Male Menopause—or Manopause—Explained by a Urologist

By Dr. Josh

two older men laughing

Menopause, from the Latin menopausis, was initial applied in the 19th century to describe the ultimate cessation of the every month menstruation of females.  That comprehension of menopause has ongoing even to this working day.

Menopause in ladies is a normal decline in the output of reproductive hormones that occurs as a woman ages.  The normal age of menopause in the US is 51, but the drop in hormone output can get started a long time earlier.  Strictly speaking, a woman is regarded as to be in menopause once she has gone twelve months with out menstruating but the hormonal drop can outcome in a selection of prevalent menopausal indicators.  The menopausal transition in girls is ordinarily described as a quick period of time of time, a stage just about every girl need to move by means of.  But the fact is that menopause is a stage of lifetime.  After one enters menopause, there is no turning again.

Possibilities are when you imagine about menopause you do not consider of it as currently being a men’s overall health issue.  Very well, what would you say if I instructed you that adult men go by means of their possess “Big Change”?  When there is no agreed-on expression to explain this change in adult males, some have started to take pleasure in some of the hormonal changes that arise as gentlemen age via a identical menopausal lens.  Male menopause (at times known as andropause or even colloquially, manopause) is not described by an absence of menstruation, but it can present with quite a few of the pretty identical signs or symptoms involved with common menopause.

What follows is a glimpse into the various modifications adult men go by as they get older and how we can use what we know about menopause to much better fully grasp some of the outcomes of hormonal decline in growing older males.

menopause manopause


The term andropause ought to clue you into a person of the most vital factors of male menopause.  Andropause refers to the halting of output of a team of hormones referred to as androgensAndrogen is the broad expression employed to explain male sexual intercourse hormones, the most very well-recognized of which is testosterone (T).  Just before expressing extra about testosterone and its marriage to male menopause, I ought to briefly mention that testosterone is not, in actuality, a “male hormone.”  Every single residing person makes and uses testosterone, not just guys.  It’s an crucial hormone in all kinds of bodies.  But for the purposes of this piece, we will, from right here ahead, focus on testosterone in the context of male bodies.

Testosterone is principally created by the Leydig cells in the testes of adult men, with a smaller quantity also generated by the adrenal glands.  Testosterone is liable for initiating the progress of the male internal and exterior reproductive organs for the duration of fetal advancement.  It is also the hormone vital for libido and the suggests by which the human body grows our muscular tissues and bones, stimulates the bone marrow to churn out extra blood cells, and provides sperm in adult existence.  Testosterone output begins in utero as soon as the entire body has been given the essential alerts.  Having said that, the male entire body doesn’t genuinely rev up testosterone generation until eventually puberty, when T degrees are normally at their best.

Testosterone output is a tightly regulated course of action carried out by the hypothalamus and pituitary gland in the mind.  In response to gonadotrophin-releasing hormone (GnRH) from the hypothalamus, the pituitary sends out a testosterone-stimulating sign in the kind of luteinizing hormone (LH).  LH circulates in the bloodstream and will make its way to the testicle in which it stimulates the creation and release of T.  As T raises in the blood, it provides feedback to the brain to suppress the generation of GnRH and LH, thereby dampening the production of extra testosterone.

As adult men age, this tightly regulated technique can start out to crack down.  Sometimes the physique gets to be incapable of continuing to create the required testosterone-stimulating hormones.  Other moments, the testicle simply loses its potential to answer to them.  On top of that, surgical procedures, radiation, and other clinical comorbidities can affect usual, balanced testosterone output.  No matter, the outcome is the same—testosterone declines and generally continues to be suboptimal.

man getting a shot from a doctor


As we discussed earlier mentioned, menopause normally happens when women are in their 40s or 50s (it can happen before in some ladies).  Male menopause is typically significantly far more elusive.

Hypogonadism is the clinical condition that describes sure hormonal indications and signs along with biochemically confirmed lower T.  It is a pretty popular dilemma, impacting up to 30% of the grownup common male populace, which interprets into hundreds of thousands of males all over the world.  Inspite of staying so pervasive, only about 5% of hypogonadal gentlemen get cure.

Let us consider a moment to distinguish concerning hypogonadism and our subject du jour, andropause.  Hypogonadism is a recognized clinical condition describing males with very low T and indicators and indicators associated with androgen insufficiency.  Hypogonadism is far more prevalent in more mature males but can take place at any age.  Andropause, on the other hand, is not a medically identified condition.  It is a way of describing a popular set of signs or symptoms connected with declining testosterone amounts that gentlemen can expertise as they age.

We know that a man’s testosterone ranges decline on common by about 1% per yr just after age 40.  For some guys, that procedure commences before, and for other people, the drop is a great deal steeper.  Even now, a greater part of adult males perfectly into their 60s and 70s have a serum testosterone level within the typical variety.  We do not routinely screen for very low testosterone so it’s tricky to say when one would anticipate to go as a result of male menopause, but it’s commonly considered of as a condition one of a kind to older adult males.

