Male Andropause: Symptoms, Low Testosterone & Testing
Updated: Sep 30
What is Male Andropause and Is It a Real thing?
We hear a great deal about menopause and the hormonal changes women experience as they get older. But what about men?
Yes Men change too.
It isn't usually an abrupt hormonal change like menopause. Instead, changes in male hormones tend to happen gradually, sometimes over many years. A man may simply notice that he doesn't feel quite like himself anymore.
Perhaps the energy isn't there. The belly is getting bigger despite not eating very differently. Muscle is becoming harder to maintain. Training takes longer to recover from. Libido isn't what it used to be. Motivation may have changed, and sometimes there is simply a feeling that the old drive has disappeared.
It is very easy to put all of this down to “getting older.” But should we?
What Do We Mean by Male Andropause?
“Andropause” is a popular term rather than a precise medical diagnosis.
Unlike women, men don't normally experience a sudden point where reproductive hormone production dramatically changes. Instead, testosterone and the wider hormonal environment can gradually change as men move through adulthood.
When there is genuine testosterone deficiency accompanied by appropriate symptoms, medical terminology such as male hypogonadism or late-onset hypogonadism may be used.
But there is an important point here. Not every tired 50 year old man with a belly has low testosterone. There can be several pieces to the puzzle.
Testosterone – It's About Much More Than Sex
Testosterone is the principal male androgen hormone. Most of it is produced within the testes by specialised cells called Leydig cells, following hormonal instructions originating in the brain.
In simple terms:
Brain → Pituitary gland → LH → Testes → Testosterone
Testosterone contributes to much more than libido.
It plays important roles in:
Sexual desire and sexual function
Sperm production and fertility
Maintaining muscle mass
Strength and physical performance
Bone health
Red blood cell production
Body-fat distribution
Energy and vitality
Maintenance of male characteristics
So when testosterone genuinely becomes deficient, its effects can potentially be noticed throughout the body.
At What Age Does Male Andropause Start?
There isn't a particular birthday when somebody suddenly enters “andropause”.
Hormonal changes can begin during adult life, with age-related changes becoming increasingly relevant from the 30s and 40s onwards. But age is only part of the story.
I think this is where men's health becomes much more interesting.
Two men can both be 55 years old and have completely different hormone profiles, body composition, fitness levels and metabolic health.
The question therefore isn't simply:
“How old are you?”
It is:
“What has been happening to your body over the last 10 or 20 years?”
Can Younger Men Have Low Testosterone?
Yes. Low testosterone isn't exclusively an older man's problem.
Although testosterone and the wider male hormonal environment can change with age, younger men can also experience low testosterone. When this happens, it is particularly important not to simply assume that it is part of normal ageing , because there may be an underlying reason worth investigating.
A younger man might be physically fit and look healthy but still experience changes such as reduced libido, poorer erections, persistent fatigue, difficulty maintaining muscle, reduced exercise recovery, low motivation or changes in mood.
There are many possible contributors.
Stress and the Modern Male
Chronic stress deserves particular attention.
Work pressure, financial worries, relationships, long working hours, excessive training, inadequate recovery and constantly being “switched on” can all contribute to the overall physiological load placed upon the body.
Stress doesn't simply “use up” testosterone. The relationship is more complicated. Persistent psychological and physiological stress can influence the hypothalamic-pituitary-gonadal (HPG) axis – the communication pathway between the brain, pituitary gland and testes that helps regulate testosterone production.
Stress can also create a knock-on effect:
Chronic stress → poorer sleep → reduced recovery → fatigue → reduced training quality → poorer food choices → changes in body composition and metabolic health
Over time, several of these factors may be working together.
Other Reasons Younger Men May Have Low Testosterone
Age is therefore only one consideration. In a younger man, other areas worth considering can include:
Poor or insufficient sleep
Chronic psychological or physiological stress
Being significantly overweight or carrying excessive abdominal fat
Very restrictive dieting or prolonged inadequate calorie intake
Inadequate protein or overall nutritional intake
Excessive exercise without sufficient recovery
Chronic illness or inflammatory conditions
Thyroid dysfunction
Certain medications
Previous testicular injury or infection
Conditions affecting the testes, pituitary gland or hypothalamus
Previous chemotherapy or radiotherapy
Anabolic-androgenic steroid use
Anabolic Steroids – Particularly Relevant to Younger Men
This is something younger men should be aware of.
