Understanding MANopause (Also Known as Andropause)

10 min read
Understanding MANopause (Also Known as Andropause)

The human body may undergo drastic changes as we get older, some of which can involve significant changes to our hormones. One of the most well-known milestones is puberty. During this various changes can occur, including sexual, emotional, and hormonal developments as the body transitions from a child to an adult.

Hormonal changes can also come later in life, a prime example is menopause. Menopause occurs in females when it’s been 12 months since their last period, and is due to a change in their hormone balance. Menopause often takes place among females when they reach their mid 40s or 50s, occurring at a median age of 51.

Despite not being as well known as menopause, men can also experience major hormonal changes later in life.

These are sometimes dubbed as “MANopause” but go by the name andropause. Andropause is a significant hormonal change that can affect the lives of plenty of men. In this article, we’ll be exploring what andropause is, what causes it as well as treatment options.

TLDR Summary

  • The human body experiences hormonal shifts as it ages, with events like puberty in youth and menopause in women in their mid-40s to 50s.
  • Men can undergo significant hormonal changes, often referred to as andropause or late-onset hypogonadism, affecting physical, emotional, and sexual well-being.
  • Unlike the sudden drop in hormones for women during menopause, men experience a gradual decline in testosterone, about 1% per year after age 40.
  • These include physical symptoms like decreased muscle mass and bone density, emotional symptoms such as depression and poor concentration, and sexual symptoms like reduced libido and erectile dysfunction.
  • Factors include lifestyle, certain medications, aging-related changes in testosterone production, obesity, and genetic conditions.
  • Treatment ptions include testosterone replacement therapy, lifestyle changes (diet, exercise, stress management), and other medications for associated conditions.

What is Male Menopause?

Male menopause is also known as andropause or late-onset hypogonadism. When it occurs, men may experience symptoms (explored later in the article) consistent with those of testosterone deficiency. Such symptoms may have a severe impact on a man’s quality of life in physical, emotional, and sexual areas.

How is andropause different from female Menopause?

Making a direct comparison between andropause and menopause may be misleading. This is because they have different onsets, symptoms and differ in how they can affect a person's life. Although men do tend to have lower testosterone as they age, the drop in hormones is far more gradual compared to the one experienced by women during menopause. Males may experience hormonal changes as gradually as a 1% drop in testosterone each year after age 40.

Making a direct comparison between andropause and menopause may be misleading.

A key difference between andropause and a female’s menopause is the heavy association with the menstrual cycle. For instance, if a woman hasn’t had a period for over 12 months they are considered to be in “postmenopause”. In female menopause, the changes to a female's menstrual cycle are a key factor, while in andropause, low testosterone levels may have a different effect on men on an individual basis.

Common Symptoms of Male Menopause?

Andropause can present a variety of symptoms for those going through it. These can be categorized into physical, emotional, and sexual symptoms. We’ve explored each of these below.


Diagram of the Symptoms of Male Menopause

Physical Symptoms

Andropause may have a physical impact on a person's life, symptoms can range from changes in strength levels to differences in body composition. Some of the ways that andropause could inhibit an individual's day-to-day life could include the following:


Fatigue can be described as a constant feeling of being tired or weak. Fatigue can apply to a person's mental or physical strength (or a combination of both).

The condition may have a series of negative effects on a person’s life which may include work performance, family life and social relationships.

Decreased muscle mass and strength

An individual experiencing andropause may find themselves losing muscle mass and strength. Sarcopenia refers to the age-related loss of muscle and strength.

It’s possible that sarcopenia could be a symptom of male menopause, with research stating that male hypogonadism is one of the major endocrine causes of sarcopenia.

Increased body fat

Another symptom of andropause could be an increase in a person’s percentage of body fat. Body fat refers to the amount of fat that makes up a person's total body mass.

Research suggests that low levels of testosterone can be associated with an increase in total body fat and reduced lean mass among males.

Loss of bone density

A loss in bone density could be a sign of andropause. It’s been acknowledged that hypogonadism is a cause of overall bone loss and can also contribute to secondary osteoporosis.

Osteoporosis refers to a condition that can be defined as low bone mineral density, often causing fractures that result in a reduced quality of life for patients.

Emotional Symptoms

Andropause may affect a person emotionally, with symptoms ranging from changes to a person's temperament to the development of mental health conditions. We’ve explored some emotional symptoms of low testosterone levels below:

Mood swings and irritability

Andropause may affect a person’s mood as well as how they feel on a day-to-day basis.

