Male Menopause: Understanding the Facts

"Male menopause" (andropause) is not a recognized medical diagnosis.

What Exists

• Late-onset hypogonadism (LOH) / Testosterone deficiency syndrome: Age-related gradual T decline (~1%/yr after 30–40). Symptoms: low libido, ED, fatigue, reduced muscle, increased adiposity, mood changes, cognitive dulling.
• Diagnosis: Symptomatic + consistently low total T (<300 ng/dL) + free T low on ≥2 morning draws.
• Treatment: Testosterone replacement therapy (TRT) if indicated — gels, injections, patches. Risks: erythrocytosis, prostate monitoring, fertility suppression, CV debate.

Key Differences from Female Menopause

• Female: Abrupt ovarian failure (estrogen ↓ 90% in years). Universal.
• Male: Gradual Leydig cell decline. Not universal (many maintain normal T). No fertility cessation.

Other Causes of Low T

• Obesity, metabolic syndrome, medications (opioids, glucocorticoids), chronic illness, pituitary/hypothalamic disease.

Don't self-treat with "boosters" or black-market T. See endocrinologist/urologist for proper workup.