Male Menopause: Symptoms, Age and Ways to Treat It

22/09/2026

Male menopause is a period when testosterone levels gradually decline. During this time some men may notice reduced libido, fatigue, loss of muscle mass, sleep problems or changes in mood. These symptoms are not explained by low testosterone alone, though, and a consultation with a doctor is needed to find their cause.

What you should know:

Unlike menopause in women, hormone production in men does not stop suddenly. Testosterone levels may decrease gradually with age, but the clinical condition, hypogonadism, is diagnosed only when low testosterone is confirmed by at least two separate morning tests together with matching symptoms;
Male menopause does not begin at the same age in every man;
Testosterone levels fall gradually with age, but age alone is not enough to make a diagnosis;
Fatigue, anxiety, poor sleep or changes in sexual function can have many other causes;
The diagnosis is made through laboratory tests. Taking testosterone on your own or self treating is dangerous for your health.

What is male menopause?

As a man gets older, certain physiological changes take place in his body. Male menopause is a natural hormonal transition during which the synthesis of testosterone in the testicles gradually decreases.

In medicine this condition is described with the terms hypogonadism and, in the relevant cases, late onset hypogonadism.

Symptomatic hypogonadism is not simply a result of age. Obesity, diabetes and other chronic diseases also contribute to its earlier development.

At what age does male menopause begin?

It is difficult to name a specific number. Testosterone levels drop gradually with age, but this change does not happen at the same pace in every man.

In some men hormonal changes begin after the age of 40, in others later. Symptoms are influenced by general health, body weight, sleep quality, level of physical activity, use of nicotine and alcohol, and chronic diseases.

A gradual decline in testosterone can start after the age of 30 to 40, although this process is not always accompanied by noticeable complaints. With age, some men may begin to experience reduced libido, less energy, loss of muscle mass or changes in sleep and mood.

Symptoms of male menopause

Hormonal changes affect various systems of the body. Sometimes the symptoms develop so quietly that a man puts them down to being overtired.

The symptoms of male menopause may include:

Physical changes: a feeling of chronic fatigue, loss of muscle mass, fat building up around the abdomen, lower bone density and episodes of sweating;
Sexual sphere: reduced libido (sex drive), poorer quality of erections and fewer morning erections;
Psychological and emotional state: mood swings, irritability, lower motivation and reduced concentration;
Sleep problems: difficulty falling asleep, waking up at night and feeling tired in the morning.

Men often link these symptoms to stress or exhaustion. That is why they do not go to a doctor.

Self check

Think about the following:

Has your libido dropped noticeably in recent months?
Do you have morning erections less often?
Are you constantly tired even though you slept well?
Have you noticed a loss of muscle mass?
Has your sleep or mood changed?
Have these changes lasted for several months?

Several yes answers are a reason to consult a doctor.

Male menopause and anxiety: why does mood change?

Male menopause and anxiety can be connected, but anxiety is not a specific sign of low testosterone. A drop in testosterone affects the balance of neurotransmitters, for example serotonin and dopamine, and this is reflected in the emotional state.

During this period male menopause and anxiety often appear together. A man may feel inner tension, nervousness without a clear reason and emotional instability. When male menopause and nervousness develop, this is not simply "a bad temper". It is the result of biological changes taking place in the body.

Correct differentiation matters here: similar symptoms can be caused by depression, thyroid dysfunction or chronic stress.

Male menopause and the heart: rapid heartbeat, arrhythmia and temperature

It is worth noting that a rapid heartbeat has many causes, among them stress, caffeine, anaemia, thyroid diseases, rhythm disorders and other conditions.

The same applies to male menopause and arrhythmia. A heart rhythm disorder is a separate medical problem and its cause should be established through the appropriate examination.

With a marked testosterone deficiency some men may experience hot flushes and sweating, although other possible causes should be ruled out in these cases as well.

If a rapid heartbeat comes with chest pain, shortness of breath, loss of consciousness or a feeling that you are about to faint, urgent medical assessment is required.

Early male menopause

Sometimes hormonal changes begin before the age of 40. This condition is called early male menopause.

Contributing causes may be:

Trauma to the testicles, inflammatory diseases and surgery;
Metabolic disorders, excess weight and diabetes;
Sleep apnoea (pauses in breathing during sleep);
Chemotherapy, radiation therapy or long term use of certain medicines;
Heavy alcohol consumption and tobacco.

Early hormone deficiency needs attention, because it can have a negative effect on bone tissue, the cardiovascular system and reproductive health.

Symptoms alone, or a single low testosterone reading, are not enough to diagnose hypogonadism. Matching clinical signs must be present and the low testosterone level must be confirmed by at least two separate morning tests.

How is the diagnosis made?

The presence of symptoms alone is not enough for a diagnosis. The testosterone level in the blood has to be checked as well. The test is usually carried out in the morning, and if the result is low, repeating it is recommended.

For more information about testosterone levels you can read our article Testosterone test and normal range.

The doctor may additionally measure LH (luteinising hormone) and FSH (follicle stimulating hormone). These are hormones produced in the pituitary gland that regulate the work of the testicles. Checking them helps the doctor establish whether low testosterone is linked to impaired function of the testicles or to the work of the pituitary gland and the hypothalamus. If necessary, the specialist will also assess other possible causes.

At the first stage, an endocrinologist consultation will help you assess the symptoms and plan the necessary tests. If sexual function has changed, a urologist may be involved in the treatment process.

Treatment of male menopause

The course and the approach to treatment are always complex, and they start first of all with changes to lifestyle.

Improving your lifestyle matters in almost every case. Regular physical activity is useful, especially strength training, along with healthy eating, enough sleep, weight control and limiting alcohol. It is also important to treat the diseases that affect testosterone levels or general health.

Hormone therapy is prescribed only when testosterone deficiency is confirmed alongside matching symptoms. Before starting treatment, the doctor assesses the possible benefits, the risks, any accompanying diseases and the patient's reproductive plans.

Taking testosterone products on your own is categorically unacceptable. It can lead to infertility, prostate problems and complications of the cardiovascular system. The course of treatment must be determined by a doctor.

When should you see a doctor?

You should see a doctor if insomnia, lack of energy or a faster heartbeat have been bothering you for several months.

To have your hormone levels assessed you can book an appointment at Todua Clinic. An endocrinologist at the Vera branch or an endocrinologist in Dighomi will help you establish the exact causes.

For problems with sexual function and male reproductive health you can consult a urologist.

If you have a rapid heartbeat, an irregular heartbeat or other cardiological complaints, a cardiologist may be involved in assessing the symptoms.

When should I take a testosterone test?

A testosterone test is appropriate when a patient has symptoms consistent with hypogonadism or a condition that carries a risk of developing it. Total testosterone is usually measured in the morning on an empty stomach. If the result is low, a repeat assessment is needed.

A doctor should interpret the results, taking into account symptoms, overall health, medications, and other tests.

Do not leave your symptoms unattended. Book an appointment with an endocrinologist at Todua Clinic, check your testosterone level and get an individual recommendation. Call 032 2 57 57 57 and reserve your consultation.

Frequently asked questions

At what age does male menopause begin?

There is no specific age. Testosterone levels fall gradually with age, but the time when symptoms appear is individual. When complaints are pronounced, it is important to assess both low testosterone and other possible causes.

What symptoms come with male menopause?

Possible symptoms are reduced libido, fewer morning erections, erectile problems, less energy and muscle strength, changes in mood, difficulty concentrating and sleep problems. These signs are not typical of testosterone deficiency alone, though.

Can testosterone deficiency be treated?

Yes. When hypogonadism is confirmed, a doctor may consider appropriate treatment.