Short answer
The short answer to "do men go through menopause?" is no, not in the way women do. In menopause, ovarian production of estrogen and progesterone "declines greatly," and it is confirmed one year after the final period (10). Men have no equivalent switch-off. Testosterone drifts down slowly, about 1.6% a year for total testosterone in one long-running US cohort (4). "Male menopause" and "andropause" are popular names for a cluster of midlife symptoms, not a stage every man passes through.
What research does recognize is a narrower condition, late-onset hypogonadism: specific sexual symptoms plus low testosterone in a morning blood sample. In a European study of 3,369 men aged 40 to 79, only about 2.1% met that combined research definition (3). Far more often, the tiredness, low mood and fading desire people call "male menopause" are linked to sleep, weight, stress, depression, medications or heart health.
If you are 45, exhausted, short-tempered and less interested in sex than you used to be, you are not imagining it, and it is not weakness. These are real changes, often with checkable explanations, and the useful move is to find out which one fits you.
Note: this article explains what research and clinical guidelines say and is not medical advice. It cannot tell you what is happening in your body or what your hormone levels are. Chest pain, shortness of breath, or thoughts of harming yourself need help now, not a diary: call 911, or call or text 988 (13, 12).
Do men go through menopause, or is male menopause a myth?
Men do not go through menopause, but "male menopause" is not pure myth either: it is a loose label for real midlife symptoms, a small share of which are linked to low testosterone.
The researchers behind the largest population study on the question opened their paper by noting that "the association between aging-related testosterone deficiency and late-onset hypogonadism in men remains a controversial concept" (3). The European Male Ageing Study (EMAS) measured morning testosterone in 3,369 men and looked for symptoms that moved with it. Poor morning erections, low sexual desire, erectile dysfunction, trouble with vigorous activity, depression and fatigue were all related to testosterone level. But only the three sexual symptoms formed a consistent pattern with low testosterone (3).
So fatigue and low mood on their own do not point to testosterone; they point to many things. The EMAS researchers defined late-onset hypogonadism as those sexual symptoms combined with low total and free testosterone in a morning blood sample, and that applied to about 2 in 100 men. In everyday care, guidelines also require the low result to be confirmed on a repeat test (1).
Andropause vs menopause: what is the difference?
Menopause is a defined endpoint with a steep fall in ovarian hormones; andropause describes a slow, partial and highly variable decline in testosterone that many men never notice.
| | Menopause (women) | "Andropause" (men) |
|---|---|---|
| What happens | Ovarian estrogen and progesterone production falls steeply (10) | Total testosterone falls gradually, about 1.6% a year within the same men in one cohort (4) |
| Timing | Average age 52 in the US, confirmed one year after the final period (10) | No fixed age and no marker event |
| Does it happen to everyone? | Yes | No: strict criteria for late-onset hypogonadism were met by 2.1% of men aged 40 to 79 (3) |
| How it is confirmed | The calendar | Symptoms plus repeated early-morning blood tests, read by a clinician (1) |
The word sticks because both happen in midlife and both are hormonal. For what menopause involves for women, including a partner going through it at the same time, see our overview of menopause.
At what age does male menopause start?
There is no starting age, because there is no start. Testosterone decline is a slope rather than a step, and health shapes it as much as birthdays do.
The Massachusetts Male Aging Study followed 1,156 men, aged 40 to 70 at the start, for 7 to 10 years. Within the same men, total testosterone fell about 1.6% a year and bioavailable testosterone 2% to 3% a year. Men in apparent good health, meaning no chronic illness, prescription medication, obesity or excessive drinking, had levels of several androgens 10% to 15% higher (4).
The Baltimore Longitudinal Study of Aging found that low total testosterone readings rose to about 20% of men over 60, 30% over 70 and 50% over 80 (5). The gap with the 2.1% from EMAS is the whole story: Baltimore counted low total testosterone readings, EMAS counted low readings plus the sexual symptoms that move with them (3). A lab value on its own is not a diagnosis, and plenty of older men with low numbers feel fine.
What are andropause symptoms, and which ones really track with testosterone?
