Is Male Menopause Real?

In the medical realm, not everyone agrees that the term “male menopause” is appropriate or accurate. After all, the word “menopause” (and perimenopause) when applied to women suggests a significant and somewhat sudden drop in sex hormone levels. This is not the scenario in men, in whom the decline is mostly slow and gradual. However, although the terminology may be off target, the real question is, is male menopause real?

What is male menopause?

The phenomenon of male menopause (aka, andropause) occurs primarily in men aged 50 and older when their production and plasma concentrations of testosterone decline. Although T typically begins a downward journey around age 30, many men don’t usually notice symptoms for several decades.

Symptoms of male menopause (at one time called male climacteric, which suggests a gradual decline rather than a sudden drop in T levels and concentrations) include fatigue, poor memory, depression, mood swings, lack of sex drive, erectile dysfunction, nervousness, accumulation of belly fat, sweats and flush. Because many of the symptoms men experience associated with hormone decline are similar to those that affect women, the term “male menopause” was coined decades ago and is still used today.

Why male menopause symptoms occur

As men age, they experience a decline in leydig cells in the testicles or problems with their hypothalamic-pituitary balance (or both). This results in abnormally low release of luteinizing hormone and low T production.

As testosterone levels decline, so do levels of sex hormone-binding globulin (SHBG), which in turn contributes to an even greater drop in bioavailable testosterone. Low testosterone levels can then translate into one or more of the symptoms already named.

Although any of the symptoms linked with male menopause can be disturbing for men, those affecting sexual function can be the most worrisome. Optimal testosterone levels for sexual functioning is around 10.4 mmol/L (300 ng/dL), although these numbers are not set in stone and can vary considerably depending on the man. For some males, changes in the concentrations of dihydrotestosterone, a metabolite of T, have an impact on sexual function.

Dealing with male menopause

Similar to women, who may turn to estrogen replacement therapy to combat menopausal symptoms, men who are experiencing symptoms of male menopause or andropause sometimes heed the call of the advertisements for testosterone replacement therapy. Like estrogen replacement, there is also controversy surrounding the use of testosterone replacement therapy (TRT) for men who are experiencing symptoms of low T.

Since TRT is associated with side effects such as increased risk of heart attack or stroke, acne and oily skin, decline in sperm count, higher risk of blood clots, breast enlargement, and shrinking testicles, men are encouraged to use natural means to boost their testosterone levels. Some of those techniques include:

  • Get sufficient sleep: your body produces testosterone while you sleep, so get at least 7 hours every night
  • Practice stress reduction: the release of the stress hormones cortisol and adrenaline can disrupt your testosterone levels
  • Drop excess body fat: fat cells transform testosterone into estrogen, so if you lose that fat, you can help stop the loss of testosterone
  • Limit alcohol: use of alcohol reduces testosterone production
  • Indulge in certain foods: foods such as Brazil nuts (high magnesium), oats (have avenacosides, which boost release of luteinizing hormone, which stimulates T), cruciferous veggies (help eliminate estrogen), and fish oil (boosts production of luteinizing hormone), among others.
  • Avoid toxins: environmental toxins, including food additives, air pollutants, phthalates, bisphenol-A, and many more can have a negative impact on hormone levels
  • Explore natural testosterone supplements: with many on the market, it is important to do your research on the ingredients included. Are they clinically supported?

Bottom line

Men typically experience a decline in testosterone levels, although the drop is not nearly as dramatic as the one women go through with menopause. Although the nomenclature may be inaccurate, many men do develop symptoms associated with lowered testosterone levels, many of which resemble those women experience during menopause. Is male menopause real? You decide.


Gould DC, Petty R. The male menopause: Does it exist? Western Journal of Medicine 2000 Aug; 173(2): 76-78

Heller CG, Myers GB. The male climacteric, its symptomatology, diagnosis and treatment. JAMA 1944; 126:472-77

Low Energy and Low Testosterone – What’s the Deal and How to Beat It?

Do you feel tired all the time, lack motivation, experience brain fog, and get sleepy during the day? Many medical and lifestyle factors can cause these symptoms, but when we are talking about men, one of those factors can be low testosterone. In fact, low energy and low testosterone can be a significant problem for men as they grow older and their T levels decline.

