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Is andropause the same as "male menopause" and should men worry about it?
Last reviewed: 02.07.2025
Thanks to information about menopause, almost everyone knows how age affects women’s hormone levels. But men have their own version of this process, too, called andropause. Although it’s less well-known in popular culture, experts say it’s a medical reality that comes with a number of misconceptions.
One such misconception is equating andropause with menopause. In women, menopause is the cessation of menstruation and the decline in estrogen production, usually occurring around age 50. In men, andropause is a gradual decline in testosterone levels that can begin in middle age.
According to the American College of Physicians, testosterone levels in men begin to decline in their mid-30s and continue to fall by an average of 1.6% per year. A 2016 study published in the journal Virulence found that by age 75, the typical man's testosterone levels have dropped by about 30% compared to what they were at age 25.
Testosterone plays an important role in sexual function, bone health, fat metabolism, muscle mass, and strength. Its levels increase significantly during adolescence with the onset of puberty. However, opinions vary on when low testosterone becomes a problem.
Low testosterone is sometimes called hypogonadism, and andropause may also be called age-related hypogonadism. Low testosterone by itself, without symptoms, is not a cause for concern, says Dr. Robert H. Eckel, a professor of medicine at the University of Colorado. "Andropause is part of the aging process, but it is not a disease in itself."
Dr. Nannan Thirumavalava, chief of male reproductive and sexual health at University Hospitals Cleveland, notes that there is no "perfect answer" to distinguishing normal age-related decline from a more serious problem.
When testosterone levels drop, the most specific symptoms are decreased sex drive or erectile dysfunction. Other symptoms can include difficulty concentrating, decreased energy, or even depression. However, he says, "there are many other things that can cause these symptoms."
In young men, low testosterone levels may indicate problems with the pituitary gland or testicles. But testosterone levels can also be affected by factors associated with cardiovascular disease, such as obesity, sleep quality, and sleep apnea.
People with type 2 diabetes or kidney failure also often have low testosterone levels. Observational studies have shown that men with unusually low testosterone levels have a higher risk of cardiovascular disease, but this does not mean a cause-and-effect relationship.
A drop in testosterone levels in itself is not a problem unless accompanied by a significant decrease in sexual function or other symptoms. In such cases, the patient should be referred to an endocrinologist.
" Hypogonadism in older men is a complex diagnosis that requires both biochemical testing and a thorough history and physical examination," Eckel says. Diagnosis requires multiple blood tests because normal testosterone levels can vary from man to man and fluctuate throughout the day.
Although treatment for low testosterone is heavily promoted, the Endocrine Society's guidelines do not support routine testosterone testing. Testosterone treatment without symptoms may have unclear long-term effects.
Many men seek testosterone therapy because of libido problems. Testosterone may improve sexual function a little, but it won’t turn a 75-year-old man into a 25-year-old. However, testosterone therapy is not an easy treatment. It can stop your own sperm production, which is a problem for men who want to have children.
Side effects such as acne and high blood pressure are also possible. Testosterone therapy can cause prostate enlargement.
The American Urological Association recommends starting testosterone therapy three to six months after a cardiovascular event.
Don't rely on over-the-counter supplements, as there is no evidence that they work. Men can improve their testosterone levels by getting quality sleep, losing excess weight, eating a healthy diet, and exercising regularly.