The symptoms most often blamed on andropause are tiredness, low sex drive, erection problems, low mood, irritability, weight gain around the middle and loss of stamina. The ones most clearly tied to low testosterone in population research are sexual: fewer morning erections, lower desire and erectile dysfunction (3).
| Symptom | Link to testosterone in research | Other explanations worth ruling out |
|---|---|---|
| Fewer morning erections, lower desire, erection problems | The only symptoms with a syndromic link to low testosterone in EMAS (3) | Sleep apnea lists sexual dysfunction and decreased libido among its symptoms (9); erectile problems are linked to later heart disease (8) |
| Fatigue, low energy | Related to testosterone level, but not part of the syndrome (3) | Short or broken sleep, sleep apnea, depression, chronic stress |
| Low mood, irritability | Related to testosterone level, but not syndromically (3) | Depression, which the USPSTF recommends screening for in all adults (11) |
| Weight gain | Weight gain is associated with falling testosterone, weight loss with rising levels (7) | Diet, activity, sleep, medications |
The American Urological Association (AUA) puts the problem in one line: the symptoms associated with low testosterone are "very non-specific and can be manifestations of other conditions (e.g., chronic fatigue, chronic stress, a depressed state)" (2). A symptom list cannot tell you what your testosterone is.
One symptom deserves special attention: new erection problems are not only a hormone question. Among 9,457 men aged 55 or older in a large US trial, new erectile dysfunction was associated with a higher risk of later cardiovascular events, and the authors concluded: "Erectile dysfunction is a harbinger of cardiovascular clinical events in some men" (8). That is an association, not proof, but it is why erection problems belong in a doctor's office.
What else is behind male menopause symptoms? Sleep, weight, stress and mood
The most common drivers of midlife fatigue, low desire and low mood are sleep, body weight, stress and depression, and several of them are themselves linked to lower testosterone.
Sleep. In a laboratory study, ten healthy young men spent one week with five-hour nights, and "daytime testosterone levels were decreased by 10% to 15%" (6). It was a small study in men in their twenties, but the direction is clear. Sleep apnea adds another layer: the National Heart, Lung, and Blood Institute lists loud snoring, gasping for air, breathing that starts and stops, daytime sleepiness, and sexual dysfunction or decreased libido among its symptoms (9). Our article on sleep and hormones in midlife goes deeper into how the two interact.
Weight. EMAS followed 2,395 men for about four years: weight loss was associated with a rise in testosterone and weight gain with a fall, and for free testosterone a significant change appeared only in men who gained or lost 15% or more of their weight (7).
Stress and mood. The AUA names chronic stress and a depressed state among the conditions that mimic low testosterone (2). The US Preventive Services Task Force recommends screening all adults for depression (11), so asking to be screened is an ordinary request.
If you want to keep notes on any of this, do, and read the next paragraph in the same breath. A few weeks of written observations makes a short appointment far more useful than memory.
But some symptoms are not diary material. Chest discomfort, discomfort spreading to the arms, back, neck or jaw, shortness of breath, or a cold sweat are heart attack warning signs, and the American Heart Association's instruction is to call 911 (13). Thoughts of suicide mean calling or texting the 988 Suicide & Crisis Lifeline now, and in a life-threatening situation calling 911 (12). Loud snoring with gasping, or daytime sleepiness that affects your focus or reactions, including at the wheel, is a reason to book an appointment soon rather than track it for months (9).
When should you get your testosterone checked by a doctor?
Get it checked when you have symptoms that fit, especially the sexual ones, and a clinician agrees testing makes sense. Age alone is not a reason: the Endocrine Society states, "We recommend against routine screening of men in the general population for hypogonadism" (1).
The two main US guidelines agree on the core rules:
Symptoms and lab results both count. The Endocrine Society recommends diagnosing hypogonadism only in men with symptoms and signs of deficiency and consistently low testosterone; the AUA makes the diagnosis only when low total testosterone is combined with symptoms and/or signs (1, 2).
One test is not enough. The Endocrine Society recommends a fasting morning test confirmed by a second one; the AUA requires two early-morning measurements on separate occasions (1, 2).
Timing around illness matters. The Endocrine Society advises against testing men who have, or are recovering from, an acute illness (1).
Some histories are a reason to consider testing anyway. The AUA tells clinicians to consider measuring testosterone, even without symptoms, in men with unexplained anemia, bone density loss, diabetes, chemotherapy, testicular radiation, HIV/AIDS, long-term opioid use, male infertility, pituitary problems and long-term corticosteroid use (2).
A low result leads to more questions. Both guidelines call for further evaluation, including pituitary hormones, before any treatment decision (1, 2).
We deliberately do not quote lab cut-offs: your number has to be read alongside the assay, the timing, your symptoms and other results, which is a clinician's job. For common misunderstandings about levels after 40, see testosterone after 40: myths and facts.
