Andropause (Male Menopause): Symptoms, Causes, and How to Treat It

By R.Davies, PhD・Hormones
Published on May 04, 2026

The ‘andropause’, also called the ‘male menopause ’, is the gradual decrease in testosterone that some men experience as they age. In this article, we’ll go through what it is, its symptoms, diagnosis, treatment and how it affects your body and quality of life.

Unlike female menopause, where estrogen decline is largely irreversible, much of what drives declining testosterone in men is linked to things you can change: your bodyweight, lifestyle, diseases and how you sleep. There are many things you can do. It can be delayed, prevented or even reversed.

What Exactly is the Andropause?

It is a set of symptoms plus a decline in testosterone, which occurs as you get older. It is medically referred to as ‘late-onset hypogonadism’, which is where your (previously fully functioning) testicles don’t produce enough testosterone to meet your body’s needs.

Andropause refers to the cluster of symptoms and hormonal changes associated with declining testosterone levels in ageing men. It is formally known as late-onset hypogonadism (LOH) in the medical literature — a condition where the testes produce insufficient testosterone to meet the body's needs, in men who previously had normal testicular function [1].

Whereas the female menopause is a (relatively) quick and almost complete loss of their estrogen-producing capacity, the andropause is slower and less dramatic. Testosterone is said to decrease in some men by 1-2% a year from their mid-30s onwards. So by the time a man reaches his 50s or 60s, levels may have dropped enough to cause noticeable changes [2]. In addition to ageing, the andropause can be driven by obesity, poor health, diseases, and many other lifestyle decisions, which means it can be (partially) delayed, prevented or reversed.

In fact, many men (who generally maintain a healthy bodyweight and good health) can maintain their testosterone levels throughout their life, and won’t experience the andropause. Research suggests that 20% of men who are over 70 years old have low testosterone levels. But more thorough assessments have suggested that 2% of men over 40 are andropausal.

Symptoms of Andropause

Symptoms tend to develop gradually, which is why they often go unrecognised for years. Many men attribute the changes to stress, poor sleep, or simply "getting older." The most common symptoms include:

Physical Symptoms

Loss of muscle mass and strength, even with regular exercise
Increased body fat, particularly around the abdomen
Reduced energy and persistent fatigue
Decreased bone density (raising long-term fracture risk)
Reduced body and facial hair
Hot flushes and sweating (less common, but reported in some men)
Enlarged or tender breast tissue (‘gynaecomastia’)

Sexual & Reproductive Symptoms

Reduced libido (or sex drive)
Erectile dysfunction or difficulty maintaining erections
Reduced semen volume
Decreased testicular size
Reduced fertility (though complete infertility is uncommon)

Psychological & Cognitive Symptoms

Low mood, irritability, and increased anxiety
Difficulty concentrating and mental fogginess
Reduced motivation and drive
Poor sleep quality and insomnia
Loss of confidence and sense of well-being

How Is Andropause Diagnosed?

No single symptom is a diagnosis on its own. The pattern and combination of many of these symptoms, alongside blood testosterone test results, is what confirms the diagnosis. There is no single “gold-standard” test at the moment.

A single low total testosterone reading doesn’t necessarily indicate that you’re going through the andropause. Clinicians will administer a few tests and examine several markers in conjunction with total testosterone (e.g., free testosterone, sex hormone-binding globulin, luteinizing hormone, follicle-stimulating hormone, prolactin, thyroid function, and blood glucose). These are taken to confirm you have low T and help deduce the cause of it [3].

The andropause isn’t the easiest condition to diagnose, as there are a lot of (common) conditions that have similar symptoms. Fatigue, low mood and reduced libido are also seen in men with depression, thyroid problems, sleep apneoa and anaemia. This is why clinical assessment is needed for proper diagnosis.

Effects of Andropause on the Body

Physical Health

Low testosterone in men is associated with increased cardiovascular disease risk, type 2 diabetes, obesity, osteoporosis, low muscle mass (‘sarcopenia’), fragility, frailty and fractures [4].

Mental Health & Brain Health

Men with low testosterone have an increased risk of depression, anxiety, and reduced quality of life. Many men anecdotally report that they have low drive (to do things), enthusiasm for life or “flatness” without having depression [2].

Fertility

Testosterone is needed to produce sperm. So, men with low testosterone tend to have low sperm volume and quality, although they are generally not completely infertile [3].

Treatment of the Andropause

For men whose andropause is caused by poor lifestyle habits (e.g., diet, activity, body weight), they can restore their testosterone levels and improve their symptoms and quality of life, usually without any medication.

For men with complex diseases, genetic conditions or prior medical conditions, lifestyle changes may not be as effective, and they’ll probably need professional medical assistance. If left untreated, the andropause symptoms tend to get worse over time as you get older (and fatter). Early diagnosis and action are more effective than waiting.

Weight Loss

Maintaining a healthy body weight and healthy fat levels is probably the best way to improve testosterone levels in overweight older men [5]. Body fat converts testosterone to estrogen (via an enzyme called aromatase). It also dials down your testosterone production system across your body.

Exercise

Regular exercise (particularly resistance training) and being physically active support healthy testosterone production. It helps keep your body fat levels under control, maintain (or potentially build) muscle, and keep your cells and other hormones working as they should. Resistance training can actually increase the sensitivity of (some) of your cells to testosterone, meaning that having low-testosterone levels becomes a bit less of a problem.

Diet & Nutrition

What you eat can directly affect your testosterone levels. Eating enough calories, enough fat (particularly saturated and monounsaturated fat), micronutrients (e.g., zinc, magnesium and vitamin D) and avoiding testosterone-killing foods is recommended. We have a full article on what to eat (and what to avoid) along with a 7-day meal plan if you want to read more.