Using anabolic-androgenic steroids or other external androgens can suppress the body's own hormonal signalling.
When the brain detects a strong external androgen signal, production of LH and FSH can fall. The testes consequently receive less stimulation to manufacture their own testosterone and sperm.
This can result in testicular shrinkage, reduced sperm production, impaired fertility and suppressed natural testosterone production.
Recovery after stopping anabolic steroids varies considerably between individuals, and persistent symptoms should be medically investigated rather than self-treated with additional hormones.
Eating Too Little Can Matter Too
There is another side of male health that receives much less attention than obesity – under-fuelling.
A younger man may be training hard while deliberately keeping his calories extremely low to stay lean. If energy intake remains inadequate relative to exercise and daily requirements, the body may begin adapting to the lack of available energy.
Poor overall nutrition, inadequate protein, insufficient dietary fat or deficiencies of important micronutrients can also compromise general health, training recovery and normal physiological function. Being lean doesn't automatically mean being hormonally healthy.
Low Testosterone at 30 Shouldn't Simply Be Accepted
If a younger man develops persistent symptoms associated with testosterone deficiency, the objective shouldn't be to immediately find a way of increasing his testosterone.
The better question is:
“Why might it be low?”
That may mean looking at testosterone alongside sleep, stress, nutrition, body composition, thyroid and metabolic health, medications, training load and testicular health.
Where genuine testosterone deficiency is suspected, appropriate medical investigation can then establish whether there is an underlying cause requiring treatment.
Low testosterone isn't just an older man's issue – and age is only one piece of the male hormonal puzzle.
What Are the Symptoms of Male Andropause?
Possible symptoms can include:
You May Notice | What Has Changed |
Lower libido | Less interest in sex or fewer spontaneous erections |
Reduced energy | Feeling persistently tired or flat |
Loss of strength | Weights or physical activities feel harder |
Loss of muscle | Arms and legs may become less muscular |
Increasing belly fat | More weight accumulating around the abdomen |
Poorer recovery | Exercise seems to take more out of you |
Mood changes | Lower mood, irritability or reduced motivation |
Poor concentration | Difficulty concentrating or “brain fog” |
Reduced vitality | Simply not feeling as physically capable as before |
None of these symptoms on their own proves that testosterone is low. And that's important. They are clues to investigate, rather than a diagnosis.
The Changing Male Shape
There is a body composition pattern that is sometimes seen as men get older.
The abdomen becomes larger while muscle definition in the arms, shoulders and legs gradually decreases.
Some practitioners have informally described this as a “frog-like” body shape a larger middle sitting on increasingly less muscular limbs.
It isn't a recognised diagnostic sign of testosterone deficiency, and there are many reasons why a man's body can change this way.
But when increasing abdominal fat occurs alongside declining muscle mass, reduced strength, fatigue and loss of libido, it gives us good reason to look more closely at the man's overall health.
The Belly Matters
Body fat isn't simply something we store underneath our skin. Adipose tissue is metabolically active.
Fat tissue contains an enzyme called aromatase, which participates in the conversion of androgens into oestrogens.
As abdominal and visceral fat increases, the hormonal and metabolic environment can change too. Obesity is associated with lower testosterone in many men and can also be associated with changes in insulin sensitivity, inflammation and SHBG – the protein responsible for transporting much of the testosterone in the circulation.
This can potentially become a cycle:
More abdominal fat → poorer metabolic health → altered hormonal environment → reduced muscle and activity → further fat accumulation
This doesn't mean that every overweight man has low testosterone.
It means that body composition is part of male hormonal health.
Muscle Loss – Don't Just Blame Your Age
Another area I pay particular attention to is muscle.
Men naturally tend to lose some muscle as they get older, particularly if they become less active. But there can be many contributors to more significant muscle loss.
These can include:
Reduced physical activity
Inadequate resistance exercise
Low testosterone
Inadequate protein intake
Overall inadequate calorie or nutrient intake
Poor absorption or digestive problems
Chronic illness
Persistent inflammation
Poor sleep
Metabolic disease
Thyroid dysfunction
Certain medications
This matters because muscle isn't just there to make us stronger or look athletic.
