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What You Need to Know About Male Menopause (Yes it Exists)

Nov 25 2020
5 min read
Close-up of an older man with hands at heart center, older woman blurry in the background with hands also at heart center.

Did you know that as a man ages his hormone levels can change?

Andropause (also called late-onset hypogonadism, androgen decline, or — more casually — male menopause) is the gradual decline of testosterone, the primary male sex hormone. Though not always as noticeable as the symptoms women experience during their hormonal shift, male menopause can cause changes that can be hard to accept. It’s important to know the signs, to talk with your physician to have testosterone levels checked, as not all testosterone declines indicate male menopause, and can be a sign of underlying health issues that can be treated. Here’s what you need to know about signs, testing, and potential treatments:

Signs of a Male's Hormone Decline

There is a great deal of variation in men’s hormone levels, but for most males, testosterone peaks during puberty and begins declining around age 40 at a rate of roughly 1 percent each year. Many men experience a more substantial drop in their late forties and early fifties. Many men are fortunate to never notice any indication of declining hormones. For others, a variety of physiological, mental, and emotional symptoms can occur. If you have any of the following symptoms, talk to your doctor about testing your hormone levels. Top symptoms of low testosterone:

  • Low sex drive
  • Impaired sexual performance or erectile dysfunction
  • Decrease in spontaneous erections, for example during sleep
  • Enlarged prostate
  • Small or shrinking testes
  • Loss of body and pubic hair
  • Swollen or tender breasts
  • Fatigue
  • Depression or moodiness
  • Memory loss or impaired concentration
  • Sleep apnea or other sleep problems
  • Hot flashes or excessive sweating
  • Infertility
  • Obesity
  • Osteoporosis, height loss, or unexplained bone fractures
  • Muscle weakness or loss of muscle mass
  • Mild anemia
  • Ineffective workouts despite consistent training
  • Loss of drive or competitive edge

Testing Your Hormone Levels

Your doctor can check your hormone levels with a simple blood test. Most physicians recommend drawing blood early in the morning when testosterone levels are highest, and some suggest repeating the test once or twice to ensure accurate readings. A healthy testosterone level result falls between 300 to 1,200 nanograms per deciliter (ng/dL). Your body, however, has more testosterone than can be easily measured in your blood work, so your doctor may request that your blood also be analyzed for other hormones, such as prolactin, estradiol, lutenizing hormone, and DHEA, to get a better sense of how your various hormone levels compare to one another.

If a blood test shows that you have abnormally low hormone levels for a male your age, your physician may order further tests to determine whether there is an underlying cause. These may include more blood tests; imaging of the adrenal, pituitary or thyroid glands; a prostate exam, or a prostate or testicular biopsy.

Getting Help

Many common health conditions men experience today can contribute to lowered testosterone levels. In fact, recent research indicates that declines in testosterone might not be a natural result of aging, but a symptom of health issues such as obesity and depression. (More: Men and Depression: Considering Therapy)

Treatment options for low hormone levels will depend on the cause of the imbalance and the symptoms you experience. For many men, lifestyle modifications can dramatically impact hormone levels and hormone-related symptoms. Eating a nutritious diet, engaging in regular exercise, maintaining a healthy weight, and drinking alcohol in moderation can help counteract a dip in hormone levels. Getting more and better sleep optimizes hormonal levels, while strength training is a natural way to boost testosterone.

In addition to feeling better, improving your hormone levels may result in reducing your risk for several other diseases including: cardiovascular disease, fractures, metabolic disease, diabetes, and risk of dementia.

Men with emotional or sexual issues may benefit from stress management counseling or other types of therapy. Those with erectile dysfunction may also find help from medications or surgical procedures.

Young and otherwise healthy men diagnosed with hypogonadism, a condition in which men produce no or very low levels of testosterone, will likely be prescribed testosterone supplements. However, the safety and effectiveness of testosterone supplements remain unproven. Scientists suspect supplements may be linked to increased risk of enlarged prostate, prostate and breast cancer, infertility, sleep apnea, and stroke. Therefore, discuss the pros and cons of testosterone supplements with your doctor.