Signs or symptoms

For the reason that we do not display screen all adult males for reduced testosterone, andropause can occasionally go unnoticed.  We ought to also point out that not all gentlemen with reduced testosterone expertise signs and symptoms.  Additional complicating the concern, the indicators and signs involved with reduced testosterone (and male menopause) are generally non-precise.  These indications can at times be similar to way of living, treatment, and/or other medical comorbidities like weight problems or diabetes.  Nevertheless, the most popular symptoms involved with male menopause are:

  • Diminished energy and inspiration
  • Cognitive decrease: issues with memory and concentration
  • Frustrated temper
  • Enhanced nervousness
  • Lessened sexual motivation/very low libido
  • Decline in frequency of spontaneous erections
  • Issues reaching or keeping an erection in the course of sexual action
  • Breast tenderness or swelling
  • Loss of bone or muscle mass
  • Very hot flashes/evening sweats
  • Fertility problems
  • Slumber disturbance

a shirtless, frustrated man

So if you are going through some of these indications, it may perhaps be truly worth getting your testosterone checked.  Original small T amounts are generally verified with more tests.  If you’re close to age 40, these indicators may be your 1st clue that you are moving into andropause.  But don’t fail to remember: very low testosterone can also have an impact on more youthful adult males who could benefit from treatment method even if they really don’t slide in a stereotypical andropause age assortment.


I’m absolutely sure you are asking yourself what the probability is that male menopause will impact you.  Unfortunately, there’s no way to know for guaranteed.  Testosterone drop is a point of life.  It comes about even to the very best of us.  But as we reviewed over, not all men expertise the results of that decline, so not every person will experience andropause.  However, there are specific factors connected with lower testosterone stages that may possibly enhance one’s opportunity of likely via male menopause.

Physical exercise and sleep are super vital for protecting testosterone concentrations.  Thirty minutes for every day of cardiovascular teaching can support improve your circulation (which is crucial for your erections, by the way) and can retain your testosterone-producing equipment churning.  Testosterone production is cyclical, normally achieving peaks in the very first several hrs after waking.  No marvel rest is key to balanced testosterone stages.  Having excellent excellent snooze aids keep your mind sharp, regulates blood glucose stages, supports a healthier immune method, controls fat obtain, and maintains testosterone creation (Leproult).  So if you are searching to prevent your possess andropausal transform, do your best to get a great night’s rest and exercise routinely.

a man doing yoga

There has prolonged been believed to be a link concerning eating plan and testosterone levels.  Nonetheless, there remains some controversy about exactly which food plan is ideal for stopping declines in testosterone.  Just one 2018 examine suggested that folks who preferred Western-type food, ate out, and consumed much less home made foods, noodles, and dark inexperienced greens were a lot more most likely to have an unhealthy physique composition and low serum whole T concentrations (Hu).  One more discovered that testosterone was lower among the men who followed low body fat or Mediterranean diet programs (Fantus).  Nonetheless, we know that what we place in our entire body typically influences what we put out, which probably contains testosterone.  So undertaking your most effective to resist taking in that sweet bar and opting as an alternative for a property-cooked, perfectly-balanced meal may possibly be 1 way to stave off male menopause.


We really do not have time to get into the nitty-gritty of cure here, but luckily guys who working experience andropause surely have selections.  The very first stage is recognizing your indications and finding tested.  You also want to make positive that there are not other contributing things that could be producing your signs and symptoms.  The moment you have verified your T is lower and ruled out other alternatives, your medical professional may perhaps focus on way of life modifications (see above) and/or remedies that can boost your testosterone and reverse the consequences of andropause.  If you decide on to commence testosterone remedy, your health care provider will demonstrate the different approaches that it can be administered along with target testosterone stages and any needed abide by-up tests.  For numerous (but not all) adult men, testosterone therapy can ease the signs and symptoms of male menopause.  If you obtain that the approved remedy does not appear to be to be repairing the challenge, absolutely explore with your medical doctor what else could possibly be heading on.


Let us end with a couple of vital reminders with regards to male menopause:

  • Testosterone decrease is inevitable. Male menopause is not.
  • Many men will expertise indicators of andropause, but the indicators are typically non-unique and may well be brought about by other components.
  • If you encounter male menopausal signs and symptoms, it may possibly be value examining your testosterone ranges and talking about remedies with an pro.
  • There is no sure-fire way to predict your odds of suffering from male menopause. But foremost a wholesome life style which include eating a perfectly-balanced food plan, finding ample snooze, and working out on a frequent foundation, may possibly be your ideal guess at avoidance.


Leproult R, Van Cauter E. Impact of 1 Week of Slumber Restriction on Testosterone Levels in Youthful Balanced Men. JAMA. 2011305(21):2173–2174. doi:10.1001/jama.2011.710

Hu TY, Chen YC, Lin P, et al. Testosterone-Related Nutritional Sample Predicts Reduced Testosterone Levels and Hypogonadism. Nutrients. 201810(11):1786. Printed 2018 Nov 16. doi:10.3390/nu10111786

Fantus RJ, Halpern JA, Chang C, Keeter MK, Bennett NE, Helfand B, Brannigan RE. The Affiliation between Well-known Eating plans and Serum Testosterone among the Adult men in the United States. J Urol. 2020 Feb203(2):398-404. doi: 10.1097/JU.0000000000000482. Epub 2019 Aug 8. PMID: 31393814.

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