Skeletal muscle is metabolically important tissue.
It plays an important role in glucose disposal, insulin sensitivity, mobility, physical independence and metabolic health.
Maintaining muscle as we age should therefore be viewed as an important part of long-term male health.
Are You Actually Eating Enough of the Right Things?
This is an area that can easily be overlooked. Hormones cannot operate independently of nutrition.
Some men eat plenty of calories but have surprisingly poor nutritional quality. Others dramatically reduce food intake in an attempt to lose weight and inadvertently reduce their intake of protein and essential nutrients at the same time.
A diet dominated by refined foods, alcohol, sugar and convenience foods may provide plenty of energy without necessarily providing the nutritional foundation we want for healthy ageing.
Adequate intake of protein, essential fats, vitamins and minerals contributes to normal physiological function.
Nutrients involved in normal energy metabolism, thyroid function, immune function and hormone physiology include nutrients such as:
zinc • magnesium • selenium • vitamin D • B vitamins • essential fatty acids • adequate protein
More supplementation isn't automatically better.
The first question should be whether the man is actually receiving, digesting and absorbing the nutrition he needs.
Immune Health, Inflammation and Testosterone
The immune system also forms part of this picture.
Short-term inflammation is a normal and essential part of our defence and repair systems.
The concern is persistent or chronic inflammatory activity associated with conditions such as obesity, metabolic dysfunction, chronic disease and some inflammatory illnesses.
Chronic illness and inflammation can influence appetite, energy metabolism, physical activity, muscle maintenance and the hormonal systems involved in reproduction.
In some situations, significant illness can temporarily suppress testosterone concentrations as the body responds to physiological stress.
This is another reason why looking at one testosterone result without considering the man's wider health can be misleading.
Stress – More Important Than Many Men Realise
Men frequently tell me:“I'm not stressed.” Then we start talking. They're sleeping five or six hours, running a business, worrying about finances, answering emails late at night, drinking several coffees to keep going and still trying to train four times a week.
The body doesn't necessarily distinguish between the different reasons we place it under pressure.
The old idea that cortisol simply “steals” testosterone's building blocks is too simplistic.
What we do know is that prolonged psychological and physiological stress can influence the signalling systems connecting the brain, pituitary gland and reproductive organs.
And there is another very practical pathway:
Stress → poor sleep → poorer recovery → reduced exercise → poorer food choices → increasing abdominal fat → declining metabolic health
Sometimes improving hormonal health means looking at the lifestyle surrounding the hormones.
What About the Thyroid?
This is an important connection. An underactive thyroid can produce symptoms remarkably similar to those associated with low testosterone.
These may include:
Fatigue
Weight gain
Poor exercise tolerance
Low mood
Reduced libido
Difficulty maintaining a healthy body composition
Thyroid hormones can also influence proteins such as SHBG and interact with reproductive physiology. If a man has low energy, reduced libido and increasing body weight, it doesn't automatically mean:
“He needs testosterone.”
Thyroid function may be another area worth investigating along with testosterone.
What Else Can Reduce Testosterone?
There are numerous possible contributors, including:
Excess body fat – particularly visceral abdominal fat, conversely an increase in estrogen
Testicular injury or disease – damage to the testes can impair their ability to produce testosterone.
Surgery – particularly procedures affecting the testes, pituitary gland or relevant endocrine structures.
Testicular removal – depending upon whether one or both testes are affected and remaining testicular function.
Certain medications – including long-term opioid use and some corticosteroid treatments. Other medicines may affect libido or sexual function without necessarily lowering testosterone.
Anabolic steroid abuse – external androgens can suppress the body's own LH and FSH signalling and consequently reduce natural testosterone and sperm production.
Chemotherapy or radiotherapy – depending upon the treatment and area involved.
Pituitary or hypothalamic conditions – the testes need instructions from the brain. Sometimes the problem isn't primarily in the testes at all.
Testicular conditions – lumps, swelling, significant varicocele, inflammation, trauma or other changes require appropriate medical investigation.
Persistent testicular pain, a new lump, swelling or a change in the size or consistency of a testicle should always be medically assessed.