What do guidelines say about testosterone therapy for andropause?
Testosterone therapy is a prescription decision for you and your clinician; we can only report what the Endocrine Society and the AUA have written. Nothing here is a recommendation from Welltory, and we give no doses or products.
Who it is for. The Endocrine Society recommends therapy for men with symptomatic, confirmed deficiency, after a discussion of benefits and risks that involves the patient in the decision. For men 65 and older, it suggests against routinely prescribing it to all men with low testosterone, and suggests an individualized decision for those with symptoms and consistently low morning levels (1). Under this guideline, a low number linked to age alone is not a reason for treatment.
What it may and may not help. The AUA tells clinicians to inform patients that therapy may improve erectile function, low sex drive, anemia, bone density, lean body mass and/or depressive symptoms, and that the evidence is inconclusive on energy, fatigue, cognitive function, measures of diabetes, lipid profiles and quality of life (2).
Heart risk. The AUA tells clinicians to inform testosterone-deficient patients that low testosterone is a risk factor for cardiovascular disease, and to counsel them that it cannot be stated definitively whether therapy increases or decreases the risk of cardiovascular events (2). The AUA lists this 2018 guideline as reviewed, with validity confirmed, in 2024.
When guidelines advise against it. The Endocrine Society recommends against starting therapy in men planning fertility in the near term, and in men with breast or prostate cancer, a palpable prostate nodule or induration, an elevated PSA without further urological evaluation, elevated hematocrit, untreated severe obstructive sleep apnea, severe lower urinary tract symptoms, uncontrolled heart failure, a heart attack or stroke within the last six months, or thrombophilia (1). The AUA adds that it should not be prescribed to men currently trying to conceive (2). Your clinician decides which of these apply to you.
Lifestyle is part of the guideline too. The AUA states that all men with testosterone deficiency should be counseled on lifestyle modifications as a treatment strategy (2).
Living with male menopause symptoms: the questions people ask next
Is male menopause dangerous?
Male menopause itself is not a disease, so it is not dangerous in the way an illness is. What can be serious are the conditions behind the same symptoms. New erectile dysfunction in men 55 and older was associated with later cardiovascular events in a large US study (8). Untreated depression is associated with a higher risk of cardiovascular events, according to the USPSTF (11). And the AUA tells clinicians to inform men with confirmed testosterone deficiency that low testosterone is a cardiovascular risk factor (2).
Does andropause go away, or is this forever?
The slow, age-related fall in testosterone does not reverse on its own: in the Massachusetts Male Aging Study, total testosterone kept falling about 1.6% a year within the same men (4). But male menopause symptoms are often not permanent, because many come from causes that change. In EMAS, weight loss was associated with rising testosterone over about four years (7); short sleep is linked to lower daytime testosterone (6); and depression and sleep apnea are treatable in their own right. The age part is slow; much of the rest may be movable.
Does exercise help with andropause symptoms?
Exercise is worth doing at any age, but long-term cohort data give little support to the idea that it raises testosterone in ageing men. In the European Male Ageing Study, changes in physical activity over about four years were not associated with significant changes in reproductive hormones, while changes in weight were (7). The best-supported link runs through body weight rather than any particular workout. If you are returning to hard training after years off, or notice chest discomfort or breathlessness when you exert yourself, see a doctor first; chest discomfort with shortness of breath, a cold sweat, or pain spreading to the arm, neck or jaw means 911 (13).
Does alcohol make male menopause symptoms worse?
Alcohol is one of the factors researchers separate out when they study testosterone and ageing. In the Massachusetts Male Aging Study, men with no chronic illness, no prescription medication, no obesity and no excessive drinking had levels of several androgens 10% to 15% higher than other men (4). Those factors were grouped, so alcohol is not isolated. A practical approach is to treat regular heavy drinking as one plausible contributor to poor sleep, low energy and low desire, and to tell your doctor how much you drink, since it changes how symptoms and results are read.
Can andropause cause anxiety or depression?
Low testosterone and low mood are related, but the link is looser than "andropause causes depression." In the European Male Ageing Study, depression and fatigue were related to testosterone level, but only sexual symptoms formed a consistent syndrome with low testosterone (3). The AUA names a depressed state and chronic stress among conditions that look like low testosterone (2). If your mood has changed, ask to be screened for depression; the USPSTF recommends it for all adults (11). If you have thoughts of suicide, call or text 988 now; in a life-threatening situation, call 911 (12).
