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April 8, 2026
Sharon Burbat
When men over 40 complain of increased sweating and start questioning the meaning of life, they are probably "in the menopause"—the andropause. What's behind it and how testosterone fares with age.
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Worse sleep, less energy, declining libido: Many men notice changes from their mid-40s, which they initially attribute to stress or aging. In fact, the declining testosterone level can also play a role. But is there really such a thing as "male menopause"? And what is the difference between the so-called andropause and female menopause?
The term "male menopause" is medically controversial. The German Society for Endocrinology and the German Society for Urology emphasize that there is no direct equivalent to female menopause. Nevertheless, it is recognized that testosterone levels in men decrease by about one to two percent each year from around the age of 30, and this can have noticeable consequences at a certain point.
Common technical terms are:
Testosterone is the most important male sex hormone. During puberty, it regulates beard growth, voice deepening, muscle development, and the development of sexual organs. In adulthood, it influences libido, energy, bone density, and mood.
Age-related decline is normal and gradual, unlike in women, where estrogen and progesterone levels drop almost completely during menopause.
A declining testosterone level can manifest through the following symptoms:
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Important: These symptoms are not automatically attributable to testosterone deficiency. Thyroid problems, circulatory disorders, Depression or psychosocial stress (midlife crises, career changes) can cause the same symptoms. Therefore, a medical examination is essential.
Not all men experience a noticeable drop in testosterone levels. In contrast to the hormonal changes in women, these changes in men are significantly less drastic.
While men "in menopause" only experience a slight testosterone deficiency, women almost completely cease the production of estrogen and progesterone, leading to infertility. Some men, however, remain fertile into old age.
There is also no specific point in time for men – as there is with menopause, the absence of menstruation – it is rather a subtle, very individual process.
The general practitioner can simply determine the testosterone level through a blood test. A clinically relevant deficiency – the so-called hypogonadism – is present in only about three to five percent of men over 60. A slightly reduced value alone is not enough for a diagnosis; the symptoms must be clearly assignable.
Lifestyle significantly influences how strongly symptoms are perceived:
In cases of diagnosed pathological testosterone deficiency (hypogonadism), hormone replacement therapy can be useful. This is only prescribed after careful diagnosis and risk assessment, with possible side effects such as increased cardiovascular risk or influence of Prostate must be taken into account.
For erectile problems, appropriate medications can be used after medical consultation.
Since midlife often coincides with other upheavals (career, relationship, identity), individual or couples counseling can be useful to process physical and psychological changes together.
No. While testosterone levels decrease in all men with age, not all develop noticeable symptoms. A clinically relevant deficiency affects only about 3–5% of those over 60.
Testosterone levels begin to decline gradually from age 30, usually from 40. Symptoms often do not appear until the 50s or 60s.
If symptoms like lack of drive, loss of libido, or sleep disturbances persist for several weeks, medical clarification is advisable to rule out other causes and check hormone levels.
Only if there is a proven, pathological testosterone deficiency. Therapy without a clear indication is not recommended and carries risks.
Yes – unlike women, many men maintain fertility into old age, although it decreases with age.