The hormone testosterone is responsible for many processes, during adolescence and throughout adult life, including maintaining muscle, producing sperm cells, libido, and generating energy. Although declining testosterone levels can have an impact on these and other factors as a part of normal aging, it’s not normal for testosterone to drop so low that fatigue becomes a way of life.

Symptoms of low testosterone
Low energy or fatigue is just one of the symptoms of having low testosterone. Others include:
• Depression
• Irritability
• Anemia
• Hot flushes
• Erectile dysfunction
• Decline in body hair growth
• Decrease in muscle mass
• Development of gynecomastia (man boobs)
• Trouble concentrating
• Loss of bone mass (osteoporosis)

If you are experiencing symptoms of low testosterone, talk to your doctor about having your T levels checked. All it takes is a simple blood test.

How to remedy low energy and low testosterone
If you want to boost your testosterone levels and your energy along with it, you may be tempted to listen to the commercials telling you to jump on board the testosterone replacement therapy (TRT) train. However, testosterone replacement therapy is FDA approved only for men who have low T levels associated with disorders of the pituitary gland, testicles, or brain that cause hypogonadism. The safety and benefits of using TRT for symptoms of low T for aging reasons has not been established. TRT also may increase a man’s risk of suffering a heart attack or stroke.

Instead, you can help battle low energy and low testosterone with natural options. It is recommended you adopt all of these lifestyle tips because they can work in synergy and improve your results.

Get checked out. Talk to your doctor about any medical conditions or medications that could be causing your low energy and low testosterone. Thyroid disease, sleep apnea, depression, insomnia, heart disease, diabetes, and anemia are associated with fatigue and/or low T, as are the following medications: opioids, some antidepressants, statins, ketoconazole, cimetidine, spironolactone, and chemotherapy. Discuss with your doctor lifestyle changes and alternative medications, if needed, to help you overcome the low energy and low testosterone that is affecting your quality of life.

Try natural testosterone supplements. Numerous herbs and nutrients have been shown to help boost testosterone levels naturally on various levels. Those ingredients include L-arginine, avena sativa, beetroot, beta-sitosterol, L-carnitine, L-citrulline, fenugreek, ginkgo biloba, green tea extract, pygeum africanum, resveratrol, tribulus terrestris, vitamin D, and zinc. Rather than take these substances individual, your best bet is to take one supplement that contains all or nearly all of them.

Improve your diet. Kick up your energy and T levels by keeping saturated fat intake low and fruits, vegetables, and other whole natural foods high on your menu. Alcohol consumption should be kept to a minimum: two drinks daily is considered moderation, but less is even better.

Stay hydrated. This is a simple tip that many men overlook, especially if they are exercising, working outdoors, or are elderly. Dehydration can cause fatigue and lower your energy levels. Carry a stainless steel water bottle and drink from it frequently.

Get quality sleep. Seven to eight hours every night is highly recommended. You need sleep to produce testosterone. If you are experiencing sleep apnea, get it treated. Your doctor can order a sleep study if sleep apnea is indicated.

Get help for depression. Depression, low energy and low testosterone often go hand-in-hand, so it’s important to address depression. If you are treated medically for depression, talk to your doctor about medications that are not in the selective serotonin reuptake inhibitor class, as these can interfere with libido and sexual performance.

Exercise. Regular physical activity raises testosterone levels. Be sure to choose activities you enjoy so you’ll be more likely to stick with it. You’ll feel more energized, improve your overall health, enhance muscle strength, and even drop some weight.

Bottom line
If you’re experiencing low energy or fatigue, low testosterone may be a reason. These natural testosterone and energy boosters can alter your life for the better if you’re willing to commit to change. The challenge is out!

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Food and Drug Administration. FDA drug safety communication: FDA cautions about using testosterone products for low testosterone due to aging; requires labeling change to inform of possible increased risk of heart attack and stroke with use. 2018 Feb 26
McHenry J et al. Sex differences in anxiety and depression: role of testosterone. Frontiers in Neuroendocrinology 2014 Jan 35(1): 42-57
Metcalf E. Does working out affect testosterone levels? WebMD 2015