Stony Brook Medicine Health News
Older man with beard jogging

Andropause Explained: Why Men 40+ Should Talk About Hormones Too

Conversations about once-taboo health issues are quickly evolving. Increased public awareness and a willingness to challenge old stigmas have opened the door for honest discussions about topics like mental wellness and women’s health. Yet, one subject remains noticeably absent: the hormonal changes and symptoms men experience as they age, called “andropause” or “age-related hypogonadism.”

While commonly referred to as the “male menopause,” most board-certified physicians prefer the term “age-related hypogonadism.” The term andropause is used when men experience low serum testosterone levels with no other apparent cause other than aging. 

In this article, you’ll find out what andropause is, how to recognize the signs and why it’s time for men over 40 to bring this important topic to the forefront.

What Is Andropause?

Andropause refers to a gradual decline in hormones, especially testosterone, that typically starts around age 40. Yet unlike female menopause, which has a definite end, andropause is a slow and steady ongoing process. The drop in hormone levels — about 1 percent a year, studies estimate — often sneaks up, making it easy for men to miss the symptoms until they begin to affect daily life. This gradual shift makes andropause hard to pinpoint but no less important to recognize.

Recognizing Andropause Signs: Not Just “Getting Older”

It’s common for men to dismiss changes in their body or mood as just part of aging. However, some of these changes may actually be signs of male hormone decline. Raising awareness about andropause can help you recognize the difference.

Physical Symptoms

  • Low energy or persistent fatigue
  • Reduced muscle mass and strength
  • Increased abdominal fat
  • Insomnia
  • Lower sex drive or sexual function

Emotional and Mental Symptoms

  • Mood swings or irritability
  • Feelings of sadness or depression
  • Trouble focusing or “brain fog”
  • Drop in motivation or confidence

These symptoms aren’t just something you have to accept. They may be your body’s way of signaling a hormonal imbalance that can be addressed.

Why Don’t Men Talk About Male Menopause? Breaking the Stigma

Many men feel embarrassed or pressured to keep quiet about fatigue, mood changes or libido issues, fearing it makes them look weak. Society often teaches men to be self-reliant and tough — it’s no wonder that talking about andropause can feel taboo. The stigma has caused many men experiencing andropause to go undiagnosed and untreated. Opening up about these changes isn’t a sign of weakness; it’s a step toward better health for yourself and a way to encourage other men to do the same.

Why Treating Andropause Is Important

Treating andropause can reverse and improve some of the physical symptoms you’re experiencing, but the importance of treating the condition goes beyond just that. Several long-term health concerns have been links to untreated low testosterone levels.

1. Cardiovascular Disease

Men with hypogonadism have higher rates of cardiovascular disease and a higher risk of having a heart attack. Treating men with testosterone replacement might help reduce the risks of heart disease.

2. Osteoporosis

An estimated one-third of men over 50 with testosterone deficiency also develop osteoporosis or osteopenia. Treating low testosterone levels actively boosts bone mineral density.

3. Diabetes

In one study, men receiving testosterone had decreased rates of becoming diabetic and those with diabetes had improved blood sugars compared to patients receiving placebo.

How to Get Diagnosed

If you suspect you might be experiencing andropause, the first step is to talk to a healthcare professional. Diagnosis usually begins with a conversation — your doctor will ask about your symptoms, overall health and any changes you’ve noticed. Don’t be afraid to be honest. Sharing all the details helps your doctor get a clearer picture.

Your doctor may:

Ask you about:

  • Fatigue or changes in energy
  • Mood shifts, irritability or sadness
  • Changes in sleep patterns
  • Reduced muscle mass or increased body fat
  • Reduced libido or sexual function

Perform a physical exam to check for:

  • Changes in muscle strength
  • Increased abdominal fat
  • Other visible symptoms of hormone decline

Order bloodwork to:

  • Measure your testosterone levels
  • Check for other hormone imbalances that might explain your symptoms

Sometimes, your doctor might repeat blood tests at different times, since hormone levels can fluctuate throughout the day. Once all the results are in, they will then determine whether low testosterone or another issue is behind your symptoms and suggest the best next steps.

What to Do Next: Simple Steps Toward Better Health

If you’re noticing symptoms related to andropause, there are steps you can take to feel better. They include:

  1. Adopt a balanced diet: Focus on nutrient-rich foods that support hormonal health, such as lean proteins, healthy fats, and plenty of fruits and vegetables. Reducing processed foods and sugar can also help maintain energy levels and overall well-being.

  2. Incorporate regular exercise: Engage in a mix of strength training, cardio and flexibility exercises. Physical activity not only boosts mood and energy but also helps regulate hormones and maintain muscle mass as you age.

  3. Prioritize stress management: Chronic stress can exacerbate hormonal imbalances. Practice mindfulness, meditation or other relaxation techniques to keep stress levels in check and improve overall health.

  4. Consider medical interventions when needed: If you’re not currently using medications or testosterone replacement therapy (TRT), your healthcare provider may recommend them to manage andropause symptoms. Talk to your doctor to explore options tailored to your needs and health.

Starting this conversation is about prioritizing your health and taking charge of your well-being.

At Stony Brook Medicine’s Department of Urology, we provide comprehensive and compassionate care tailored to fit your needs. Urologists specialize in treating issues of the kidneys, bladder, urinary tract and male reproductive system. Each member of our team is committed to delivering exceptional treatment for both common and complex urologic conditions.

  • William Berg, MD
    Urology

    Dr. Berg has always been passionate about the science of medicine and the art of healing. He earned his medical degree from New York Medical College, and went on to complete his urology residency at Stony Brook University Hospital. Following residency, he pursued specialty fellowship training in the treatment of male fertility, male sexual dysfunction, and microsurgery with the world-renowned Mark Sigman, MD at the Warren Alpert Medical School of Brown University. Dr. Berg's practice is dedicated to helping men build a family as well as managing issues of sexual dysfunction and low testosterone. He has a special interest in helping men navigate these sensitive topics, and aims to create a compassionate, non-judgmental atmosphere where he can create individualized treatment plans for each patient.

    View all posts
This article is intended to be general and/or educational in nature. Always consult your healthcare professional for help, diagnosis, guidance and treatment.