, how long treatment lasts is decided case by case.
Can andropause cause depression?
Depression was one of the signs related to T in the European study. It has many other causes, so tell your healthcare provider about low mood whatever the lab says.
Does andropause cause erectile dysfunction?
Low T can contribute, and erectile dysfunction was one of the three sexual symptoms tied to it. Other conditions can cause it too, which is one reason a healthcare provider looks at the full picture.
Medical disclaimer: This article is general information, not medical advice and not a diagnosis. Talk to your doctor about any symptoms, and before starting hormone treatment or any supplement. Sources: the Endocrine Society’s hypogonadism page, the AUA testosterone deficiency guideline, the MedlinePlus testosterone test page, the European Male Ageing Study, the TRAVERSE trial and the Endocrine Society guideline.
