As men age, there’s a lot of focus on staying physically fit and mentally sharp. But what about the subtle, often overlooked changes in mood, libido, energy, and overall well-being? These shifts could be signs of andropause, a phase many men go through but rarely discuss.

Sometimes referred to as "male menopause," andropause involves a gradual decline in testosterone levels, which can impact a man’s quality of life. Understanding andropause is crucial for those looking to maintain their health and vitality well into their later years. 

Here are ten things to know about "the change" for men.

1. Yes, male menopause is a thing. But it's misunderstood.

While the term “male menopause” might sound like the punchline of a joke, the symptoms and changes are very real. Starting in their 30s and 40s, men typically begin to experience a drop in testosterone levels, at a steady rate of about 1% each year.1-4

Also called late-onset hypogonadism, this age-related dip in testosterone isn't usually a problem. Symptoms of andropause – including a lower sex drive, irritability, and loss of muscle mass – can be subtle and often go unnoticed because they match what many men see as a natural part of aging.1-4

But andropause isn't a cookie-cutter experience. For some men, the drop in testosterone is significant and causes symptoms that dampen daily well-being. In some cases, low testosterone points to issues with the pituitary gland or chronic disease.1-3

2. Don't expect hot flashes.

For women, menopause is often a dramatic, curtain-falling event. A sudden drop in estrogen can cause hot flashes and mood swings, seemingly overnight.1-4 

Men, on the other hand, might not even realize what’s happening until they’re deep into andropause.2 That's because the drop in testosterone is gradual, and the symptoms are typically less disruptive.1-4 The most common complaint of andropause is a loss of sex drive or erectile dysfunction, which can be triggered by decreased testosterone or another factor, like stress or health problems.1

Another difference between the sexes: Menopause signals the end of a woman's childbearing years, while men typically stay fertile until later in life – albeit with decreased results.3

3. Andropause isn't a midlife crisis – but it might look like one.

The age-related drop in testosterone is a biological reality, but it can manifest in psychological and emotional symptoms that are eerily similar to the stereotypical midlife crisis: depression or anxiety, sudden worries about physical appearance, and mood swings.1,2

These symptoms shouldn't be brushed off as a normal reaction to facing the midpoint of life. In many cases, treating mental health with therapy or medication can ease the symptoms of andropause and have you feeling like yourself again.1

4. Aging is a factor, but not the only one.

Yes, getting older is a significant player in the andropause game, but it’s not the only contributor. Lifestyle choices, health conditions, and stress can all play a role in testosterone decline. 

Do you smoke? Rarely leave your office chair during the day? Stay up late with a cocktail or two? These habits can cause andropause-like symptoms, such as erectile dysfunction, depression, weight gain, and trouble concentrating.1,5

An unhealthy lifestyle can also lead to chronic health conditions like heart disease, obesity and diabetes – all of which are known to cause low testosterone.1,2,4 Men with these health conditions might experience more pronounced symptoms of male menopause at an earlier age than their healthier counterparts.5

5. Your job, and your stress levels, can make it worse.

High-stress jobs can alter your hormones, like cortisol and DHEA-S, which in turn have an impact on testosterone production. Jobs that involve long hours, high responsibility, or intense physical labor are more likely to increase the body’s stress response, potentially worsening the effects of andropause.5

Although night shifts may sometimes be quieter, irregular sleep patterns caused by work schedules can also lead to more severe andropause symptoms.5

6. Testosterone replacement carries some risk – but it’s generally safe.

Very low testosterone levels, along with significant symptoms, might make you a candidate for testosterone therapy (TT).6 But while TT can help with male menopause symptoms, giving you a boost where you need it most, it’s not all sunshine and six-pack-abs. 

Historically, doctors have been hesitant to prescribe TT to older men because earlier research has suggested a lack of long-term safety. But recent studies have shown that TT can alleviate troublesome andropause symptoms like fatigue, sexual dysfunction, mood swings, and muscle loss – which can significantly improve quality of life.6

There are still some concerns about TT, like an increased chance of heart issues or kidney injury, so it’s essential to weigh the benefits against the risks.3,7 Done right, though, TT can help you feel more like your old self.

7. You can boost testosterone naturally.

You might not need a prescription to give your testosterone a lift. Sometimes, the best medicine is old-fashioned exercise and a balanced diet. Regular workouts, especially the ones that get your heart pumping and your muscles working, can help nudge those testosterone levels up.3 Eat a healthy diet with plenty of fruits and vegetables to support the function of testicular Leydig cells, which are responsible for producing testosterone.8

Reducing stress through mindfulness practices, getting enough sleep, and avoiding excessive alcohol can further support healthy testosterone levels.