Don't Forget Sleep
Sleep deserves its own mention. Testosterone physiology is closely associated with normal sleep patterns. Someone who regularly sleeps poorly may also experience fatigue, poor concentration, reduced exercise recovery, increased appetite and lower libido – many of the same complaints that bring men looking for testosterone testing.
And there is another important consideration in overweight men:
sleep apnoea.
A man who snores heavily, stops breathing during sleep, wakes unrefreshed or struggles with significant daytime sleepiness should discuss this with his healthcare professional.
Sometimes the problem isn't simply hormones.
Looking Beyond a Testosterone Number
This is how I prefer to look at male health. Rather than asking only: “Is my testosterone low?” Ask:
Why am I feeling different?
Could body composition be contributing?
What is happening with blood-glucose regulation?
What about thyroid function?
How am I sleeping?
Am I maintaining muscle?
Is my nutrition adequate?
Are medications relevant?
Is there chronic illness or inflammation?
What is happening with stress?
And finally, what do the hormones actually show?
Testosterone Testing and Male Health Screening
Explore my biomarker screening service for more information about the assessment and available tests.
For men who want to understand more about their health, I offer selected point-of-care biomarker screening at Insights to your Health. Depending upon the assessment, biomarkers available can include:
Biomarker | What It Can Help Us Explore |
Testosterone | Provides information about testosterone concentration and whether further investigation may be appropriate |
Oestradiol (E2) | Provides additional information about the male hormonal environment |
HbA1c- Glycated Haemoglobin | Helps assess longer-term blood-glucose exposure and metabolic health |
TSH, T3 & T4 -Thyroid Hormone,s | Provides information about thyroid hormone status |
PSA - Prostate Serum Antigen | Provides information relating to prostate health and can identify results requiring medical follow-up |
CRP - C-Reactive Protein | A non-specific marker that can provide information about inflammatory activity |
LH - Luteinising Hormone | Signals the Leydig cells in the testes to produce testosterone. When testosterone is low, LH can help determine whether the issue may be primarily testicular or related to signalling from the brain/pituitary. |
FSH - Follicle-stimulating hormone | Works mainly with the Sertoli cells in the testes and is important for sperm production and fertility. It can provide additional information about testicular function. |
Prolactin | A pituitary hormone. Persistently elevated prolactin can suppress reproductive hormone signalling, potentially contributing to low testosterone, reduced libido and sexual dysfunction. |
SHBG - Sex Hormone Binding-Globulin | A protein that binds and transports testosterone in the blood. SHBG helps put total testosterone into context, because changes in SHBG can affect how much testosterone is available to tissues. |
These tests are used to provide information and help identify areas that may warrant further investigation. They are not used on their own to diagnose testosterone deficiency, prostate disease, thyroid disease or any other medical condition.
Where a result or a man's symptoms indicate that further investigation would be sensible, appropriate medical assessment through his GP can be recommended.
Formal investigation of suspected testosterone deficiency may require repeat laboratory morning testosterone measurements and, depending upon the circumstances, tests such as SHBG, free testosterone, LH, FSH and prolactin.
Men Change – But Don't Ignore the Signs
Getting older is inevitable. Feeling progressively less well shouldn't automatically be accepted as part of it. If your energy has changed, your waistline is increasing, you've lost muscle or strength, your libido isn't what it used to be, or you simply don't feel like yourself anymore, it may be worth looking at the bigger picture. Sometimes the answer may involve hormones. Sometimes it doesn't. But understanding what is happening gives you something far more valuable than guessing. This gives you somewhere to start.
Can Natural Products and Supplements Support Testosterone?
Yes – nutrition, certain nutrients and selected herbal supplements may have a role in supporting normal male hormonal health. But this is another area where looking at the big picture is far more useful than simply buying something labelled a “testosterone booster”.
If testosterone is lower than expected, I would first want to ask why:
Is nutrition adequate?
Is the man deficient in an important nutrient? Is he carrying excessive abdominal fat?
Is he sleeping properly?
Is he under considerable stress?
Is he overtraining or under-eating?
Could thyroid function, medication, metabolic health or testicular function be contributing?
Addressing these areas may be just as important as the supplement itself.
