Male menopause or andropause

Is there a male menopause or andropause?

Male menopause is often used in the media as shorthand for the health consequences of an age-related drop in testosterone in men. Whilst helpful as an easy to understand analogy to the female menopause, male menopause is not a medically accurate term. The term menopause describes the time in a woman’s life when her monthly periods stop as her oestrogen levels significantly decline, usually between 45 to 55 years of age. Men do not universally suffer from an equivalent change of life.

However, while their experience is different from that of the female menopause, men’s hormone levels and balance do go through changes as they age, particularly if they fall into ill health. Falling levels of testosterone and increasing resistance to its action can cause men from around the age of fifty (and in some cases younger) to lose their morning erections and develop erectile dysfunction (ED) amongst other symptoms that may indicate that they are suffering from the male menopause. So to answer the question: “Is there a male menopause?” the answer is, for many men, “yes”.

The Centre for Men’s Health is a specialist clinic providing testosterone replacement therapy and ED treatment to help men in this situation.

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Male Menopause – Isn’t it just a mid-life crisis?

No, the male menopause is not just a mid-life crisis. 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 it’s an emotional problem.” She says that we usually start out adult life with aspirations of what we want to do and struggle towards achieving them. Sometimes we are thwarted, but sometimes we achieve them. When we’ve achieved them, and perhaps other things happen like our parents get ill or die, we start to wonder: “What do I do next? What do I do with the second half of my life? Is that all there is?” That’s the existential crisis. If you’ve had good experiences earlier in your life, that’s often a very easy change, but for people who’ve had problems earlier in life, that’s sometimes a very difficult period.”

However, Coleman explains, this is not to do with hormonal levels and activity, as is the case with what is commonly called the male menopause.

Male menopause, andropause or Testosterone Deficiency Syndrome – What’s in a name?

Other common terms used to describe the male menopause and the symptoms and signs that usually come with it include andropause, hypogonadism and Testosterone Deficiency Syndrome. All these refer to the same condition. The Centre generally uses the term Testosterone Deficiency Syndrome (TDS), as we believe this most accurately describes the condition and its cause.

However, as ‘male menopause’ is a term used extensively in the media to encompass a wide range of symptoms, for the purposes of explaining how it might be recognised, on this page we will continue to use the expression male menopause.

Male menopause – What are the symptoms?

The range of possible male menopause symptoms to look out for is similar whether the cause of a man’s level of total or active testosterone becoming too low (deficient), or their body being unable to make effective use of the testosterone in the blood, is due to ageing or other factors.

The signs and symptoms of the male menopause often include loss of energy, drive, libido (sex drive) and erection problems, especially a loss of morning erections. The list of male menopause symptoms can also include depression, irritability, night sweating, joint pains, weight gain, memory loss, lowered self-confidence and poor concentration.

In addition to these male menopause symptoms, there is mounting evidence indicating that very low testosterone can be responsible for a host of serious diseases in later life including diabetes, osteoporosis and Alzheimer’s disease.

At what age does the male menopause begin?

While most men who experience age related testosterone health problems will experience male menopause 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 is the male menopause diagnosed?

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 alongside 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 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 discuss the findings and put together a plan with you for treatment options for any health problems we find.

What are the treatment options?

If, following a blood test, other investigations and information gathering the doctor considers that the patient may be suffering from the male menopause/testosterone deficiency syndrome, he will discuss the benefits and potential risks of testosterone replacement therapy (TRT) or other testosterone treatment with him. If treatment is indicated and the patient wishes to proceed, a trial period of TRT or testosterone stimulation therapy will be initiated.

TRT is usually given by testosterone gel, cream or long acting injections. Testosterone Replacement Therapy (TRT) has been shown to be highly effective in relieving the symptoms of the male menopause/testosterone deficiency – in particular in restoring energy, health and sex drive.

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 male menopause symptom relief is maintained or changed to other types if needed. 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, the 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 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.

What forms of Testosterone Replacement Therapy (TRT) are available to treat the male menopause?

Testosterone replacement therapy at the Centre’s two clinics comes in many forms. Usually it’s given by testosterone gel or injections. However, we provide a range of medications and treatment modalities to suit all lifestyles.

For the first two to six months we normally recommend a testosterone gel which is easy to apply. This method can safely be continued for as long as you are happy with the daily applications. In the long term, some patients prefer the ease of long acting injections which are given 6 – 10 weeks apart.

To ensure the safety and effectiveness of the treatment, our specialist doctors monitor our patients carefully on an ongoing basis. Therapy can be carefully tracked via our on-site pathology lab and blood testing services. We discuss alternative treatment methods during regular follow up appointments and changing to alternative treatment types is straightforward.

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Are you going through the male menopause?

If you think you may be going through the male menopause, 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 email you your results.

Just click the ‘Take the Test’ at the bottom of this page.

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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