8. Changing your lifestyle can help.

Some experts say that low testosterone is the result of poor health, rather than the other way around.3 But that's good news: If your andropause symptoms are being triggered by disease or lifestyle, then treatment or new habits might be able to reverse its course.4 

Simple changes can have a big impact. Get to a healthy weight, quit smoking, cut back on the booze, get enough sleep, and manage your stress.3 Get your vitamin D level checked. If it’s low, starting a supplement might be helpful.9

Even if you're feeling good, don't forget to check in with your doctor. Regular check-ups can help catch any potential issues early and treat other health conditions. Think of it as fine-tuning your life’s engine to keep it running smoothly as the miles add up.

9. Be picky about testosterone-boosters.

The market is awash with testosterone-boosting supplements, but don’t be fooled. Many of them are all hype and no help. Some might even do more harm than good. 

But there are some exceptions. One review of the research found that products with certain ingredients might be helpful for late-onset hypogonadism. These ingredients include Eurycoma longifolia, pomegranate fruit rind, cacao seed extracts, and purified shilajit extract.10

Before you reach for that miracle pill, do your homework. Look for products backed by science and consult with your doctor to make sure you’re not wasting your money – or risking your health – on snake oil.

10. Seek treatment with your partner.

Andropause isn’t just your burden to bear. Reduced libido, mood swings, and irritability can strain a partnership. 

Neither men nor women are likely to seek treatment for hormonal changes in midlife, but for very different reasons. Menopause is a well-known and inevitable aspect of life, so many women don't think of calling a doctor for symptom relief. Conversely, most men don't know about andropause, so when symptoms arise, they might not realize there are things they can do to mitigate the change.11

Joint therapy sessions or attending medical appointments as a team can help both of you understand what’s happening and how to deal with it. After all, two heads (and hearts) are better than one when it comes to navigating life’s changes.

Embracing the change

Male menopause might not be as flashy or well-known as its female counterpart, but it doesn't have to be a mystery. With the right treatment, lifestyle choices, and support, male menopause can be just another chapter in a long and satisfying life.

A word from Thorne

As mentioned above, both stress and low vitamin D levels can contribute to low testosterone. You can check your D levels at home with Thorne’s Vitamin D Test or the levels of your stress hormones cortisol and DHEA with Thorne’s easy, at-home saliva Stress Test. And, like our friends from Mayo Clinic said, it’s important to do your homework when choosing a dietary supplement. Thorne’s Advanced Testosterone Support combines shilajit with zinc and two botanical extracts to support healthy testosterone levels.*

References

  1. The 'male menopause.' NHS. https://www.nhs.uk/conditions/male-menopause/. [Accessed Aug. 6, 2024.]
  2. Is andropause the same as 'male menopause,' and should men worry? American Heart Association. https://www.heart.org/en/news/2024/06/21/is-andropause-the-same-as-male-menopause-and-should-men-worry. [Accessed Aug. 6, 2024.]
  3. Kanakis GA, Goulis DG. Addressing andropause: Challenges and strategies for healthy aging in men. Maturitas. Published online June 13, 2024.
  4. Huhtaniemi IT, Wu FCW. Ageing male (part I): Pathophysiology and diagnosis of functional hypogonadism. Best Pract Res Clin Endocrinol Metab. 2022;36(4):101622.
  5. Martelli M, Zingaretti L, Salvio G, et al. Influence of work on andropause and menopause: A systematic review. Int J Environ Res Public Health. 2021;18(19):10074.
  6. Theodorakis N, Feretzakis G, Vamvakou G, et al. Testosterone therapy for functional hypogonadism in middle-aged and elderly males: current evidence and future perspectives. Hormones (Athens). Published online July 26, 2024.
  7. Lincoff AM, Bhasin S, Flevaris P, et al. Cardiovascular safety of testosterone-replacement therapy. N Engl J Med. 2023;389(2):107-117.
  8. Martin LJ, Touaibia M. Prevention of male late-onset hypogonadism by natural polyphenolic antioxidants. Nutrients. 2024;16(12):1815. 
  9. Amini S, Jafarirad S, Abiri B. Vitamin D, testosterone and depression in middle-aged and elderly men: A systematic review. Crit Rev Food Sci Nutr. 2023;63(21):5194-5205.
  10. Morgado A, Tsampoukas G, Sokolakis I, et al. Do "testosterone boosters" really increase serum total testosterone? A systematic review. Int J Impot Res. 2024;36(4):348-364. 
  11. Rozenberg S, Nappi RE, Schaudig K, et al. Couplepause: Deconstructing sick menopause and andropause during midlife. J Sex Med. 2023;20(11):1270-1273.