Medically Reviewed By

Dr. Ian Strand, DO, FAAMM

Published Sep 14, 2026 TRT Hormones

Do Men Go Through Menopause? Andropause and Low Testosterone

Somewhere in his forties or fifties, a man notices things have shifted. Energy is flatter. Workouts do not produce what they used to. Sleep is lighter, the middle is softer, and interest in sex is not what it was. Someone inevitably calls it male menopause, and the phrase sticks because it captures the feeling. Whether it describes the biology is a different question.

Here is what the research supports, what the popular terms do and do not mean, how much testosterone really changes with age, and how often that change is the actual explanation.

What Menopause Is, and Why Men Have No Direct Equivalent

Menopause in women is a discrete event. Ovarian production of estrogen and progesterone declines over a few years, cycles become irregular, and then stop. The point itself is defined precisely, at 12 months after the final menstrual period. There is a before and an after. Our article on perimenopause symptoms covers that transition in more detail.

Nothing that abrupt happens in men. The testes keep producing testosterone into old age. Production tends to slow, but it does so slowly, unevenly, and without a defined endpoint. Two men of the same age can sit in very different places. That is the core reason endocrinologists tend to avoid the words andropause and male menopause: they imply a universal event with a start and a finish, and the biology does not work that way.

How Testosterone Changes With Age

The clearest picture comes from following the same men over time rather than comparing different men at different ages. The Baltimore Longitudinal Study of Aging did that with stored samples from 890 men and found total testosterone declining at roughly 1 percent a year through midlife and beyond.

There is a second layer worth understanding. Most testosterone in the bloodstream travels bound to a carrier protein called sex hormone-binding globulin, and only the unbound portion is readily available to tissue. That binding protein tends to rise with age, so the free fraction often declines faster than the total. This is one reason a total testosterone result can look unremarkable while a man still feels the effects, and why a fuller panel is more informative than a single number.

How Common Is Age-Related Low Testosterone?

This is where the honest answer differs from the impression most men get online. The European Male Ageing Study surveyed a random population sample of men aged 40 to 79 across eight centers, measured morning testosterone by mass spectrometry, and asked what combination of findings actually identifies a meaningful problem.

The researchers concluded that late-onset hypogonadism is best defined by three sexual symptoms occurring together, which were poor morning erections, low sexual desire, and erectile dysfunction, alongside a confirmed low morning testosterone level. Applying that standard, roughly 3 percent of men in their sixties and 5 percent of men in their seventies qualified.

Two things follow from that. The first is the point above. The second is more useful in practice: the symptoms that best distinguish it are the sexual ones. Fatigue and low mood are common in midlife for many reasons and turn out to be poor discriminators on their own.

Why the Symptoms Are Easy to Misread

The experience that sends men looking for answers is real. The difficulty is that it maps onto a long list of possible causes. Untreated sleep apnea produces almost exactly this picture. So does thyroid dysfunction, insulin resistance, chronic stress, depression, alcohol, and a number of common medications. Some of these can also lower testosterone themselves, which means a low reading is sometimes a signal pointing at something upstream rather than the diagnosis. Treating the number without asking why it is low tends to leave the real problem in place. Our guide to low testosterone symptoms goes further into how the symptoms sort out.

When It May Be Worth Reaching Out

Ordinary variation in energy is not a reason to act. It may be worth a conversation if symptoms have been persistent rather than occasional, if the sexual symptoms described above are part of the picture, or if you would like a clearer answer than guesswork. Professional guidelines from the Endocrine Society describe diagnosis as requiring symptoms together with testosterone levels that are consistently low, typically on a morning sample and often confirmed with a second test. If treatment does turn out to be appropriate, it is a clinical decision made with a licensed clinician who is monitoring you over time, and you can read how we approach that on our hormone evaluation page.

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