Over the past decade, the term “male menopause” has begun to gain cultural ground. This is sometimes accompanied by juvenile snickering, but is now increasingly met with genuine interest and scientific curiosity.
Everyone knows that women go through menopause, and many people understand that men experience hormonal changes as they age, so it is reasonable to ask if these phenomena are comparable. Do men go through menopause? It is a question that has both an easy scientific answer and a much more complex social and emotional one. The question itself hints at the relationships between hormones and our sense of self, the way we interact with others, and the way we think society perceives us. It speaks to both the biological reality and lived experience of aging.
When we ask “do men go through menopause?” we’re really asking if hormone changes in aging men are normal and explicable. We’re asking if a loss in testosterone is understandable and expected or if it is somehow a judgment in character. So while the answer is, scientifically, “no”, men’s experiences are more complicated.
The fact is that many men do go through serious hormonal upheaval as they age, and recognizing the biological underpinnings of those experiences is the best way to understand that it is normal and explicable. It’s also the first step toward treatment.
Do Men Go Through Menopause?
Both women and men undergo natural hormonal changes and fluctuations as they age. However, the nature of these changes is different. For women, menopause is a sharp and relatively sudden decline in the production of estrogen and progesterone. This is often preceded by perimenopause, a transitional period marked by hormonal fluctuation that may last for years. The ultimate result is a permanent end to a woman’s reproductive capacity.
For men, however, there is typically no sudden drop in sex hormones. Rather, testosterone production typically begins to slow down as you enter your 30s and often becomes particularly noticeable after age 40. Eventually, in some men, testosterone levels drop so low that they cause symptoms that seem roughly equivalent to menopause. This is also known as late-onset hypogonadism or age-related androgen deficiency, which is why we often see it referred to as andropause.
But as a 2014 study points out, andropause and menopause are not entirely analogous:
Men do show a decline of serum testosterone from age 40 to 50 years onwards but it is a slow decline of 1-2% per year and over time it may amount to hypogonadism. The mechanism of a decline in serum testosterone in men does not resemble the menopause; it is partially an aging neuroendocrine system with a less efficient testosterone production.
Less efficient does not mean the end of production, and it is highly atypical for testosterone levels to decline to the degree estrogen and progesterone fall in women. Additionally, while low testosterone can impact sperm production, it does not inevitably cause permanent infertility. Andropause is also not universal; most men maintain healthy testosterone levels even with age-related decline and do not experience disruptive symptoms. However, that doesn’t mean the symptoms aren’t real in those who do experience them or that the impact on your life is any less important.
The Effects of Male Menopause
While the term male menopause might not be the most scientifically precise terminology, in some ways, that doesn’t matter. What matters is how it affects your life. Andropause has a number of symptoms that can range in severity, sometimes becoming deeply disruptive and distressing. These include:
- Decreased libido
- Poor concentration and memory
- Body composition changes
Some of the earliest literature describing this phenomenon referred to it as “climacteric syndrome.” If you’ve experienced it, you’ll understand the inclusion of “climacteric”, which comes from a Greek word indicating the rungs of a ladder. There’s no one day where you wake up and your libido is gone or you are suddenly fatigued. It comes gradually as you move slowly rung by rung. The view never changes suddenly; there’s no one moment where you see things dramatically differently. But at some point, you notice you’re at a different elevation.
Significantly, lower testosterone production doesn’t have to reach clinical hypogonadism to have an impact on your life. Diminished testosterone levels that remain within the normal range may still produce noticeable effects and have potentially serious consequences. A lower libido can impact relationships, as well as your sense of self. Fatigue can change the way you work, play with your kids, or participate in self-care. Poor concentration can affect everything you do.
So while andropause may not be an exact imitation of menopause in women, the distinction hardly matters. Whatever you call it, it can change your life. That’s why it is important to look for options to feel better.
Treatment Options for Male Menopause
It’s important to note that the symptoms associated with andropause can be caused by more than an inevitable natural decline in testosterone, which opens up meaningful ways to address the effects independently. In particular, research suggests that obesity can be a major factor. According to the study quoted above, falling testosterone levels are partially the result of “an aging neuroendocrine system with less efficient testosterone production but equally or more important, the result of inhibition of testosterone production by metabolic factors in relation to visceral obesity.” Moreover, they add, “these effects are in part reversible with weight loss.” But, of course, fatigue, low energy levels, and other andropause symptoms can also promote obesity. As such, age-related hypogonadism and obesity are not mutually exclusive, but mutually reinforcing.
Furthermore, low testosterone—regardless of the cause—often requires medical intervention. That’s why many men, like women experiencing menopause, look to hormone replacement therapy. The potential benefits of testosterone therapy for men are many, including increased muscle mass and lower cardiovascular risk. Often, however, the most immediate benefits are higher energy levels, restored libido, healthier weight control, and improved emotional health. In a very real way, these benefits can translate into enhanced functionality in all facets of life.
While testosterone replacement therapy is widely regarded as the best treatment for low testosterone, there are many different testosterone therapies available, and it is important to consult a hormone replacement expert who can guide you through your options. Take the time to discover which treatment is right for you. This is about your health and well-being: it is worth it to do what is best for your body.
Andropause. Male menopause. Hypogonadism. Climacteric syndrome. Getting older. Whatever you want to call it, from the most accurate to the least, it can change your life. But recognizing that it is happening, and understanding why, means it doesn’t have to change who you are. And with hormone replacement therapy, you can do something about it.
If you want to know more about treatment options for male menopause, BodyLogicMD can help. The practitioners in the BodyLogicMD network are top medical professionals specializing in hormone health and hormone replacement therapy. A BodyLogicMD-affiliated practitioner can assess your hormone levels and design a personalized treatment plan to help you feel your best as you age. Contact a local practitioner to schedule your first appointment, or take the BodyLogicMD Hormone Balance Quiz to learn more about how hormones may be affecting your daily life.
Disclaimer: These statements have not been evaluated by the Food and Drug Administration. All content on this website is for informational purposes only. The content is not intended to diagnose, treat, cure or prevent diseases.
Charlotte is a patient care coordinator specializing in bioidentical hormone replacement therapy. She is committed to helping patients who struggle with the symptoms of hormonal change and imbalance explore their treatment options and develop effective strategies to optimize wellness.