When we talk about menopause, we generally think about women, but did you know that men also experience hormonal changes as they get older?
You may have heard the term andropause, sometimes described as the male equivalent of menopause. However, the two are actually quite different.
The difference between Menopause and Andropause is:
In women, menopause involves a relatively rapid decline in ovarian hormone production and eventually the end of menstruation. In men, testosterone generally declines more gradually, often beginning around middle age. Not every man will develop symptoms, and low testosterone is not simply an inevitable part of getting older.
Testosterone plays an important role in much more than sexual function.
It influences muscle mass and strength, bone health, red blood cell production, mood, motivation, energy and sexual wellbeing.
As testosterone levels decline, some men may notice changes such as reduced energy, loss of muscle mass, increased abdominal fat, reduced libido or erectile difficulties. They may also experience changes in mood, motivation, concentration and sleep.
Many of the symptoms’ men experience can also be caused or worsened by stress, poor sleep, excess body weight, alcohol, lack of exercise, certain medications and underlying health conditions.
We shouldn’t automatically assume that every tired or irritable man has low testosterone. As with everything else concerned with health, it is important to look at the whole person.
Some of the factors that influence men’s health are:
- Nutrition
- Exercise
- Sleep
- Stress management
Nutrition:
Nutrition is important in that a diet providing adequate protein, healthy fats, vegetables, minerals and micronutrients can support overall metabolic and hormonal health.
Exercise:
Strength training is particularly valuable as men age because it helps maintain muscle mass, bone density, insulin sensitivity and physical function.
Sleep:
Sleep is another major piece of the puzzle. Poor or inadequate sleep can affect testosterone production as well as energy, mood and metabolic health.
Stress Management:
Managing chronic stress is important because when the body is constantly under stress, it can have consequences for sleep, metabolic health and overall hormonal balance.
As with any other health condition, if a man is experiencing persistent symptoms, it is worth discussing them with a healthcare professional.
Testosterone deficiency is diagnosed based on symptoms together with appropriately timed blood tests, rather than symptoms alone.
Testosterone replacement therapy can be appropriate for some men with confirmed testosterone deficiency, but it isn’t something that every man needs simply because he is getting older. There are potential benefits as well as risks, so it needs to be assessed individually and monitored appropriately.
An interesting part of male hormone health that often gets overlooked in the relationship between testosterone and estrogen.
Many men are surprised to learn that they need oestrogen too.
An enzyme called aromatase converts some testosterone into estradiol, which is the main form of estrogen in the body. This is a completely normal process, and men need a certain amount of estradiol for healthy bones, sexual function, brain health and metabolism.
Aromatase is found in higher amounts in fat tissue.
So, when a man gains excess body fat, particularly around the abdomen, there can be increased conversion of testosterone into estradiol. This can potentially contribute to a hormonal imbalance where testosterone levels can be lower, body composition can change, muscle mass is reduced, libido decreases and sometimes difficulties with sexual function can be experienced.
Estrogen is not the enemy.
Men need oestrogen too. In fact, having too little oestrogen can also negatively affect bone health, body composition and sexual wellbeing. It’s not simply about having as much testosterone as possible and as little oestrogen as possible, it’s more about the balance.
Perhaps one of the most important things for men to understand as they age is that hormones don’t work in isolation.
Testosterone, estrogen, insulin, cortisol, thyroid hormones and many other systems are interconnected.
Rather than asking how to increase your testosterone, perhaps the better question is to ask how you can create the conditions in your body that support healthy hormone balance.
Listen to my interview with Anton Brink from Radio Cape Pulpit on 10 September 2026 to learn more. Listen to my next interview on Thursday at 7.45am.