Andropause is often described as the male equivalent of female menopause. It refers to the age-related decrease in testosterone levels in men – a process that usually progresses gradually but can have significant effects on physical, mental, and emotional well-being.
In a medical context, it is also referred to as age-related hypogonadism. Andropause is a natural part of the aging process but is often not recognized or taken seriously, although it can cause numerous symptoms that can significantly affect the lives of men over 40.
What is Andropause?
Unlike female menopause, which usually occurs abruptly, testosterone levels in men decline slowly and continuously, typically starting between the ages of 30 and 40. The body loses about 1% of total testosterone per year, as well as approximately 1-2% of free testosterone, although individual differences are significant. Below a certain threshold, functional testosterone deficiency can occur, leading to clinical andropause.
However, testosterone is not only responsible for sexual function and libido. It influences almost all areas of men's health: muscle mass, bone density, fat distribution, mood, concentration, energy levels, sleep quality, and even the immune system are closely related to hormone balance.
Causes of Andropause
Age alone does not trigger andropause; rather, it is primarily accompanying factors that increase with age and accelerate hormone decline.
- Chronic stress (increases cortisol, lowers testosterone)
- Obesity, especially visceral belly fat
- Lack of exercise
- Alcohol and nicotine consumption
- Sleep deprivation
- Diabetes mellitus and metabolic syndrome
- Inflammatory processes
- Medications (e.g., antidepressants, beta-blockers)
- Environmental toxins and endocrine disruptors
Genetic factors also play a role: some men have a natural predisposition to earlier or more pronounced hormone reduction.
Symptoms: How does Andropause manifest itself?
Andropause affects many areas of life. The symptoms are often diffuse and are not always immediately identified as hormonal by those affected or by doctors.
Typical signs:
- Decreased libido and sexual desire
- Erectile dysfunction
- Decrease in muscle strength and muscle mass
- Increase in body fat, especially in the abdomen
- Exhaustion and fatigue
- Irritability, mood swings, depressive mood
- Concentration problems
- Sleep problems
- Reduced resilience and motivation
- Decrease in bone density (osteopenia/osteoporosis)
Important: Not every one of these symptoms automatically indicates testosterone deficiency. But the combination of several signs, especially in men over 40, should raise awareness.
Diagnosis: How is Andropause diagnosed?
The diagnosis of andropause is made through a combination of clinical anamnesis and hormone laboratory tests.
Important laboratory values:
- Total testosterone
- Free testosterone (biologically active portion)
- Sex hormone-binding globulin (SHBG)
- Luteinizing hormone (LH)
- Estradiol, prolactin, and DHT (optional for further classification)
Blood sampling should be done on an empty stomach in the morning, as testosterone levels fluctuate throughout the day. Additionally, questionnaires such as the AMS test (Aging Males Symptoms Scale) can be used to assess symptoms.
How is Andropause treated?
Depending on the severity and distress, there are various approaches – from lifestyle changes to hormone therapy.
1. Lifestyle Optimization
For mild to moderate testosterone deficiency, targeted lifestyle changes can make a big difference:
- Strength training (2–3 times per week)
- Healthy, protein-rich diet with zinc, magnesium, vitamin D
- Sufficient sleep
- Stress reduction (e.g., mindfulness, breathing techniques)
- Weight reduction for overweight individuals
- Reduction of alcohol, sugar, processed foods
2. Supplements
Certain micronutrients support the body's own testosterone production:
- Zinc
- Magnesium
- Vitamin D
- Omega-3 fatty acids
3. Testosterone Replacement Therapy (TRT)
If testosterone levels are significantly lowered and symptoms are pronounced, testosterone replacement therapy may be considered, for example, as a gel, injection, or patch.
Important: TRT should only be carried out under medical supervision. Before starting, hormone levels, prostate health, and hemoglobin levels must be checked. Regular checks are required during therapy.
Risks of untreated Andropause
Chronically low testosterone levels can lead to long-term health problems:
- Increased risk of cardiovascular diseases
- Decrease in bone density (osteoporosis)
- Metabolic syndrome / Type 2 diabetes
- Depression
- Loss of libido and relationship problems
- Reduced self-esteem and decline in performance
Therefore, it is important not to ignore or trivialize symptoms.
Conclusion
Andropause is a natural but often underestimated phase in a man's life. It can significantly impair quality of life, but it doesn't have to. The key is to look closely early on, take symptoms seriously, and actively counteract them.
With a combination of hormone diagnostics, lifestyle improvement, and, if necessary, medical support, andropause can not only be managed but also used as an opportunity: for a healthier, more powerful, and more conscious life in the second half of life.
Tip: A laboratory test provides a first overview of your testosterone levels.
This can be done by a family doctor, specialists, in a direct laboratory, or comfortably from home, for example through Adon Health. Important: Ensure transparency by knowing and regularly checking your values.