Andropause is often described as the male equivalent of female menopause. It refers to the age-related decline in testosterone levels in men – a process that is usually gradual but can have significant effects on physical, mental, and emotional well-being.
In a medical context, this is also referred to as age-related hypogonadism . Andropause is a natural part of the aging process, but it is often not recognized or not taken seriously , even though it can cause numerous symptoms that can significantly affect the lives of men over 40.
What is the andropause?
Unlike female menopause, which usually occurs abruptly, testosterone levels in men decline slowly and continuously – generally starting between the ages of 30 and 40. The body loses approximately 1% of total testosterone per year, as well as about 1-2% of free testosterone , although there are significant individual variations. Once a certain threshold is reached, a 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 linked to hormonal balance.
Causes of andropause
It is not age alone that triggers andropause, but primarily accompanying factors that increase with age and accelerate the decline in hormone levels.
- Chronic stress (increases cortisol, lowers testosterone)
- Excess weight, especially visceral abdominal fat
- Lack of exercise
- Alcohol and nicotine consumption
- Lack of sleep
- 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 early or pronounced hormone reduction.
Symptoms: How does andropause manifest itself?
Andropause affects many areas of life. The symptoms are often vague and are not always immediately attributed to hormones by those affected or their doctors.
Typical signs:
- Decreased libido and sexual desire
- Erectile dysfunction
- Decrease in muscle strength and muscle mass
- Increase in body fat, especially around 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 a testosterone deficiency. However, a combination of several signs, especially in men over 40, should raise concern.
Diagnosis: How is andropause diagnosed?
Andropause is diagnosed through a combination of clinical history and hormone laboratory tests .
Important lab values:
- Total testosterone
- Free testosterone (biologically active fraction)
- Sex hormone-binding globulin (SHBG)
- Luteinizing hormone (LH)
- Estradiol, prolactin and DHT (optional for further classification)
Blood should be drawn in the morning on an empty stomach , as testosterone levels fluctuate throughout the day. Additionally, questionnaires such as the AMS test (Aging Male Symptom Scale) can be used to assess symptoms.
How is andropause treated?
Depending on the severity and level of suffering, there are various approaches - from lifestyle changes to hormone therapy .
1. Lifestyle optimization
In cases of 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, and vitamin D
- Sufficient sleep
- Stress reduction (e.g., mindfulness, breathing techniques)
- Weight loss in cases of obesity
- Reduction of alcohol, sugar, and 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 reduced and symptoms are pronounced, testosterone replacement therapy may be considered, for example as a gel, injection or patch.
Important: TRT must only be performed under medical supervision. Hormone levels, prostate health, and hemoglobin levels must be checked before starting. Regular check-ups are necessary during therapy.
Risks of untreated andropause
Chronically low testosterone levels can lead to long-term health problems:
- Increased risk of cardiovascular disease
- Decrease in bone density (osteoporosis)
- Metabolic syndrome / type 2 diabetes
- Depression
- Loss of libido and relationship problems
- Reduced self-esteem and decreased performance
Therefore, it is important not to ignore or downplay symptoms.
Conclusion
Andropause is a natural but often underestimated phase in a man's life. It can significantly impact quality of life, but it doesn't have to. The key is to pay attention early , take symptoms seriously, and take proactive steps to counteract them.
With a combination of hormone diagnostics, lifestyle improvements and, if necessary, medical support, andropause can not only be managed, but even used as an opportunity: For a healthier, more powerful and more conscious life in the second half of life.
Tip: A laboratory test provides an initial overview of your testosterone levels.
This test can be performed at your family doctor's office, by specialists, in a direct laboratory, or conveniently from home, for example via Adon Health . The important thing is to ensure transparency by knowing your test results and checking them regularly.