What kind of doctor treats male menopause?
Start with your primary care doctor, who can review symptoms, medications, sleep and mood, and order blood tests at the right time of day. If testing confirms low testosterone, or something else turns up, you may be referred on. Endocrinologists work from the Endocrine Society guideline, which calls for finding the cause of a deficiency before treatment (1); urologists work from the AUA guideline, which also covers erectile function and fertility (2). A sleep specialist may be the right next step if snoring, gasping or daytime sleepiness are part of the picture (9).
How to bring this up with your doctor
Say it in one sentence first: "For the past few months I've been tired all the time, my sex drive has dropped and I'm getting fewer morning erections, and I'd like to work out why." It names the symptoms guidelines care about most and asks for an investigation, not a particular treatment.
Bring a short written record, not a pile of screenshots. When it started, how you are sleeping (and whether a partner has mentioned snoring or pauses in your breathing), changes in weight, alcohol, mood and stress, and every medication and supplement you take, including anything bought online. One page is enough.
Ask about the blood test: "Should this be a morning test, and will we repeat it before drawing conclusions?" Both main US guidelines call for early-morning measurement and a repeat (1, 2).
Ask what else could explain it. "Could this be my sleep, my weight, my mood or one of my medications?" It is reasonable to ask for depression screening (11) and, if snoring or sleepiness are involved, whether a sleep evaluation makes sense (9).
If erections have changed, ask about your heart too. New erectile dysfunction has been associated with later cardiovascular events (8), so blood pressure, cholesterol and blood sugar belong in the same conversation.
If treatment comes up, ask about both sides. "What could it help with, what probably won't change, and what rules it out for me?" The AUA lists energy and fatigue among the outcomes where evidence is inconclusive (2), and the Endocrine Society lists conditions in which therapy should not be started, including near-term fertility plans (1). Your clinician decides which apply to you.
And do not put these down to age. Chest pain or pressure, shortness of breath, or a cold sweat with arm, neck or jaw discomfort means 911 (13). Thoughts of suicide mean calling or texting 988, or 911 if a life is in immediate danger (12).
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How Welltory helps — and what it cannot do
The limits first, because they are the point here. Welltory is a general wellness product, not a medical device. It does not diagnose, detect, predict, monitor, prevent, treat or mitigate andropause, low testosterone, depression, sleep apnea or any other condition. It cannot measure testosterone or tell you anything about your hormones. What it offers is a division of labor.
You note the day; the app is already recording heart rate and sleep. When Welltory flags a stress stretch and asks "What happened?", you can tap a suggested tag, type a few words or just talk: "short night", "woke at 4am", "two beers", "deadline", "late dinner", "low mood", "felt flat all afternoon". You know what the day was like, and you are the one putting it on the record.
Then look at the two together. Stress minutes, sleep analysis, Battery, resting heart rate and HRV are recorded the same way every day. Put your notes beside them and you have dated pairs: what you experienced, and what was recorded at the time. These are your own numbers next to your own history, not a population range and not a line marked normal. Stress minutes, sleep analysis and Battery need a supported wearable; with the morning phone-camera reading alone, you have your spot measurements.
After two to three weeks of tagging, My Patterns has something to work with. My Patterns collects the tags you add to stress and rest stretches on the Today screen, so it needs iOS with an Apple Watch or Oura. Patterns appear at around seven tagged events in the current month, with some history from the month before. It shows which tagged situations tend to come alongside stressful stretches, which tags do not happen often but hit your body hard, trends by day of week, heart-rate data, and every time a tag occurred.
That list is what you take to the doctor. The Journal (Premium) keeps your measurements, tags and notes, and from the Welltory web app you can export a CSV (Dashboard → choose a chart → Export). It is a record you made, not a conclusion the app reached. Any pattern in it is an association to discuss with your doctor, not proof of a cause and not a verdict on your hormones.
The red flags belong here too, in the same type size: chest pain or pressure, shortness of breath, or a cold sweat with arm, neck or jaw discomfort means calling 911, and thoughts of suicide mean calling or texting 988 (or 911 if a life is in immediate danger), not adding a tag (13, 12). Loud snoring with gasping, or daytime sleepiness that affects your focus or reactions, including at the wheel, is a reason to book an appointment soon (9).
