Andropause, 7 signs of the ‘male version’ of menopause

Medically Reviewed by Dr. Silvana Chedid on August 31, 2026

Andropause describes a gradual, age-related decline in testosterone that many men begin to notice sometime after their thirties or forties, and it plays out very differently than female menopause. Where menopause involves a comparatively sharp drop in estrogen over a defined window, andropause unfolds slowly, over years, and to a different degree in every man who experiences it.

At Chedid Grieco, our team sees firsthand how often hormonal health gets overlooked in conversations about family building and general wellness alike. With consultations available in Miami and treatment provided at our clinic in Brazil, we work with patients and couples who are thinking seriously about their long-term health, and age-related hormonal change in men is a topic worth understanding clearly rather than dismissing as an inevitable, unremarkable part of getting older.

What Is Andropause?

Andropause is the term commonly used to describe the gradual decline in testosterone that occurs in men as they age. It is sometimes informally called “male menopause,” though that label can be misleading, since the underlying biology is quite different from what happens in women. According to the Urology Care Foundation, roughly four in ten men over the age of 45 have low testosterone levels, making age-related hormonal decline a far more common experience than many men realize.

Testosterone plays a role in far more than sexual function. It contributes to muscle mass, bone density, mood regulation, energy levels, and red blood cell production, which is part of why a gradual decline can show up in ways that seem unrelated to hormones at first glance.

How Andropause Differs From Menopause

The most important distinction between andropause and menopause is the pace and shape of the hormonal change. Menopause is a defined biological event, diagnosed after twelve consecutive months without a menstrual period, and it involves a comparatively abrupt drop in estrogen and progesterone, typically between ages 45 and 55.

Andropause has no equivalent defined endpoint. Testosterone levels in men begin decreasing by around one percent per year starting in a man’s thirties, according to information published by Mayo Clinic, and this slow decline continues for the rest of a man’s life. Because the change is so gradual, symptoms are often subtle, easy to attribute to stress or normal aging, and easy to overlook for years before a man connects the dots.

Common Signs of Age-Related Testosterone Decline

Signs of andropause vary from one man to the next, and not every man experiences every symptom. According to Mayo Clinic and Cleveland Clinic, the signs most commonly associated with low testosterone include the following.

• Reduced energy and persistent fatigue that does not improve with rest.
• Changes in mood, including irritability, low motivation, or a flatter emotional baseline.
• Decreased sex drive or a noticeable drop in interest compared to prior years.
• Difficulty concentrating or a general sense of mental fog.
• Sleep disturbances, including trouble falling asleep or staying asleep through the night.
• Changes in body composition, such as reduced muscle mass, strength, or an increase in body fat, particularly around the abdomen.
• Gradual loss of bone density, which can develop silently over time without an obvious symptom.

Because these signs develop gradually, many men live with them for months or years before mentioning them to a physician. Recognizing the pattern is often the first step toward getting an accurate picture of what is happening.

These Symptoms Can Have More Than One Cause

It is worth noting that fatigue, mood changes, and reduced concentration are not exclusive to declining testosterone. Thyroid conditions, sleep apnea, depression, and the side effects of certain medications can produce a very similar symptom picture. That overlap is exactly why self-diagnosis is unreliable and why a physician, rather than guesswork or an online symptom checklist, should be the one connecting the dots.

A physician can order the appropriate bloodwork, rule out other explanations, and determine whether testosterone levels fall outside a normal range for a man’s age. This kind of general medical evaluation, not a fertility-specific test, is the appropriate starting point for a man noticing these changes.

How Age-Related Testosterone Decline Is Typically Assessed

According to the American Urological Association, testosterone deficiency is generally confirmed through two separate early-morning blood tests, since levels naturally fluctuate throughout the day and a single reading can be misleading. A physician will usually pair those results with a review of a man’s symptoms, medical history, and any medications he is taking before drawing conclusions.

This is worth emphasizing because it is easy for men to assume a single symptom, or a single lab value, tells the whole story. In practice, an accurate picture takes a bit more patience and a physician willing to look at the full context rather than one data point in isolation. Men who track when their symptoms started and how they have changed over time often find that conversation with their doctor moves faster and produces clearer answers.

Why This Is Worth Discussing With a Physician

Andropause is not a medical emergency, and for most men it does not require urgent action. It is, however, a legitimate general health topic that deserves the same attention men give to blood pressure, cholesterol, or an annual physical. Left unaddressed, chronically low testosterone has been associated with increased risk factors including reduced bone density and changes in cardiovascular health, according to Cleveland Clinic.

Bringing these symptoms up with a primary care physician or endocrinologist allows for proper testing rather than assumptions. Depending on what bloodwork shows, a physician may recommend lifestyle changes such as regular exercise, improved sleep habits, and a balanced diet, or discuss additional options if levels are confirmed to be low. There is no single path that applies to every man, and any decision about evaluation or treatment belongs between a patient and his physician.

Many men put off this conversation because the symptoms feel minor on any given day, or because they assume nothing can be done. Neither assumption holds up well over time. A short appointment focused on general wellness, rather than a specific complaint, is often enough to open the door, and a physician can help sort out whether what a man is experiencing is connected to hormones, a separate condition, or simply a season of life that calls for better sleep and less stress.

Hormonal Health and Family-Building Conversations

A gradual decline in testosterone is a normal part of aging and, on its own, does not mean a man has stopped producing sperm or has become infertile. Even so, many men first start paying closer attention to their overall health, hormonal or otherwise, around the same time they and a partner begin thinking seriously about growing their family.

For couples already exploring family-building paths such as in vitro fertilization or egg donation, general health, including a man’s hormonal health, is a reasonable part of the broader conversation with a treating physician. It is not, however, a reason to assume a fertility problem exists, and it should not replace a proper evaluation from a physician who understands a patient’s full health picture.

Our Approach at Chedid Grieco

Dr. Silvana Chedid brings more than 30 years of experience in reproductive medicine and introduced ICSI to Brazil, helping build a practice that has supported nearly 9,000 families to date. Our clinic is female-led, FDA-licensed and NYDH-licensed, and operates under Brazil’s regulatory framework, completing roughly 1,200 cycles per year with individualized, boutique treatment planning rather than a one-size-fits-all protocol. We also welcome and support LGBTQI+ patients and couples who are building their families in whatever way makes sense for them.

If you and your partner are considering your options for growing your family, or simply want to understand how hormonal health fits into that bigger picture, our team at Chedid Grieco is here to talk through what makes sense for your situation. Reach out through our Contact form to schedule a consultation.

Frequently Asked Questions About Andropause