Research suggests that abnormal levels (both high and low) of testosterone can result in changes in mood as well as mood disorders.


Although depression may be a stand-alone condition, research suggests that there is a link between depression and hypogonadism.

Research acknowledges that depression and anxiety are some of the most common psychopathological symptoms associated with male hypogonadism.

General lack of enthusiasm or energy

Feeling as if you lack enthusiasm or energy may be a result of andropause. Reduced energy and less cognitive ability are thought to be symptoms that may coincide with low testosterone.

It’s also worth noting that less enthusiasm or energy may be a result of previous symptoms we mentioned including fatigue or depression.

Poor concentration

The inability to concentrate may have a vast impact on a person's life, affecting their ability to perform at work and engage during tasks within their personal life.

Poor concentration is identified as one of the possible symptoms associated with androgen deficiencies.

Sexual Symptoms

A person’s sex life may be negatively affected by andropause, which could inhibit their ability to perform as well as their overall sex drive. We’ve explored some of the sexual symptoms below:

Sexual dysfunction

Men going through andropause may find that their sexual capabilities have been adversely affected, resulting in a potential sexual dysfunction.

It’s said that hypogonadism may lead to sexual dysfunctions such as erectile dysfunction (ED).

Low Sex Drive/Libido

A person’s libido or sex drive describes their desire to engage in sexual activity. It’s possible that a low level of testosterone may directly affect a person's sex drive.

Some research has found that participants displaying low libido were at an increased chance (albeit modest) of having low testosterone levels.

Erectile Dysfunction

Erectile dysfunction is a condition in which a person is unable to maintain a rigid erection for long enough to have satisfactory sex.

As we noted under the sexual dysfunction heading, research states that hypogonadism may result in erectile dysfunction.

Common Causes of Male Menopause

As male menopause may consist of a variety of symptoms, when exploring the causes we’ve focused on the universal symptom: hypogonadism. We’ve highlighted some of the possible causes in the table below:

Diagram of the Common Causes of Male Menopause

Lifestyle factors

Lifestyle may have an impact on the onset of andropause.

A piece of research showed a positive correlation between work-related factors such as psychological stress, physical effort and sleep disorders with andropause manifestations.


It’s possible that medication may trigger hypogonadism in males.

Long-term opioid use may lead to hypogonadism and is even known by the name opioid-triggered hypogonadism; a condition that is said to be underdiagnosed due to low clinical awareness.

Aging/Testosterone production changes

It’s thought that testosterone levels can decrease between 0.4% and 2% each year after a person reaches 30 years old.

With 35% of men in their seventies said to have lower testosterone than younger men and 13% of men in their old age reaching the diagnostic level for hypogonadism.

Obesity and chronic health conditions

There is thought to be a strong link between obesity and a person's testosterone levels.

In fact, according to research obesity is thought to be strongly associated with low testosterone levels in men and one of the strongest predictors for men receiving testosterone treatment.

Genetic factors

Research states that male congenital hypogonadotropic hypogonadism (CHH) is a heterogeneous group of genetic disorders that may impair the production of hormones in men.

Such conditions may result in low testosterone and even impair fertility.

How Is Male Menopause Diagnosed?

Men won’t be diagnosed with “male menopause” but are more likely to receive a diagnosis of late-onset hypogonadism. This diagnosis is likely to be based on the prevalence of symptoms that suggest a testosterone deficiency.

Men won’t be diagnosed with “male menopause” but are more likely to receive a diagnosis of late-onset hypogonadism.

They may be sexual for example, loss of libido, PE and loss of morning erections as well as a demonstration of low testosterone levels. Individuals may be examined physically while low testosterone levels can be confirmed with a blood test.

Perform a physical exam

According to research on diagnosing and managing low serum testosterone levels, physical exams may consist of a number of findings. For example, a person's physical presence may indicate excess body fat or obesity.

Other presentations such as hair loss, gynecomastia (enlargement of breast tissue), mild anemia, and osteoporosis. Testicular volume may also be observed to examine whether they display a normal range (15 to 30ml).

Blood test (Testosterone Level)

Checking an individual's testosterone levels can be indicative in identifying abnormal ranges of testosterone. According to research, It’s said that Hypogonadism is diagnosed when morning serum levels of testosterone dip below 300 ng/dL. With the ‘normal’ range considered to be between 300 ng/dL and 1000 ng/dL.