Where to find other people in the same situation. This part is for the women in your life rather than for you: if a partner or another woman close to you is living with an energy-limiting condition, Welltory runs a paid, moderated community called Energy Lab for women aged 18 to 65 living with ME/CFS, long COVID, fibromyalgia, POTS, MCAS and similar. It runs alongside the app: members keep collecting their own data, and the Lab is where people learn to read it together, with a medical board answering the science. It is education and peer support, not medical care, it does not replace a clinician, and there is a 14-day money-back guarantee on a first purchase.
How we made it
Made with AI tools, then edited and fact-checked by the Welltory team. See our Editorial & AI policy.
Data analysis by Jane Smorodnikova, co-founder of Welltory and the person who built the methodology behind how we read physiological data.
Written by Tatsiana Yashyna.
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This article is for educational purposes only and is not a substitute for medical advice, diagnosis, or treatment from a qualified clinician.
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Written by Jane Smorodnikova
The founder and CEO of Welltory. A recognized tech leader with two Master's degrees and experience at MIT, she has scaled Welltory to over 17 million users.
Written by Tatsiana Yashyna
Deputy COO at Welltory. With a background in medicine and years of working with health data, she translates research and real physiological signals — sleep, stress, heart rate, and hormones — into clear, evidence-based explanations that help people understand what their bodies are telling them.
References
- Bhasin S, Brito JP, Cunningham GR, et al. Testosterone therapy in men with hypogonadism: an Endocrine Society clinical practice guideline. The Journal of Clinical Endocrinology & Metabolism 2018;103(5):1715–1744. https://doi.org/10.1210/jc.2018-00229
- Mulhall JP, Trost LW, Brannigan RE, et al. Evaluation and management of testosterone deficiency: AUA guideline. Journal of Urology 2018;200(2):423–432 (reviewed and validity confirmed 2024). https://doi.org/10.1016/j.juro.2018.03.115 · Full guideline: https://www.auanet.org/guidelines-and-quality/guidelines/testosterone-deficiency-guideline
- Wu FCW, Tajar A, Beynon JM, et al; EMAS Group. Identification of late-onset hypogonadism in middle-aged and elderly men. New England Journal of Medicine 2010;363(2):123–135. https://doi.org/10.1056/NEJMoa0911101
- Feldman HA, Longcope C, Derby CA, et al. Age trends in the level of serum testosterone and other hormones in middle-aged men: longitudinal results from the Massachusetts Male Aging Study. The Journal of Clinical Endocrinology & Metabolism 2002;87(2):589–598. https://doi.org/10.1210/jcem.87.2.8201
- Harman SM, Metter EJ, Tobin JD, Pearson J, Blackman MR. Longitudinal effects of aging on serum total and free testosterone levels in healthy men. The Journal of Clinical Endocrinology & Metabolism 2001;86(2):724–731. https://doi.org/10.1210/jcem.86.2.7219
- Leproult R, Van Cauter E. Effect of 1 week of sleep restriction on testosterone levels in young healthy men. JAMA 2011;305(21):2173–2174. https://doi.org/10.1001/jama.2011.710
- Camacho EM, Huhtaniemi IT, O'Neill TW, et al. Age-associated changes in hypothalamic-pituitary-testicular function in middle-aged and older men are modified by weight change and lifestyle factors: longitudinal results from the European Male Ageing Study. European Journal of Endocrinology 2013;168(3):445–455. https://doi.org/10.1530/EJE-12-0890
- Thompson IM, Tangen CM, Goodman PJ, Probstfield JL, Moinpour CM, Coltman CA. Erectile dysfunction and subsequent cardiovascular disease. JAMA 2005;294(23):2996–3002. https://doi.org/10.1001/jama.294.23.2996
- National Heart, Lung, and Blood Institute. Sleep apnea: symptoms. https://www.nhlbi.nih.gov/health/sleep-apnea/symptoms
- National Institute on Aging. What is menopause? https://www.nia.nih.gov/health/menopause/what-menopause
- US Preventive Services Task Force; Barry MJ, Nicholson WK, Silverstein M, et al. Screening for depression and suicide risk in adults: US Preventive Services Task Force recommendation statement. JAMA 2023;329(23):2057–2067. https://doi.org/10.1001/jama.2023.9297
- National Institute of Mental Health. Men and depression. https://www.nimh.nih.gov/health/publications/men-and-depression
- American Heart Association. Warning signs of a heart attack. https://www.heart.org/en/health-topics/heart-attack/warning-signs-of-a-heart-attack