Male Menopause: What exactly is the andropause?


It’s A Man’s, Man’s, Man’s World!

The term ‘andropause’ is often used in the media to label the male menopause, described in the dictionary as “a collection of symptoms, including fatigue and a decrease in libido, experienced by some older men and attributed to a gradual decline in testosterone levels.”

While menopausal women stop producing oestrogen around their 50s, andropause only slows the production of testosterone. Men remain fertile for the rest of their lives, although the quantity and quality of their sperm decrease with age.


Not unlike women, some men develop physical and psychological symptoms when they reach their late 40s and 50s. General lack of energy or enthusiasm, difficulty sleeping, loss of libido, erectile dysfunction, mood swings and irritability, poor concentration, fat redistribution, developing a belly and ‘man boobs’! These are but a few of their symptoms.

The NHS aren’t impressed with the term ‘andropause’, finding the term misleading. Why? “It suggests the symptoms are the result of a sudden drop in testosterone in middle age, similar to what occurs in the female menopause. This isn’t true.”

They go on to state that “although testosterone levels fall as men age, the decline is steady – less than 2% a year from around the age of 30-40 – and this is unlikely to cause any problems itself.

Men may develop testosterone deficiency in later life (late-onset hypogonadism), that may be responsible for causing some of these symptoms, however more often the symptoms have nothing to do with hormones.

What are the common causes and most importantly, what can men do to treat the ‘male menopause’?



Now’s the time to start looking at elements in your life that could be attributed to these symptoms.

For example loss of sex drive, erectile dysfunction and mood swings could be caused by

  • Stress

  • Anxiety

  • Depression

Erectile dysfunction may also be caused by other physical changes in tandem with the psychological issues, such as changes in blood vessels or a nerve problem. This is not an uncommon problem in men over 40 and is something to talk to a GP about.

“Midlife crisis”

Men can internalise stress. There are psychological problems commonly attributed to work or relationship issues -  ageing parents, money problems and divorce.

Crisis often hits men when they perceive that they’ve reached ‘life’s halfway stage’. Anxieties may develop over what they’ve accomplished, in their career or personal life. They may feel career hungry juniors are snapping at their heels, on top of the stress of paying down mortgages, providing for family and helping offspring if they’re in higher education, all contributing to that feeling of crisis.

Psychotherapist and relationship therapist, Pam Custers, says this can create the ‘perfect storm’. It’s a time when partners may be going through their own physical and psychological changes, “therefore relationships may take a blow as a partner’s desire reduces, so they begin to feel disconnected”. Talking with your partner is vital, help them understand, what, and how you feel. Feeling connected is the glue that holds couples together.

Symptoms of anxiety, stress, low self-esteem and lack of sleep may also be caused by the following and therefore lifestyle habits may need to be addressed:

  • Poor diet

  • Lack of exercise

  • Drinking too much alcohol

  • Smoking

Exercise & relaxation really help!

These are the miracle cures that have probably been neglected!

There’s no snake oil - physical activity helps boost self-esteem, mood, sleep and energy. People who exercise regularly have a lower risk of developing many conditions such as heart disease, type 2 diabetes, stroke, and some cancers. Yup, the NHS say exercise can reduce the risk of these major illnesses by up to 50%, and lower risk of early death by up to 30%.

You don’t have to join an expensive gym. Simply walk instead of taking the car - cycling, swimming, yoga and breathing exercises, are all beneficial in treating stress, low mood, depression and anxiety.

Aim to achieve 150 minutes of physical activity over a week.

Time to talk!

If you’ve been regularly exercising and there’s no improvement, book a visit to your doctor. They’ll ask about your work and personal life, to assess whether your symptoms are caused by psychological issues.

It may be that they suggest a ‘talking therapy’ to help with stress and anxiety, such as cognitive behavioural therapy (CBT).

Late-onset hypogonadism

Caused by the testes producing very few or no hormones. The condition affects only 2.1 percent of males. Where lifestyle or psychological reasons aren’t responsible for symptoms of ‘male menopause’, in very few cases hypogonadism may be responsible.

Sometimes present from birth, but late-onset hypogonadism can develop in later life, particularly in diabetic or obese men. The NHS state “this is an uncommon and specific medical condition that isn’t a normal part of ageing.”

Results of blood tests via your GP will diagnose the condition and testosterone levels.


Is HRT an option?

Your doctor may book a blood test to measure testosterone levels. If the results suggest testosterone deficiency, you may be referred to an endocrinologist, (a specialist in hormone problems).

You may be offered testosterone replacement to level out your hormones. The treatment could be in the form of either:

  • Tablets

  • Patches

  • Gels

  • Implants

  • Injections

There you have it, ‘male menopause’ is the correct medical term although it’s not necessarily as hormonally-led as a ‘female menopause’. However, it still impacts on everyday life and happiness, so it’s important that men find the underlying causes, in order that they take appropriate action.

Watch our vlog with Psychotherapist Pam Custers ‘Hot Flush Talking Menopause & Relationships’.


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