Interest in andropause and whether “male menopause” is really a thing keeps climbing, and a lot of what men hear about testosterone as they age turns out to be myth. Here are the burning questions and what doctors and researchers say is actually true.
Is andropause the same thing as menopause in women?
Not quite. Andropause describes a gradual, variable decline in testosterone with age. It is not the abrupt hormonal shutdown that defines female menopause.
Dr Ravinder Anand-Ivell, associate professor of endocrinology and reproductive physiology at the University of Nottingham, told The Guardian that “The menopause represents acute symptoms caused by the relatively abrupt cessation of ovarian hormonal function due to the exhaustion of a woman’s egg reserve at around 50 plus [or] minus five years of age,” adding, “Men have no equivalent physiology.” Prof Richard Sharpe of the University of Edinburgh agreed, saying testosterone declines “from late 30s to early 40s onwards” but with “no precipitous fall” comparable to menopause. Men also remain fertile for life, according to obstetric and gynaecology medical clinic Luna Obgyn, though fertility drops with age.
Do all men experience andropause and low testosterone symptoms?
No. Not every man goes through it. Some maintain normal testosterone levels throughout ageing and never develop noticeable symptoms, while others face significant physical and emotional changes.
According to Doctors Hospital Cayman, “Not all men experience male menopause. While testosterone levels decline with age, the symptoms and severity can vary widely depending on whether or not there is a testosterone deficiency. Some men may not experience noticeable changes or symptoms because their levels of testosterone are stable, while others might face significant physical and emotional challenges due to low levels.”
Prof Sharpe told The Guardian the drop “can be quite variable between individuals,” and unlike menopause it does not happen universally in men.
Does low testosterone actually cause every symptom men blame on it?
Not always. Fatigue, low motivation, mood swings and trouble concentrating get pinned on testosterone constantly, but plenty of other causes overlap.
Murray Hewlett, CEO of Affinity Health, said, “It’s important to note that these symptoms may not solely result from lowered testosterone levels. They can also be attributed to other age-related factors, lifestyle choices or underlying health conditions. For instance, obesity, diabetes, thyroid conditions or depression can contribute to or exacerbate the symptoms experienced by men during andropause. If you suspect you are experiencing symptoms of andropause, it is essential to consult with a healthcare professional who can evaluate your specific situation.”
Sleep problems, chronic illness, medications and stress can all mimic a hormone problem, so a proper workup matters before blaming testosterone.
Is testosterone therapy a fountain of youth for ageing men?
No. Testosterone replacement therapy is intended for men with confirmed deficiency and symptoms, not a general anti-ageing fix, and unsupervised use can cause real harm.
Dr Ryan Smith, a urologist at UVA, warned that some men treat it like an age-reversing drug. “It’s not the fountain of youth, as some men think,” he said. On self-injecting testosterone bought online, Smith explained, “You get a big rise in testosterone from these injections. But only for a couple of days. Then you crash, a rollercoaster effect. This can suppress your normal hormonal process and cause permanent problems to your pituitary gland and fertility.”
Careful diagnosis and monitoring are the standard, since unnecessary treatment carries risks with no real payoff.
Can men actually get hot flashes from low testosterone?
Yes. Hot flashes are not exclusive to female menopause. They show up in men, especially those receiving treatment that suppresses testosterone.
Harvard Health reports that “Hot flashes in men plague about 70%-80% of men who receive androgen deprivation. Low testosterone is the culprit, but scientists don’t know just how reduced sex hormone activity produces the problem. The thermal control centre in the part of the brain known as the hypothalamus appears responsible. The nervous system sends out signals that cause blood vessels in the skin to widen, producing flushing and warmth. To counter the rise in skin temperature, the body rapidly converts a warm flush to a cold, clammy sweat.”
What actually causes testosterone to decline as men age?
Lifestyle and ageing drive most of it. Testosterone typically falls about 1% a year starting in the mid-20s, and habits like poor sleep, heavy drinking, smoking and chronic stress can speed the drop.
Pharmacist Abbas Kanani told wellness company Holland & Barrett, “It’s typically caused by lifestyle or psychological factors that come with age, such as increased stress or anxiety, smoking, drinking alcohol excessively and poor diet.”
Dr Luke Bradford, medical director of The Royal College of GPs, told 1news that testosterone drops “about 1% per year after age 25, so it’s going to halve over the course of your life.” Bradford added that work pressure, relationship stress, financial worries and caregiving strains often compound the picture and can produce symptoms that look hormonal but are not. – dpa