Checking an individual's testosterone levels can be indicative in identifying abnormal ranges of testosterone

The research notes that professionals diagnosing hypogonadism may exercise their clinical judgment when symptoms of hypogonadism are persistent despite displaying normal testosterone levels.

Treatment recommendations for Andropause

It’s important to note that andropause can consist of a number of different symptoms. We’ve highlighted how the low testosterone symptom of male menopause may be addressed.

1. Testosterone replacement therapy (TRT)

TRT can be administered by injection or in the form of patches or gels, and involves boosting a person’s testosterone levels often due to a deficiency. One study found that men (over 50) who experienced testosterone treatment for andropause will experience increased testosterone levels along with an improved quality of life. This includes improved sexual desire, energy, erectile function and a decrease in depression.

2. Lifestyle Changes

Although testosterone therapy is the recognized treatment for hypogonadism, research suggests that testosterone levels may be impacted by a person's lifestyle habits. We’ve listed a few examples of how your lifestyle may affect testosterone levels below.

3. Balanced diet

Research has identified obesity and low serum testosterone levels as being strongly influenced by an individual's diet. So, if you believe that you have a testosterone deficiency as a result of a poor diet you should discuss the possibility with your medical professional.

Curious about ways to enhance your sexual health and vitality?

4. Regular Physical Exercise

Given that obesity is linked with low testosterone levels, regular physical exercise may help to reduce the impact of obesity. Research found a 12 week aerobic exercise intervention increased serum total, free, and bioavailable testosterone in obese and overweight men.

5. Stress Management

Research has made reference to stress potentially reducing an individual's testosterone levels. Stress can stem from a variety of causes, such as work, family, and financial pressures. Stress management may include improving your nutrition, exercise habits or introducing mindfulness techniques. If you believe you are stressed it may help to seek guidance from a therapist.

6. Get recommended hours of sleep

Making sure that you get the recommended amount of sleep could be paramount for ensuring that testosterone levels remain in the normal range. One study measured testosterone levels among 10 healthy males in both rested and sleep-deprived states. It concluded that the men exhibited lower testosterone levels during the day while sleep deprived when compared to their rested state.

7. Consider your alcohol consumption

A review of the consumption of alcohol on testosterone synthesis acknowledged that when men consume alcohol in excess it can have an adverse effect on their testosterone levels. It went on to state that many countries may require an urgent review of their levels of alcohol consumption, given the importance of testosterones role in the health and wellbeing of men.

8. Medication

Although the main treatment for testosterone deficiencies tends to be testosterone replacement therapy, medication may play a role in an individual's treatment for andropause.

For example, for individuals who are exhibiting mental health issues along with low testosterone, a medication for depression or anxiety such as selective serotonin reuptake inhibitors (SSRIs) may be recommended.

When to Consult a Doctor

Consulting a medical professional in order to treat andropause is paramount. If you are experiencing any of the physical, emotional or sexual symptoms that we’ve highlighted in this article, there’s a chance that you may be experiencing andropause.

Consulting a medical professional in order to treat andropause is paramount

If you believe you may be going through andropause consult a doctor for a professional opinion and advice on treatment.


At what age does male menopause typically occur?

According to the NHS, many of the symptoms of male menopause are experienced by individuals when they reach their late 40s to early 50s. Such symptoms may include depression, impaired libido, erectile dysfunction, and a range of other physical and emotional signs.

Is male menopause a reversible condition?

Given that male menopause can be made up of a number of varying symptoms it may be possible that some may be treatable. For example, the research in our TRT section made reference to the possible improvements to a person’s quality of life that may result from testosterone therapy.

Are all men affected by male menopause?

The simple answer to this question is no, not all men get affected by male menopause. Testosterone levels vary between men, as does the prevalence of symptoms associated with hypogonadism.


Male menopause, also known as andropause or late-onset hypogonadism can trigger a number of symptoms that may negatively affect a person's life. Some of these may include physical, mental, and sexual difficulties. An individual's testosterone levels may be affected by a number of factors which could include lifestyle habits, medication, or even genetics.

Male menopause, also known as andropause or late-onset hypogonadism can trigger a number of symptoms that may negatively affect a person's life

Research has suggested that testosterone treatment for andropause can be an effective way to manage the symptoms and improve an individual's quality of life. However, it should be noted that the diagnosis and treatment of the condition by a medical professional are of utmost importance. Although the information in this article is intended to be informative, it cannot be considered a substitute for professional medical advice.

Learn more about male sexual health

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