Male menopause: Symptoms and Treatment

Introduction

Science has extended the life expectancy of the male gender significantly in the past 60 years. Millions of men are above the age of 40, and the number is expected to increase in the coming decades. On the flip side, men must deal with age-related health challenges such as declining testosterone levels and male menopause – andropause.

What is Andropause?

Healthy, ageing males undergo various hormonal changes such as decreasing androgen and plasma levels. Andropause is a common term for male menopause, which describes the overall changes in male hormone levels linked to the ageing process. Men who are 50 years or older tend to experience an acute drop in testosterone production. This is often linked to hypogonadism, and both health conditions involve low T-levels and other similar symptoms. 

Testosterone is a male sex hormone produced in the testes. It facilitates many changes during puberty, maintains muscle mass, fuels sex drive, regulates a man's fight-or-flight response, fuels energy, and regulates other important evolutionary processes. Keep in mind that andropause is different from female menopause. For instance, not all men experience andropause, and for those who experience it, dropping testosterone levels doesn't involve a complete shutdown of the male reproductive system. But low hormone levels can cause sexual complications. 

Symptoms of Andropause

By name, low testosterone can be troublesome. Researchers at the International Journal of Clinical Practice recently found that low T-levels can cause different symptoms and complications. Here are the common symptoms of male menopause. 

The Role of Testosterone in Libido and Sexual Health

Testosterone is a vital hormone that plays a key role in maintaining libido, sexual function, and overall reproductive health. If you're experiencing a low sex drive, it could be a sign of low testosterone levels—a condition that may be linked to menopause, aging, or other health-related issues.

Low testosterone can also lead to erectile dysfunction (ED), making it difficult to get or maintain an erection. Additionally, it may contribute to a reduced sperm count, affecting fertility. Addressing testosterone imbalances early can help improve both sexual performance and overall well-being.

Low Testosterone and Depression: What You Need to Know

Testosterone doesn't just influence physical health—it also plays a crucial role in regulating your mood and emotional well-being. A drop in testosterone levels can increase the risk of depression, especially in men experiencing andropause (also known as male menopause).

Common symptoms of depression linked to low testosterone include:

• Persistent feelings of sadness, anxiety, irritability, or emptiness
• Difficulty concentrating or remembering things
• Loss of interest in activities you once enjoyed
• Increased feelings of anger or frustration
• In severe cases, suicidal thoughts may occur
• Often, those around you—friends, family, or co-workers—may recognize changes in your behaviour before you do. Depression is a serious condition that shouldn't be ignored. What many people don’t realise is that hormonal imbalances, particularly low testosterone, can be a hidden cause.

If you're experiencing these symptoms, it’s important to speak with your doctor. Early diagnosis and treatment can significantly improve both your mental health and quality of life.

Insomnia

Declining testosterone can also contribute to sleep disorders like insomnia. This hormone plays a crucial role in regulating sleep quality and patterns. Once your T-level starts declining, you might experience disturbed sleep or insomnia. The common symptoms of insomnia include sleeplessness and difficulty falling asleep. This can lead to irritability, daytime sleepiness, being angered easily, and trouble focusing. 

Low Energy

Testosterone is one of the key hormones that help your body maintain high energy levels. Men experiencing menopause often feel fatigued. They also struggle to find sufficient energy to participate in their routine activities. 

Abdominal Fat

Excessive abdominal fat can be a cause and impact of low testosterone. Generally, testosterone slows down your body's belly fat build-up. If your T-level drops, there is a chance you will accumulate fat around your mid-section. There are enzymes in fat that convert testosterone into oestrogen, which means your T-level will continue to drop. 

Bone Density

As mentioned earlier, testosterone maintains bone density. However, your bone density may drop if you develop andropause. This can lead to osteoporosis, a health condition in which bones become brittle and very fragile. In most case, osteoporosis does not cause many symptoms. You can only learn about the condition if you undergo routine screening tests or sustain an unusual bone fracture. 