Managing Chronic Disease

Having certain diseases like diabetes and cardiovascular disease can suppress your testosterone levels and accelerate the andropause. Managing these conditions through medication, lifestyle, or both is a key pillar of any treatment plan.

Reducing Environmental Exposures

Pollutants like pesticides, plastics, radioactive materials, heavy metals, and endocrine-disrupting chemicals found in your environment can disrupt your testosterone levels [6]. Reducing unnecessary exposure to these disruptors is a reasonable and low-risk change you can make.

Improving Sleep

The majority of your daily testosterone production occurs wile your in deep sleep. Sleep deprivation or poor sleep quality can reduce testosterone levels significantly (even in young healthy men). Prioritising seven to nine hours of good quality sleep is not optional — it is fundamental. If you want a more detailed, structured programme covering all aspects of optimising testosterone naturally — including exercise, diet, sleep, and supplements — we have a full course on it.

Drugs

Testosterone replacement therapy (‘TRT’) can be used to restore normal testosterone levels and is highly effective at relieving a lot of the andropause symptoms (e.g., mood, libido, muscle and bone health). However, it suppresses your natural testosterone production system and your sperm production, so it is not suitable for men who want to have children [3]. There are also other drugs available that stimulate testosterone (without affecting fertility), but just like TRT, these need to be medically prescribed and need oversight and ongoing monitoring.

Key Takeaways

Andropause is a genuine and increasingly recognised condition that can affect older men. Its symptoms of low energy, reduced libido, loss of muscle, mood changes, and brain fog can seriously affect quality of life. However, it is neither inevitable nor irreversible for most men.

There are several lifestyle changes you can make to improve it. For many men, optimising their body fat levels, exercise, diet, and sleep can restore normal testosterone levels (and low-T symptoms) without the need for any drugs or medications.

If you are in (or past) your 40s and recognise several of the symptoms, it may be worth getting your testosterone levels checked by a medical professional. And regardless of your t-levels, there is little downside to starting to make healthy lifestyle changes we’ve suggested here.

Frequently Asked Questions

Is andropause the same as the male menopause?

Basically, yes — it captures the general idea of what is going on. But because there are a lot of fundamental differences between the “male menopause” and the “female menopause”, specialists prefer to call it ‘late-onset hypogonadism’ to avoid any confusion.

At what age does andropause typically start?

Testosterone begins declining slowly from the mid-to-late 30s, but most men do not develop noticeable symptoms until their 40s or 50s. The age of onset varies widely and is heavily influenced by your lifestyle and how healthy you are. Lean, healthy, active men can maintain healthy testosterone levels for life.

How do I know if I have andropause or just normal ageing?

With a blood test. Many symptoms of the andropause (e.g., fatigue, low mood, reduced libido) can have other causes. Diagnosis needs to be done by a doctor; you should not self-diagnose based on the symptoms.

Can I raise my testosterone without medication?

Yes — for many men, especially those who are overweight or have poor metabolic health, significant improvements in testosterone are achievable through weight loss, resistance training, improved diet, better sleep, and management of chronic health conditions. Guidelines recommend these approaches as the first line of treatment before considering medication.

How long does it take to see results from lifestyle changes?

Hormonal improvements from weight loss and lifestyle change typically begin to show in blood tests within eight to twelve weeks of consistent effort. Improvements in your energy, mood, and libido sooner.

Will andropause affect my fertility?

Declining testosterone in andropause can reduce sperm quality and volume, but complete infertility is caused by it is uncommon. It is important to note that some drugs and medications that are used to treat low-testosterone may affect your fertility. You should discuss treatment options with a medical professional before starting any medication.

Is andropause linked to depression?

There are links between low testosterone and depression, low mood, and anxiety in men for sure. However, treatment is not straightforward. Mental health issues should be assessed and managed alongside your hormonal health (not instead of).

Are testosterone supplements effective?

Most ‘testosterone boosters’ have limited evidence behind them and are unlikely to make a meaningful difference to your testosterone levels. A small number of supplements (like ashwagandha and fenugreek) have some benefits in men with low or borderline low testosterone levels. Some vitamin and mineral supplements may help those who don’t get enough from their diet. In fact, some testosterone supplements may actually reduce your testosterone levels [7] — save your money for something else.

Sources

1. Huhtaniemi I. Late-onset hypogonadism: current concepts and controversies of pathogenesis, diagnosis and treatment. Asian J Androl. 2014;16(2):192-202. PMID: 24407185

2. Corona G et al. Risks and benefits of late onset hypogonadism treatment: an expert opinion. World J Mens Health. 2013;31(2):103-125. PMID: 24044106

3. Bhasin S et al. Testosterone therapy in men with hypogonadism: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2018;103(5):1715-1744. PMID: 29562364

4. Rochira V. Late-onset hypogonadism: bone health. Andrology. 2020;8(6):1539-1550. PMID: 32469467

5. Colleluori G et al. Aromatase inhibitors plus weight loss improves the hormonal profile of obese hypogonadal men without causing major side effects. Front Endocrinol. 2020;11:277. PMID: 32499757

6. Roychoudhury S et al. Environmental factors-induced oxidative stress: hormonal and molecular pathway disruptions in hypogonadism and erectile dysfunction. Antioxidants. 2021;10(6):837. PMID: 34073826

7. Clemesha CG et al. 'Testosterone Boosting' Supplements Composition and Claims Are not Supported by the Academic Literature. World J Mens Health. 2020 Jan;38(1):115-122. PMID: 31385468