Male menopause or andropause

Is there a male menopause?

Male menopause is often used in the media as shorthand for the symptoms and health effects suffered by men due to an age-related drop in testosterone levels and activity. However, when used about men, the term menopause can be misleading.

For women, it describes the time when their monthly periods stop as oestrogen levels significantly decline, usually between 45 to 55 years of age. 

On the other hand, not all men suffer from a comparable change of life. But men’s hormone levels and balance often go through changes as they age, particularly if they fall into ill health due to problems like obesity, stress and high alcohol intake. This can affect many men with symptoms that are sometimes severe. So in reply to the question, does the male menopause exist?, the answer is yes, it is a real, identifiable health problem.

The good news is that it can be treated successfully and effectively with testosterone replacement therapy.

Is the male menopause just a mid-life crisis?

No, the male menopause is not the same as a mid-life crisis although they may occur at the same age. As clinical psychologist Jean Coleman explains: “You can get a mixture of mid-life crisis and andropause (male menopause) in some men, but mid-life crisis is an existential crisis and an emotional problem.” 

However, Coleman says, this is not to do with hormonal levels and activity, as is the case with what is commonly called the male menopause, which has its own distinctive pattern of andropause symptoms.

Are there other names for the male menopause?

Other common terms used to describe the male menopause and the symptoms and signs that usually come with it include andropause, late onset hypogonadism, male climacteric, low T, man-o-pause and Testosterone Deficiency Syndrome. All these refer to the same condition. The Centre for Men’s Health generally uses the more precise medical term Testosterone Deficiency Syndrome (TDS), as we believe this most accurately describes the condition and its cause.

What are male menopause symptoms?

Male menopause symptoms include:

• Loss of energy;
• Low libido (sex drive);
• Erection problems, especially a loss of morning erections;
• Depression;
• Anxiety;
• Irritability and anger;
• Night sweating;
• Hot flushes;
• Joint pains;
• Weight gain;
• Memory loss;
• Reduced beard growth;
• Lowered self-confidence;
• Poor concentration/’brain fog’;
• Gynaecomastia (‘man boobs’)

In addition to these male menopause symptoms, there is mounting evidence indicating that very low testosterone can be linked to a host of serious diseases in later life and older age. These can include diabetes, osteoporosis (reduced bone mass/brittle bones) and Alzheimer’s disease. There is even research suggesting that Low T levels can make men more vulnerable to the effects of Coronavirus/Covid-19.

How long does male menopause last? At what age does it start?

The male menopause has no set duration, and may come on gradually over a period of months or even years, becoming long-lasting if not treated appropriately, damaging a man’s health and well-being. 

Most men who experience age related testosterone health problems will see male menopause symptoms and signs during their late forties to early fifties, but they can start any time from the age of 30 onwards. So there is no fixed ‘male menopause age’.

Am I going through the male menopause?

If you think you may be going through the male menopause or andropause, why not take our Testosterone Deficiency Syndrome Symptom Review Test to see if you have the symptoms?

It’s a free, easy questionnaire, developed by international experts, which you can take in the privacy of your own home. Just answer a series of questions and we’ll e-mail you your results.

What is testosterone and what is its role in men’s bodies?

Testosterone is the primary male sex hormone and plays a central role in the development of male reproductive tissues such as the testes and prostate as well as of secondary sexual characteristics including increased muscle and bone mass and growth of body hair. Low testosterone levels, and more importantly activity, are the central cause of the male menopause.

Can I be suffering from the male menopause even if my testosterone level seems to be normal?

Yes. Put simply, this is because it is the availability and activity of testosterone that counts more than just its total level. There are many factors that can prevent the testosterone in your blood from being used effectively by your body.

Of the testosterone circulating in the blood 40-50% is weakly bound to a type of globular protein called albumin and another 50-60% is strongly bound to SHBG (sex hormone-binding globulin). Only 1-3% of the hormone is free testosterone. As men age, SHBG levels rise and free testosterone levels fall. This, combined with other factors, can lead to men suffering from symptoms of the male menopause.

How do our doctors diagnose the male menopause?

Here at the Centre for Men’s Health, any diagnosis of the male menopause is based on a very thorough review of your health and symptoms by one of our team of experts.

The first step is to ask you to take a blood test before your first visit. The doctor will then undertake a detailed review of your testosterone levels and connected hormone measures. He will also look at wider health measures such as prostate inflammation, liver and kidney function, red and white blood cell count and blood fat.

Then, at your appointment in one of our two UK clinics (London or Manchester), the doctor will review your male menopause symptoms, your medical history and will also conduct a physical examination. We also discuss the results of your blood test with you. We can then talk over the findings and put together a plan with you for treatment options for any health problems we find.

What treatment options are available for the male menopause?

Testosterone replacement therapy at the Centre’s two UK clinics comes in many forms. TRT is usually given as a gel or injection for the first two to six months. It is often needed long-term and can safely be continued in these forms if good relief of male menopause symptoms is maintained or changed to other types if needed.

Is treatment for the male menopause safe?

