How Does the Male Menopause Affect Men?

Getting older, male hormones, and sexual function

Last reviewed: 09 Mar 2019

Man with friend in cafe reading about the male menopause

Key takeaways

  • The male menopause is not a 'recognised' health condition

  • The male menopause can refer to a number of recognised health conditions affecting older men

  • There are a set of symptoms associated with the male menopause

  • The male menopause doesn't cause sexual problems like erectile dysfunction, but they are related

  • Testosterone levels drop in older men but this is not the same as a 'testosterone deficiency'

  • You might be able to get treatment for some male menopause symptoms

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Women go through the menopause when they reach a certain age and their hormone levels change, with some noticeable symptoms. It could be possible that this change happens for men as well, maybe over a longer time period.

Find out what changes can happen as a man ages and whether it will affect his health and sexual function.

What is the male menopause?

The male menopause is – a phenomenon relating to the fall in testosterone levels. It refers to a number of symptoms men may develop in their late 40’s or 50’s. The male menopause is often used to describe these symptoms. This is misleading because it suggests that the symptoms are caused by a decline in the male sex hormones as in the female menopause, which isn’t true.

Medically this phenomenon may be referred to as either:

  • Testosterone deficiency
  • Andropause
  • Late onset hypogonadism

Some men may experience late onset hypogonadism, which is a testosterone deficiency that develops later in life. In many cases however, the symptoms are nothing to do with hormones.

Is it a recognised health condition? – no, the male menopause is not recognised by the NHS or other authorities in the same way as the female menopause. In the UK, there are no official NHS guidelines, but the Society of Endocrinology recommends that each man is treated on a case-by-case basis depending on how severe his symptoms are.

There is little evidence to confirm that the male menopause is a medical condition. There have been a few studies but the results are inconclusive. They mostly conclude that individual symptoms should be treated rather than relying on testosterone levels alone.

What are the differences and similarities between the female menopause and the male menopause?

  • Once menopause is complete in a woman, she is no longer able to have children. Men with symptoms of the male menopause can still have children as their sperm production continues
  • Every woman goes through the menopause but not every man goes through the male menopause
  • Sex hormones in women decline at a much greater rate than men’s, causing women to experience more noticeable symptoms
  • Both occur around the age of 50
  • Hormone Replacement Therapy can help in managing either

Am I experiencing male menopause symptoms?

One way to tell is symptoms – there are a set of symptoms which are thought to be linked to the male menopause. You may develop symptoms such as,

  • Low sex drive
  • Erectile dysfunction
  • Mood swings or irritability
  • Poor concentration and short term memory
  • Loss of muscle mass
  • A change in fat distribution such as ‘man boobs’ (gynaecomastia) or a large ‘belly’
  • Tiredness or low energy levels
  • Difficulty sleeping (insomnia)
  • Fragile bones (osteoporosis)

Are there other factors linked to the male menopause? – there could also be other causes of the perceived ‘male menopause’. Lifestyle or psychological problems are often responsible for many of the above symptoms. Lifestyle choices such as poor diet, smoking or excess alcohol can also trigger the above symptoms.

Hypogonadism may be responsible for the symptoms of the ‘male menopause’ – this is a condition where the testes produce very little or no hormones. This condition may be sometimes present from birth.

Late onset hypogonadism can also develop later in life and is more common in men who are obese or have type 2 diabetes. It can cause the ‘male menopause’ type symptoms mentioned but it is a specific medical condition, which is uncommon and isn’t part of the normal aging process.

Can the male menopause cause erectile dysfunction?

No, it cannot cause it – erectile dysfunction (ED) is not an inevitable part of the male menopause symptoms and is not directly caused by it.

Mental health, the male menopause, and ED could be linked – stress, depression and anxiety brought on by worrying about the onset of male menopause symptoms can sometimes trigger ED. Depression may be triggered by a ‘midlife crisis’ where men may worry about what they have achieved as they approach the halfway stage of their life.

Age, the male menopause, and ED could also be linked – ED often occurs in older men as they are prone to other medical conditions that increase the risk such as heart disease, diabetes or obesity. Physical reasons are also sometimes the cause such as heart disease or surgery, which are more common in older men too. Because the male menopause occurs as men age, ED can occur alongside it.

ED can be treated by medicines called phosphodiesterase type 5 (PDE-5) inhibitors. Other treatment may be lifestyle changes or surgery, but this depends on the cause of ED.

Is age affecting my testosterone levels?

It’s possible for age to affect testosterone levels – testosterone is the male sex hormone produced by the testes. It is normal to experience a decline in testosterone levels as you age. Testosterone levels decline gradually. The rate of decline is usually around 2% each year from around age 30 to 40. This steady decline is unlikely to cause any problems itself.

Does that mean I could have low testosterone? – although testosterone levels do decline over time, that doesn’t mean all older men experience ‘low testosterone’. ‘Low testosterone’ is a distinct medical condition, usually with a specific cause and involved lower levels of testosterone that you see in older men naturally. A simple blood test can determine your levels of circulating testosterone. Speak to your doctor if you’re concerned about low testosterone levels for further advice.

Does low testosterone cause sexual problems? – your level of testosterone is not the only factor that determines your sex drive or performance, but low levels can lower your libido and contribute to ED. A low testosterone level is not always the cause of sexual problems in older men, but it can contribute especially if there are also other medical conditions.

Can I get male menopause treatment?

You might be able to – depending on what you’re experiencing, there may be various forms of treatments to help. Speak to your doctor if you are experiencing any of the symptoms mentioned. They’ll ask about your work or personal life to assess whether your symptoms may have a psychological cause, such as stress or anxiety.

There are a few solutions for the symptoms of male menopause – if stress, anxiety or depression are affecting you, you may benefit from medication, or a talking therapy such as cognitive behavioural therapy (CBT). Your doctor may also recommend other lifestyle changes such as,

  • Eating a healthy and balanced diet
  • Exercise
  • Getting enough sleep
  • Reducing stress levels

These lifestyle changes can benefit all men and adopting them can provide a dramatic difference to your symptoms. They can also help tackle the aging effects in men.

If you do have hormone problems – hormone replacement therapy is another treatment option. This is usually prescribed by an endocrinologist (a specialist in hormone conditions), depending on the results of your blood test.

This treatment is usually continued throughout your life and can be in one of the following forms:

  • Tablets
  • Patches
  • Gels
  • Implants
  • Injections

Dr Nicholas Antonakopoulos graduated from the University of London in 2006. He did his postgraduate training in hospitals in the London area, and he trained for four years in Trauma and Orthopaedic Surgery before completing his training in General practice in 2015.

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Last reviewed: 09 Mar 2019

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