Should we be concerned about the male menopause?

Progress has been slow when it comes to menopausal awareness and the issues women face in midlife. But with around 25% men experience symptoms, should we also be paying more attention to the andropause, its male counterpart?

We’ve teamed up with the reproductive experts at Fertifa to find out how male menopause affects men both physically and mentally, and how it can be treated.

Do men have a menopause?

“The straightforward medical answer is no. However, it is worth exploring this topic,” says Fertifa’s Medical Director, Dr Gidon Lieberman. “Menopause is a term exclusively used to describe the hormonal changes women undergo, typically occurring in their late 40s when oestrogen production significantly decreases. In contrast, most men continue to produce testosterone throughout their lives.”

However, “it's essential to acknowledge that testosterone levels in men do naturally decrease with age,” Dr Gidon adds. “Some men may perceive or encounter these changes, while others may not. Distinguishing between the effects of ageing itself and those attributed to declining testosterone levels can be quite challenging.”

There is a recognised phenomenon in midlife where some men may experience a cluster of symptoms. These symptoms can include mood swings, loss of muscle mass, reduced exercise capacity, changes in fat distribution, diminished enthusiasm or energy (anhedonia), sleep disturbances, fatigue, decreased libido, difficulties concentrating, and worsening short-term memory.

“The gradual nature of this decline may lead to a subtle awareness of these symptoms. However, it's worth noting that most men won't experience significant or distressing symptoms due to declining testosterone levels.”

- Dr Gidon Lieberman, Medical Director at Fertifa

Typically, testosterone levels in men peak in their late 20s, and for some individuals, this hormone's levels gradually decline over the subsequent decades. “The gradual nature of this decline may lead to a subtle awareness of these symptoms,” Dr Gidon explains. “However, it's worth noting that most men won't experience significant or distressing symptoms due to declining testosterone levels.”

In some cases, certain men may encounter testicular failure, resulting in a sudden and pronounced decline in testosterone production, leading to abrupt and noticeable symptoms.

Is there a test for male menopause?

The way to test for a testosterone drop is fairly straightforward: Fertifa’s clinical team advise that a simple blood test should identify low testosterone in men. “If your results show a testosterone deficiency then you may be given testosterone replacement therapy,” they explain. “Which typically comes in the form of a gel or injection.”

Is there a way to help male menopause symptoms?

So, does testosterone replacement therapy (TRT) restore all the vim and vigour of one’s pre-menopause self? There’s certainly been a growing interest in its role in recent years. Testosterone has been known to help counter the symptoms. In fact, Robbie Williams fans might remember his foray into TRT after finding out he had entered early male menopause in his 30s; the singer said the treatments gave him "a new lease of life".

But each patient is unique, so the treatment plan should be, too – Fertifa can walk men through the best course of action for them. “Lifestyle modifications can certainly make a significant difference,” says Dr Gidon. “Wherever possible, men should be aiming to reduce body fat, minimise alcohol consumption, quit smoking, and avoid recreational drugs.”

"Studies have shown 75% of men in the UK will put off going to the doctor, even when feeling ill."

- Fertifa’s clinical team

It’s no secret that men’s health can be a sensitive subject, and many actively avoid seeing a doctor. In fact, “studies have shown 75% of men in the UK will put off going to the doctor, even when feeling ill,” the clinical team note. One survey by the Cleveland Clinic showed around 20% of men admitted they wouldn’t be truthful with their doctor; of those, 46% said this was because they were too embarrassed.

Sexual health can add another layer of anguish. Among other milder symptoms, a fall in testosterone can cause decreased libido and erectile dysfunction – all of which can cause feelings of isolation and anxiety in men, despite being common health issues.

But this is the beauty of Fertifa – they believe in reproductive rights for all. The team abides by the principle that reproductive challenges can affect anyone and so should be available to everyone. As such, they offer care for both female and male reproductive health, including men presenting any mid-life symptoms – they even have a specialist dedicated exclusively to men’s health.

The wellbeing of men continues to be a salient societal issue, but Fertifa’s open and inclusive nature takes aim at the stigma of male reproductive challenges, which encourages men to prioritise their health free of shame.