Other warning symptoms

Other symptoms associated with male menopause include: 

• Decreased motivation 
• Breast enlargement 
• Difficulty remembering some things
• Low self-confidence
• Reduced body hair
• Increased nervousness
• Reduced muscle strength and mass

It is essential to mention that most of the symptoms discussed are also symptoms of other health conditions. Before you self-diagnose yourself with andropause, it is essential to make an appointment with your healthcare provider. 

Changes in Testosterone as you Age

In males, the production of testosterone hormone starts very early indeed, often at the beginning of the 7th week of embryonic development. T-levels remain high throughout fetal development but begin to fall just before delivery. Baby boys usually experience a blip in testosterone hormone production between 3 and 6 months of age but start to fall again by the time the babies are a year old. Between 6 years and 8 years of age, adrenal androgen production increases, triggering transient growth spurt and development of body hair with less sexual development.

During puberty, a surge in LH and GnRH facilitates the rapid production of testosterone, which goes on to stimulate muscle growth and bone development. This surge in hormones also fires up the production of red blood cells, growth of body hair & facial hair, enlargement of the male voice box, awakening of production capacity & sexual function, and enlargement of the male genitals. 

In many young men, testosterone hormone production hits a maximum at about the age of seventeen and remains high for 20 to 30 years. A healthy young man produces approximately 6 milligrams of testosterone hormone daily. However, this level of T hormone production varies depending on many factors such as health, diet, and more. 

In some males, testosterone hormone levels remain high throughout their lives but mostly start to decline at the age of 40. Contrary to the precipitous drop in hormones that most women experience at menopause, the decline in testosterone in men is usually gradual, averaging to 1% each year. This decline is imperceptible at first, but as you age (age of 70), the average testosterone production is likely to be 30%.

Still, T-levels remain within what's considered normal range in about 75% of older males. This is why most men can father children, even in their late 80s and beyond. Besides, older males who worry about dropping testosterone hormone might be reassured by a recent study that found no link between declining testosterone levels and the risk of sexual issues like erectile dysfunction (ED). 

So, what's considered a Normal Testosterone Level?

Testosterone isn’t just about sex drive and muscle mass—it plays a crucial role in your mental health, mood regulation, and overall well-being. When testosterone levels drop, especially in men over 40, symptoms of depression and emotional imbalance can become more noticeable.

According to the British Society for Sexual Medicine (BSSM):

• Testosterone levels below 12 nmol/L may indicate deficiency, especially if symptoms are present
• Levels under 8 nmol/L are clearly low and often qualify men for TRT
• Even levels up to 14 nmol/L may link to early signs of metabolic issues, including prediabetes, fatigue, and mood changes

Common Symptoms of Depression caused by Low Testosterone:

• Ongoing sadness, irritability, or emotional numbness
• Trouble with focus, memory, or decision-making
• Loss of interest in hobbies, relationships, or sex
• Feelings of anger, anxiety, or emptiness
• In more serious cases, suicidal thoughts

While depression can have many causes, low testosterone, especially during andropause (male menopause), is a common yet often overlooked factor.

If you're experiencing these symptoms and your testosterone levels are below 12–14 nmol/L, it’s important to consult a healthcare professional. With the right approach—whether it's hormone therapy, lifestyle adjustments, or both—many men report significant improvements in their mood, energy levels, and quality of life.

You may not need to know all the details of testosterone metabolism, but you should understand that these complexities account for significant flaws in research on TRT (Testosterone Replacement Therapy). If you want to know your exact T-level and whether you're healthy sexually, you should schedule an appointment with a specialist who can successfully perform a testosterone blood test. 

Diagnosing & Treating Male Menopause

To diagnose male menopause, your doctor can take blood samples to test your body's T-level. Unless male menopause is disrupting your or causing severe challenges, you can manage its symptoms without treatment. It is essential to mention the biggest hurdle in male menopause treatment is talking to your doctors about the symptoms you may be experiencing. This is because most men are intimidated to discuss such issues, even with their doctors. Here are some of the treatment options for male menopause. 

