Do men go through menopause? Just like women, men experience a stark shift in male hormones. 

Read on to learn all about menopause for men, often called andropause or irritable male syndrome.

Is Male Menopause Real?

An often dismissed aspect of aging is sex hormonal changes. While it is a natural part, these changes can feel foreign and startling when they actually start to happen. 

While women go through the dramatic experience of menopause, men have hormone changes that occur more gradually. The term "male menopause" has come to mean aging-related hormone changes that men experience around the same age that women are experiencing menopause.

For women, in a shorter period of time, hormone levels drop and ovulation stops. In men, over a longer period of time, testosterone levels decline gradually. 

"Male menopause," more formally known as andropause, is often referred to by other names, such as: 

• Hypogonadism (late-onset)
• Age-related low testosterone
• Testosterone deficiency syndrome
• Androgen deficiency
• Irritable male syndrome (IMS)

Testosterone levels decline at an average of 1% yearly after the age of 40, and between 10-25% of men are estimated to have low testosterone. 

Understanding Andropause

There are some classic signs of andropause to be aware of. As a man, signs and symptoms of male menopause may manifest as: 

• Mild anemia 
• Breast tenderness (i.e. swelling or discomfort)
• Decline in sexual desire 
• Decline in sexual activity
• Decrease in height
• Decreased energy 
• Depressed mood
• Erectile dysfunction (or decreased spontaneous erections)
• Hot flashes or sweats
• Increased tiredness or sleep disturbances
• Infertility 
• Lack of motivation or confidence
• Low trauma fractures or a low bone mineral density (BMD)
• Poor concentration
• Reduced muscle strength 

How Male Menopause Differs From Female Menopause

Andropause for men is not an exact equivalent to female menopause. Key differences include that men do not completely lose the ability to reproduce, whereas women stop ovulating. 

Also, not all men will experience andropause (although it is estimated that about 1 in 4 men might). 

Other Signs and Symptoms

Other signals that the body is undergoing a major change are not limited to sexual changes. Emotional and physical symptoms may occur, including mood swings and irritability. It’s important to be aware of these related symptoms to help recognize a decline in testosterone production. 

Treatment Options for Low Testosterone Levels

All hope is not lost! With low testosterone, there are actually many options for treatment and feeling like one's self again. 

Treatment generally starts with three steps: 

1. Asking a doctor for a blood test for low testosterone.

2. Testing a second time for low testosterone to confirm.

3. Testing the pituitary gland to determine the cause and rule out other types of hormone deficiencies 

While recommendations for low testosterone vary, most protocols begin with this line of testing.

Testosterone Therapy 

Testosterone therapy is a common option for the treatment of low testosterone. If chosen, a doctor can make recommendations relating to administration, target levels to aim for, and follow-up testing. 

However, testosterone therapy does have its risks. It is thought to accelerate the growth of cancerous cells along with possibly increasing the risk of heart attack, stroke, and blood clots. 

Recent studies have found low testosterone levels linked to cardiometabolic disorders, so there is promise in the future for potential drugs targeting these mechanisms. 

Lifestyle Choices

Aging is not the only process that has an effect on testosterone. Certain medications and lifestyle choices can also affect middle-aged to elderly men (for better or worse). These factors can include stress or exposure to toxins or pollutants. 

Some healthy habits to consider for better health include:

• Eating a balanced diet with testosterone-boosting foods and/or a men's meal delivery program
• Exercising regularly
• Getting enough sleep 
• Managing stress levels in a healthy way 

Approaches for Couples

Since both men and women experience changes during midlife, couples can work to acknowledge and address the symptoms that surface. For both menopause and andropause, couples can talk clearly about their health options, opportunities to improve sexual satisfaction, and improvements in their intimacy. 

Male Menopause: Final Takeaways

While it may feel like it at the moment, male menopause (andropause) is not particularly long-lasting. In middle age, men may need to look into their healthcare options to address lower levels of testosterone. 

Beyond that, there are many medications, therapies, and lifestyle approaches to choose from to help a man feel like himself again. 

References:

Barrientos G, Llanos P, Basualto-Alarcón, Estrada M. Androgen-Related Cardiac Metabolism in Aging Men. Front Endocrinol. 2020;11:316. 

Jannini EA, Nappi RE. Couplepause: A New Paradigm in Treating Sexual Dysfunction During Menopause and Andropause. Sex Med Rev. 2018;6(3):384-395.

Male menopause: Myth or reality? Mayo Clinic. Published June 20, 2020. https://www.mayoclinic.org/healthy-lifestyle/mens-health/in-depth/male-menopause/art-20048056. 

Martellí M, Zingaretti L, Salvio G, Bracci M, Santarelli L. Influence of Work on Andropause and Menopause: A Systematic Review. Int J Environ Res Public Health. 2021;18(19):10074.

What is Male Menopause? (Andropause). Henry County Hospital. Published May 15, 2020. https://www.henrycountyhospital.org/News-Events/HCH-News/2020/May/What-is-Male-Menopause-Andropause-.aspx.