Male menopause (andropause): symptoms, causes and testing

If you’ve been feeling flatter, more tired, less interested in sex, or not quite like yourself, it is easy to wonder whether the male menopause, or the manopause as it’s commonly called, could be part of the reason, especially in your 40s or 50s.

However, it’s not really the male equivalent of female menopause. In women, menopause is a clear hormonal event. In men, testosterone usually falls much more gradually with age, and symptoms can be the result of stress, poor sleep, weight gain, depression, medication, or wider health issues. 

Male menopause is generally considered an unhelpful term used in the media, with andropause, androgen deficiency in the ageing male (ADAM), or late-onset hypogonadism [1] more typically used by the medical profession. 

In this article we'll cover:

• Is male menopause real?
• Andropause symptoms
• How is male menopause diagnosed?
• What happens if testosterone is low?
• Can I boost my testosterone levels naturally?
• What causes male menopause?
• Male menopause or just getting older?
• When to test for male menopause
• When is a broader hormone blood test better?

Is male menopause real?
 

Male menopause or andropause is used to describe the changes some men notice in midlife, especially when energy, mood, sex drive, body composition, or wider male hormone health does not feel quite the same as it used to. But it is not really the male version of menopause in the way it is for women. 

That is because testosterone does not suddenly crash in midlife. It usually falls slowly over time, which helps explain why some men notice changes and others do not. 

Levels can begin to decline around age 30, often by less than 2% per year [2], and midlife symptoms can be linked just as easily to factors such as stress, poor sleep, weight gain, low mood, or other health issues. That is why low testosterone should not be assumed from symptoms alone. It needs to be backed up by blood test results as well.

Find out more about how testosterone levels change with age.  

Andropause symptoms
 

Andropause symptoms are similar to those of low testosterone.

These include:

• Low sex drive
• Erectile dysfunction
• Fewer morning erections
• Tiredness or low energy
• Low mood
• Reduced motivation
• Loss of muscle mass
• Increased body fat
• Poor concentration
• Reduced fertility

These symptoms are common, but they are not specific to testosterone. Stress, sleep problems, anxiety, alcohol, weight gain, and depression can all create a similar picture. That is one reason guessing is not always helpful.

Read more about the symptoms of low testosterone. 
 

How is male menopause diagnosed?
 

This is the part that matters most.

Low testosterone should not be diagnosed with symptoms alone. 

Current guidance says a diagnosis should be based on a combination of:

• Symptoms that fit testosterone deficiency
• A low morning testosterone result from a blood test
• A repeat morning blood test to confirm it 2 weeks later

The Endocrine Society recommends confirming low testosterone with repeat morning blood testing, and guidelines also support assessing luteinising hormone (LH) and follicle stimulating hormone (FSH), to help determine whether the problem is starting in the testes or in brain signalling [3].

If you take a Testosterone Blood Test with Medichecks, our doctors will advise you on any next steps. 

What happens if testosterone is low?
 

If testosterone is confirmed to be low and symptoms fit, the next step is usually to look at the cause and decide what to do about it. Sometimes lifestyle changes can help. This includes maintaining a healthy BMI, weight training, and ensuring your vitamin D, B12, and folate are optimal. In other cases, testosterone replacement therapy (TRT) may be discussed after a proper assessment.

The key point is that testosterone treatment is not a shortcut for every midlife dip in energy or motivation. If testosterone levels are normal, the answer may lie somewhere else.

Can I boost my testosterone levels naturally?
 

There are ways you can naturally boost your testosterone levels if they’re low or borderline.

The following measures can have a positive impact on testosterone:  

• Get sufficient sleep — seven to nine hours per night is ideal 
• Eat a nutritious and balanced diet 
• Avoid alcohol 
• Exercise — strength training is particularly effective 
• Minimise stress 
• Make sure you’re getting adequate vitamin D, magnesium, and zinc 
• Lose weight if you’re overweight 

Read more about how you can boost your testosterone levels naturally. 

What causes male menopause?
 

For most men, there is not one dramatic hormonal switch. Although testosterone can decline slowly with age, symptoms can also be associated with wider health and lifestyle factors. This is why it is not always easy to know what is behind the symptoms without a blood test. 

Common causes behind the symptoms:

• Ageing
• Higher body fat
• Poor sleep
• Stress
• Depression or low mood
• Type 2 diabetes
• Alcohol and smoking
• Certain medications
• Testicular injury or damage
• Pituitary problems
• Previous steroid use
• Vitamin deficiencies

Male menopause or just getting older?
 

This is where a lot of men get stuck.

Some changes can become more noticeable with age. But that does not mean everything should be shrugged off as “just getting older”. If symptoms are persistent, affecting day-to-day life, or occurring together, it is worth looking at them more closely. 

The better question is usually not “am I going through the manopause?” but “could low testosterone or something else be causing this?”

When to test for male menopause

Testing becomes more useful when symptoms are ongoing or multiple symptoms are present.

It can also be worth testing if symptoms have appeared after steroid use, alongside obesity or type 2 diabetes, or if you simply feel that something has shifted and is not improving. Current guidance supports blood testing symptomatic men rather than relying solely on symptoms.

What blood test helps?

If testosterone is your main concern, a morning testosterone blood test is usually the best place to start. Medical advice is to test in the morning because testosterone is highest then. If the result is low, it’s usually repeated to confirm it.

When is a broader hormone blood test better?
 

Our Male Hormone Blood Test is a useful testing option if symptoms are mixed or you want more context. Alongside testosterone, it includes markers such as LH, FSH, prolactin, and oestradiol. This extra context can be valuable when symptoms extend beyond low libido or fatigue.

Male menopause is a widely used phrase, but it’s not really a diagnosis in itself. What matters more is whether low testosterone or a wider hormone issue could be behind the symptoms you are experiencing. 

If symptoms are persistent, a morning testosterone test can be a sensible first step. If the picture feels broader, a blood test for male hormones can provide more insight. Either way, testing is often the clearest way to move from guesswork to answers.

References 

1. British Association of Urological Surgeons (no date) Male menopause (androgen deficiency in the ageing male). (Accessed 11 May 2026). 
2. NHS (2022) The ‘male menopause’. (Accessed 11 May 2026). 
3. Bhasin, S., Brito, J.P., Cunningham, G.R., Hayes, F.J., Hodis, H.N., Matsumoto, A.M., Snyder, P.J., Swerdloff, R.S. and Wu, F.C.W. (2018) ‘Testosterone therapy in men with hypogonadism: an Endocrine Society clinical practice guideline’, The Journal of Clinical Endocrinology & Metabolism, 103(5), pp. 1715–1744. (Accessed 12 May 2026).