1. Healthy Diet

Nutrition should focus on maintaining your health and preventing diseases. Accumulating scientific evidence suggests that improving your eating habits with a balanced diet, avoiding stress, getting sufficient rest, and regular exercise can help manage andropause. Also, reducing the intake of toxic substances such as alcohol and tobacco could be helpful. Note that these are dietary and lifestyle changes that might decrease the symptoms of male menopause, improve your day-to-day life, and ultimately, improve your overall health. 

A healthy, balanced diet can improve the production of testosterone in your body. A recent study published in the journal of clinical medicine suggests that a healthy and balanced diet can ensure effective disease prevention and better weight management. The particularity of male menopause lies in increasing the consumption of specific foods and following important nutritional recommendations to achieve an optimal nutritional status that could help combat the symptoms of andropause.

That means the dietary approach is based on offering the recommended amount of nutrients. This way, your body will have a sufficient amount of energy to maintain a healthy weight level and enough supply of proteins to allow muscle protein synthesis and reduce the risk of loss of muscle mass. Changes in your body composition associated with male menopause are also related to a health condition known as sarcopenia. This is a common condition among older people, particularly the age 50 or older, in which the patient experiences accelerated loss of muscle mass.

During male menopause, bone deterioration, loss of muscle mass, cardiovascular challenges, and other symptoms of male menopause are very common. Here are some of the essential nutrients that you need to combat some of the common symptoms of male menopause.

Calcium: As mentioned earlier, testosterone plays a key role in a man's bone metabolism. This is why low T-levels are associated with a higher risk of bone fractures and osteoporosis. So, consuming calcium-rich foods such as dairy and its derivatives, nuts, green leafy vegetables, and legumes is essential in preventing bone loss. 

Zinc: This mineral plays a critical role in maintaining the proper functioning of the male reproductive system and balancing essential hormones like testosterone. A deficiency in this mineral is also linked to weak immunity and a bad mood. Nutritionists and other health experts recommend the inclusion of oysters, legumes, tubers, meats, seafood, dark chocolate, and other foods rich in zinc in your diet to remedy zinc deficiency.

Omega-3 fatty acids: These nutrients help maintain and regulate heart function and can help prevent or lower the risk of cardiovascular problems associated with male menopause. Some of the common sources of Omega-3 fatty acids include plant-based foods, tuna, bluefish, sardines, and more.

Vitamin D: This nutrient can potentially increase the natural production of testosterone. It is directly involved in the regulation of your androgenic metabolism. Some of the foods with a high quantity of vitamin D include eggs, fatty acids, mushrooms, fish liver oil, butter, milk, and meat.

Antioxidants: It is recommended to consume the right quantity of foods rich in antioxidants. Such substances can help decrease cellular damage associated with oxidative stress and control inflammation generated by the stress hormone known as cortisol. Some of the foods rich in antioxidants include grapes, peppers, red berries, pure cocoa, tea, tomatoes, and more.

Other important nutrients you need to combat the symptoms of male menopause include vitamin E and healthy fats. Avocados, extra virgin oil, and nuts are generally rich in vitamin E and contain unsaturated fats. These nutrients are very beneficial in speeding up natural testosterone production. Cruciferous vegetables also play a key role in reducing excessive oestrogen, and this could increase the effectiveness of testosterone.

2. Regular Physical Activity

Hormonal changes are a natural part of your life and the ageing process. The good news is that most symptoms of male menopause respond positively to regular physical activity or exercise. In addition to a healthy diet, you can take other steps to stimulate increased testosterone production in your body.

A recent study found that testosterone levels increase through consistent physical training, especially high-intensity interval training (HIIT) and heavy weightlifting.

That means if you want to restore and maintain the recommended levels of testosterone, you may want to engage in these types of physical activities for greater virility. Resistance training and weightlifting also help counteract increases in visceral body fat, bone density loss, and the decline in lean muscle mass.

