"Andropause" Is Not a Diagnosis, but Something Real Happens

Testosterone drifts down in many men as they age.

By Neil Solomon · 2 min read

Women hear the word menopause from their forties on. Men rarely hear a word at all. Some magazines say "andropause," and doctors mostly do not use it. So what is going on?

What changes

Testosterone drifts down in many men as they age. The drift is slow, much slower than the change women go through. The medical term for a low level that comes with symptoms is late-onset hypogonadism. It has no sharp starting age and no single event that marks it.

How common it is

The European Male Ageing Study followed men aged 40 to 79. It counted a man as having late-onset hypogonadism when he had at least three sexual symptoms, such as low desire or fewer morning erections, plus a low blood level of testosterone. About 2 percent of men met that definition.

The numbers come from a secondary report of the study, so treat them as close estimates.

Why the word is slippery

Many men in their fifties feel tired, flat or less interested in things. Only a small share of them have a testosterone level that explains it. The same feelings can come from poor sleep, a thyroid problem, heavy drinking, depression or stress. For that reason, doctors are cautious about naming one cause.

Another difference is that men have a daily rhythm. Testosterone is highest in the morning and falls through the day. That is why guidelines call for early-morning blood tests.

The sources include no study that shows a monthly cycle in men like the one in women.

What to take from this

If you are a man in your forties, fifties or sixties and you feel off, "andropause" could be treated as a question. A small group of men have a level low enough to matter, and a check could find them. For everyone else, other causes are more likely, and those can be found too.