Start With the Nutritional Foundations
Normal hormone production depends upon adequate nutrition. Zinc is particularly relevant to male reproductive health and normal testosterone physiology. If zinc intake or status is inadequate, correcting that deficiency may be beneficial. This doesn't mean that continually taking larger amounts of zinc will keep pushing testosterone higher – more is not necessarily better. Other nutrients including magnesium, vitamin D, selenium, B vitamins, adequate protein and essential fats all contribute to different aspects of normal metabolism and health. Their relevance will depend upon the individual man's diet, nutritional status and wider health picture.
What About Herbal Support?
A number of herbs and natural extracts have been investigated for their potential role in male health.
These include, among others:
Eurycoma longifolia (Tongkat Ali) – one of the more interesting herbs in this area. Research suggests that certain standardised extracts may have potential for supporting testosterone in selected groups of men, although it should not be regarded as a replacement for investigating genuine hypogonadism.
Fenugreek (Trigonella foenum-graecum) – frequently included in male-health formulations. Some studies have reported changes in testosterone or aspects of male wellbeing, although the overall evidence remains mixed and the effects appear relatively modest.
Maca (Lepidium meyenii) – traditionally associated with male vitality, libido and sexual wellbeing. An important distinction is that improving libido or sexual wellbeing doesn't necessarily mean that a herb has substantially increased testosterone.
Other botanicals and nutritional compounds are also used in men's health, but the evidence varies considerably between ingredients, extracts and individuals.
This is why I don't particularly like the idea of simply taking a generic “testosterone booster”, there are standardised herbal extracts which have an edge over generically marketed formulations.
A supplement should have a reason for being there.
Supplements Should Support the Man – Not Just the Number
If poor nutrition, stress, excess body fat, inadequate sleep or overtraining is contributing to the problem, taking a handful of herbs while ignoring those factors doesn't address the bigger picture.
Sometimes the most useful approach may involve:
Improving nutrition → correcting deficiencies → improving sleep → managing stress → reducing excess abdominal fat → maintaining muscle → allowing adequate exercise recovery → then considering targeted nutritional or herbal support.
That is a much more sensible approach to male health than simply trying to force testosterone upwards.
When Natural Support Isn't Enough
There are also situations where nutritional and herbal support isn't the appropriate answer.
If testosterone is genuinely and consistently low, particularly where there are significant symptoms, the underlying reason needs to be investigated.
Sometimes improving the hormonal environment requires medical assessment, further blood testing and, where clinically appropriate, medical treatment and monitoring.
That isn't a failure of the natural approach. It is recognising when a different level of intervention is required
.
Talking to an appropriately qualified healthcare professional about persistent symptoms is therefore important. A knowledgeable health practitioner or reputable health store can also help with appropriate nutritional and supplement choices, while suspected hormone deficiency or significant symptoms should be medically investigated.
Natural support and medical care do not have to compete with one another. The most important thing is finding out what is actually happening and choosing the most appropriate avenue for that individual man.
Who Can Help?
If you are experiencing symptoms associated with low testosterone, start by looking at the bigger picture.
Biomarker & Nutritional Screening can explore testosterone alongside areas such as oestradiol, thyroid function, HbA1c, PSA, inflammation, FSH, LH , nutrition, body composition, stress, sleep and lifestyle.
Your GP can arrange formal laboratory testing where symptoms or screening results require further investigation.
Specialist Care – where appropriate, your GP may refer you to an endocrinologist, urologist or other male-health specialist for further investigation and treatment.
Screen → Understand → Investigate → Refer when necessary
The goal isn't simply higher testosterone. It's better male health.
About the Author
Gavin Oppert, BPharm
I bring more than 25 years’ experience across pharmacy and nutritional medicine to my personalised health assessments. My aim is to help you understand your health, connect the information with your everyday life and make practical, informed choices.
References and Further Reading
Eurycoma longifolia and testosterone: systematic review and meta-analysis of clinical trials (2022).
Take the Next Step for Your Health
If changes in energy, strength, libido or body composition have left you feeling unlike yourself, I can help you explore your nutrition, lifestyle and selected biomarkers as part of a personalised health assessment.
Appointments are available at clinics in Malton, Preston, Congleton and Barrow-in-Furness. Contact your preferred clinic directly to book.
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