Testosterone treatment has been in use for over half a century and has a remarkably good safety record over that time, as confirmed by the detailed studies at this centre. However, every effort is made to exclude pre-existing prostatic cancer, by clinical examination, and a sensitive blood test to measure levels of Prostate-Specific Antigen (PSA).

To ensure the safety and effectiveness of treatment of the male menopause/testosterone deficiency, it is essential that the results are carefully monitored. Both to establish the diagnosis and to monitor the treatment and relief from symptoms carefully, blood tests and laboratory measurements are required at regular intervals. Following the initial consultation and diagnosis, detailed clinical examinations need to be carried out at 3-6 month intervals.

Will my male menopause treatment relieve my symptoms?

While it may take time for the treatment to become fully effective, patients report often dramatic relief from their male menopause symptoms, with benefits including improved energy levels, and restored vitality and sex life. Often the particular physical symptoms that are the hallmark of the male menopause like hot flushes, mood swings, irritability and poor erections are dramatically lessened by TRT treatment. To find out more about how our patients saw their symptoms improve after they started treatment, see Dan’s story and Ian’s story.

Can I get treatment for the male menopause on the NHS?

You can get TRT on the NHS, but only on a restricted basis. Eligibility for male menopause NHS treatment is mainly determined using a relatively low and inflexible blood level cut off for total testosterone. Men whose blood results fall above this, even if they have all the typical andropause symptoms, are unlikely to be given treatment. This means that many men who could benefit from TRT, based on a more detailed review of their testosterone levels and symptoms, are potentially missing out. 

Want to find out more about the male menopause and TRT? The Centre for Men’s Health’s founder, Professor Malcolm Carruthers, pioneered TRT in the UK. He published several books explaining TRT and why many men can benefit from it.

References:

‘Male menopause’ is real and treatable, say pharmacy researchers, University of Alberta, Canada, 2022

https://www.ualberta.ca/folio/2022/01/male-menopause-is-real-and-treatable-say-pharmacy-researchers.html

Male menopause (androgen deficiency in the ageing male), The British Association of Urological Surgeons

https://www.baus.org.uk/patients/conditions/7/male_menopause_androgen_deficiency_in_the_ageing_male/

Questions men ask us:

Do men go through menopause?

No. Men do not go through the menopause in the same way as women. However, men can suffer from Testosterone Deficiency Syndrome, resulting from an insufficiency in either the level or activity of testosterone. This is commonly called the ‘male menopause’, although other terms such as andropause and late-onset hypogonadism are also used.

Do men's hormones change with age?

Yes. Men’s total testosterone levels normally peak in their early twenties and gradually decline after that. Many factors in life can lower testosterone levels as well. These can include smoking, obesity, stressful environments as well as other less common causes like trauma or surgery.

What treatment can you take for male menopause?

Treatments include creams, gels and long-acting injections to restore testosterone to a level sufficient to alleviate the symptoms of the ‘male menopause’, or more correctly Testosterone Deficiency Syndrome. Any treatment should be preceded by careful diagnosis looking at the the results of relevant blood tests, symptoms, medical history, lifestyle and a physical examination as well as screening for prostate cancer.

What happens if a man takes menopause pills?

Treatment for the ‘male menopause’ or andropause, or more correctly Testosterone Deficiency Syndrome, is in the form of creams, gels or long-acting injections, rather than pills. If the treatment is successful, the patient should find his symptoms are relieved, energy levels recover and quality of life improves. To find out more, see some Centre for Men’s Health patient stories.

At what age does andropause start?

While most men who experience age related testosterone health problems will experience symptoms during their late forties to early fifties, they can start any time from the age of 30 onwards. However, men suffering from these distressing symptoms can often be helped by, testosterone replacement treatment, aided if necessary by erection medications, a combination of which can provide a success rate of up to 90% for ED.

How can andropause be prevented?

While a healthy lifestyle with regular exercise and a good diet and avoiding contributory factors like smoking and excessive stress levels can help reduce the likelihood of andropause occurring, some men find that nevertheless they suffer from the symptoms of the andropause or ‘male menopause’. In this case, they may need to seek treatment to restore their testosterone levels and relieve their symptoms.

What are the symptoms of andropause?

The characteristic symptoms of the andropause, ‘male menopause’ or more accurately Testosterone Deficiency Syndrome are decreased sex drive, erection problems, loss of energy, depression, weight gain, brain fogs, memory loss, irritability and night sweats.

Does the male menopause really exist?

The ‘male menopause’ or more accurately Testosterone Deficiency Syndrome is a real phenomenon for many men, with symptoms including decreased sex drive, erection problems, loss of energy, depression, weight gain, brain fogs, memory loss, irritability and night sweats. However, while all women go through the menopause, only a minority of men suffer from the ‘male menopause’.

How long does the andropause last?

There is no standard length of time over which the andropause occurs, but it may occur over several years and have severe consequences for a man’s health, happiness and general wellbeing. Fortunately, treatments are available that can help men to recover from the condition.

How do men treat the menopause?

Men do not go through a menopause in the same way as women do, but they can suffer from Testosterone Deficiency Syndrome, which is often commonly called the ‘male menopause’. This can be treated, after careful diagnosis and screening, using creams, gels or long-acting injections to boost their testosterone levels and relieve symptoms.

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