Remember, high-intensity training alone won't eliminate the symptoms of male menopause. However, when combined with a healthy diet, proper rest, and other evidence-based strategies, your chances of success improve significantly. Like any health-related approach, it's important to talk to your doctor before starting high-intensity training or any new exercise program.

3. Get Enough Sleep

The causes of insomnia in men vary significantly from causes of sleeplessness in women. The low testosterone levels linked with male menopause can contribute to sleep challenges in men, which in turn results in insomnia or other sleep challenges. Sleep apnoea affects about 9% of all adult males and is very common in obese men. The loud snoring and inhibited breathing are the common symptoms of sleep apnea and often disrupt sleep throughout the night. 

These disruptions affect both you and other people who may be trying to sleep nearby. The good news is that testosterone replacement therapy and other forms of treatment of male menopause symptoms can improve sleep apnoea. Keep in mind that adequate sleep is an easy way of achieving normal testosterone levels and treating the symptoms of male menopause. 

In males, insomnia caused by low testosterone levels and sleep apnoea causes other problems such as reduced insulin sensitivity, fatigue, low human growth hormone levels, and even high cortisol levels. The latter is a stress hormone that could increase with prolonged insomnia due to the excessive stress in your body. Continuous high levels of cortisol can create unfavourable hormone patterns that influence testosterone production negatively. Also, it can lead to adrenal fatigue, which is likely to worsen insomnia. 

If unchecked, these factors will feed off each other in a somewhat feedback loop. It is essential to mention that the human growth hormone is naturally produced during the first 90 minutes of your sleep. If your sleep is disrupted, HGH production will be reduced. This can result in reduced lean muscle mass and low levels of testosterone.

High quality and sufficient sleep are essential for proper insulin sensitivity and control of glucose levels in your body. If sleep is disrupted, your body might stop utilizing insulin effectively and perhaps need more insulin to keep your blood sugar under control. This could lead to weight gain and, in the worst-case scenario, diabetes. Generally, sufficient sleep plays a key role in maintaining the recommended levels of testosterone and fight most symptoms of male menopause.  

4. Reduce Stress and Anxiety

Anxiety, irritability, depression, and other related body changes are common in males with low testosterone. The shared symptoms of depression and low testosterone (and male menopause) usually make the diagnosis very challenging. Besides, difficulty in thinking, anxiety, and depression are also signs of a normal ageing process.

That means most symptoms of male menopause overlap with those of depression and low testosterone. People who have depression often have normal hormone levels and do not experience decreased muscle mass or breast swelling associated with low testosterone. So, when these symptoms start overlapping, it is important to start dealing with stress levels. 

There are many ways of dealing with stress and anxiety. Mindfulness or meditation and breathing exercises are often used for anxiety and overcoming stress issues. Focusing on each breath can help you feel relaxed and probably empty your mind off negative thoughts. If you do not know how to perform such exercises on your own, consider joining yoga and meditation groups. 

You can also keep a journal as a way of helping you organise your thoughts and your feelings. Just write down what is in your mind at a specific time each day. Sometimes, writing your thoughts down on paper could help you analyse your thoughts and make you feel better. If you are experiencing extreme anxiety, seek help from a professional.

It is essential to mention that stress can have a negative impact on your body and could worsen the symptoms of male menopause. So, it is in your best interest to relax your mind as this could be key in treating fatigue, insomnia, low T-levels, and other andropause symptoms you may be experiencing. 

Generally, the most effective treatment for male menopause is a healthy diet and positive lifestyle changes. Adopting these new habits can help make dramatic changes in your overall health because, with time, you may start experiencing a decline in the male menopause symptoms you are battling. Keep in mind that declining testosterone levels are part of your ageing process. So, do not be harsh on yourself. If you are worried about a sharp decline in your T-levels, talk to your doctor. Testosterone Replacement Therapy may be necessary.

Conclusion

As you get older, it is normal to experience a drop in your testosterone level. Most symptoms of male menopause are manageable even without treatment. All you need is a healthy, balanced diet and a few lifestyle changes. In case some of the male menopause symptoms are causing you hardships, seek help from your doctor.