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April 8, 2025
Sharon Burbat
When men over 40 complain about increased sweating and begin to question the meaning of life, they are probably going through "the change" - the andropause. What lies behind it and how testosterone levels are in old age.
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Can men experience menopause? That the hormonal balance in women changes significantly between 40 and 50, leading to severe symptoms such as sleep disorders and hot flashes, seems to be well known. (Find out here what helps with sleep disorders during menopause.) On the other hand, the fact that men can also go through a kind of menopause and that their hormone levels change with age is rarely discussed. In fact, there seems to be a counterpart to menopause, namely andropause. (This is derived from the Greek words "man" and "end.")
Testosterone is one of the most important male sex hormones. During puberty, an increase in testosterone in boys ensures that facial hair begins to grow, the sex organs enlarge, the voice breaks, and the musculature grows faster. But with age, testosterone levels decrease. And this can cause some men to experience menopausal symptoms feel.
Men with testosterone deficiency show a significant loss of libido. This is accompanied by excessive sweating, sleep disorders, fatigue, decreased muscle strength, more abdominal fat, decreased concentration, skin changes, and lack of drive. Similar to women of their age, bone density can decrease. A possible consequence: osteoporosis. (By the way, here are tips for joint pain during menopause.) However, not everything that feels like menopause is exactly that in the end. Other diseases that become more common with age – such as circulatory disorders, thyroid problems or depression - can also be responsible for the complaints. In addition, the middle of life is fundamentally characterized by changes. The appearance changes. New questions arise: related to work, family, relationships, and lifestyle. Often, psychological and physical stress cannot be clearly separated from each other.
Hormonal change in men sometimes begins as early as their 30s, usually in their 40s. However, testosterone levels typically do not drop suddenly and significantly, but rather continuously and gradually. At 50, 60, men then note corresponding changes.
Not all men experience a drop in testosterone levels that becomes noticeable. Unlike the hormonal changes in women, those in men are much less drastic. While men in "menopause" only experience a slight testosterone deficiency, in women, the production of estrogen and progesterone almost completely ceases, leading to infertility. Some men, on the other hand, remain fertile into old age. There is also no defined point in time for men - as for example with the menopause, the absence of menstruation - it is rather a gradual, very individual process.
The wording is controversial. Thus, the German Society for Endocrinology and the German Society for Urology assume that menopause in men does not exist in clear comparability to menopause in women. Andropause is also not seen as a real counterpart to menopause, which does not mean that men do not also experience changes in hormone balance and consequently show symptoms. However, they do not experience a severe androgen deficit.
Since the wording is controversial, other terms are also used, such as:
PEDAM (Partial endocrine deficiency of the aging male)
PADAM (Partial androgen deficiency of the aging male)
Andropause
Climacteric virile
If there is a proven pathological testosterone deficiency (hypogonadism) - as opposed to a natural testosterone decline - and the symptoms can be clearly attributed to this, hormone replacement therapy may be considered. Otherwise, doctors do not assume a connection between testosterone decline and lack of motivation.
Sometimes couples counseling is recommended to calmly discuss the physical changes caused by testosterone deficiency and the accompanying changes in sexual life. If necessary, the doctor may also prescribe a potency-enhancing drug, but serious side effects must be urgently pointed out and monitored.
Other measures such as exercise, healthy diet and social contacts are advisable. How strongly the symptoms are experienced depends significantly on lifestyle. In particular, sporting activities are often consciously avoided during male menopause, yet they would do a lot of good right now and counteract the dwindling muscles. Especially positive at this point is also the renunciation of alcohol and smoking as well as avoiding stress and getting enough sleep .
Age-related hypogonadism, hypogonadism of the aging male, affects only about three to five percent of those over 60. The testosterone level can be easily determined by the family doctor using blood values.
In healthy men, testosterone levels decrease from the age of 30, at the latest from 40, by one to two percent per year.
