Male menopause (andropause): what's real and what to check

Is male menopause real?

No, not in the way menopause is. Menopause is a fairly quick drop in hormones that ends a woman's reproductive years. Men have no equivalent. There's no age when testosterone switches off or when a man's ability to have children ends.^1,2

healthdirect calls "male menopause" and "andropause" misleading terms.³ Hormones Australia, the public site run by the Endocrine Society of Australia, says they have no medical meaning and are often used to promote testosterone treatment for reasons other than a genuine hormone disorder, where there's no evidence of benefit.²

What is real: plenty of men in their 40s, 50s and 60s feel flat, tired, heavier and less interested in sex. Healthy Male's view is that these symptoms are genuine but non-specific, and a low testosterone level is probably not to blame.¹ So the useful question isn't "am I going through andropause?" It's "what's actually driving this?"

Is andropause the same as late-onset hypogonadism?

Not quite. "Andropause" is an everyday label. Researchers use "late-onset hypogonadism" for something narrower: an older man with clear symptoms and testosterone that stays low on repeat morning tests.^4,5 That's a diagnosis a doctor makes after a history, an examination and more than one blood test.^3,6

At what age does male menopause start?

There's no set age, because there's no single event. Across groups of men, average testosterone starts drifting down somewhere between 30 and 40, depending on the source.^1,5,7 bpac nz puts the start at around 35, with the pace picking up from about 65.⁵ Healthy Male describes a slight fall in group averages of about 1 to 2% a year after about 40 and says poor health, not ageing, drives it.¹

Study	Who was tested	What happened to testosterone (group averages)
Healthy Man Study, Australia (2012)	325 men aged 40 and over who reported very good or excellent health, each sampled nine times over three months	No fall with age. Each extra BMI point went with about 0.35 nmol/L lower testosterone.8
Shi et al., Australia (2013)	1,382 community-dwelling men aged 35 and over, tested five years apart	16.2 to 15.6 nmol/L, about 0.13 nmol/L a year, largely explained by smoking and changes in health, especially obesity and depression.9
European Male Ageing Study (2013)	2,395 men aged 40 to 79, retested about 4.4 years later	About 0.1 nmol/L a year. Weight gain went with a fall, weight loss with a rise.10
Massachusetts Male Aging Study, US (2002)	1,156 men aged 40 to 70, retested 7 to 10 years later	Total testosterone about 1.6% a year within each man; bioavailable testosterone 2 to 3% a year.11

These are group averages from observational studies. They don't predict what any one man's level will do. Testosterone also runs highest in the morning, so the time of the test matters.⁵ Our guide to testosterone levels by age covers the published ranges.

Does testosterone drop because of age or because of health?

Health seems to matter more than birthdays, going by the Australian research. The Healthy Man Study authors suggested the fall seen in older men may come from health problems that build up with age rather than a true hormone deficiency.⁸ The authors of the five-year Australian study concluded a fall with age isn't inevitable. In their data, developing a waist of 100 cm or more went with testosterone dropping 0.25 nmol/L a year.⁹ healthdirect adds a counterpoint: healthy older men may have somewhat lower levels from ageing itself, and that is generally not a medical concern.³

The Endocrine Society of Australia says obesity, metabolic syndrome and type 2 diabetes are linked with lower testosterone, and it's unknown whether that is a correctable deficiency or a side effect of those conditions.⁶ healthdirect says getting diabetes and other conditions under control, and losing weight, can improve testosterone levels.³ Keep the limits in mind. This is general guidance and research on groups of men, not a forecast for any one man.

What are the symptoms of male menopause?

The symptoms usually blamed on it are lower sex drive, weaker erections, tiredness, low mood, irritability, poor concentration, broken sleep, more body fat and less muscle. Hot flushes and sweats are also listed for genuinely low testosterone.^3,5

Nearly all of them can also come from poor sleep, depression, weight gain, heavy drinking, many medical conditions and some medicines.^1,5 bpac nz says three sexual symptoms together are the most telling: fewer morning erections, erection problems and fewer sexual thoughts.⁵ In the European Male Ageing Study, fatigue, low mood and low physical vigour were also linked with testosterone level, but only those three sexual symptoms clustered together with low testosterone.⁴

Even then, few men fit the research definition. Of 2,966 men aged 40 to 79 in that study, 2.1% met the research definition of late-onset hypogonadism: at least three sexual symptoms, total testosterone under 11 nmol/L (about 317 ng/dL) and free testosterone under 220 pmol/L.^4,12 The researchers concluded the evidence supports a genuine syndrome in only a minority of ageing men, especially those under 8 nmol/L.¹² Converting a US figure? Use our unit converter.

What else causes these symptoms in men over 40?

Start with the common causes. This checklist isn't a diagnosis, just things to raise with your GP.

What to check	Why it's on the list	Symptoms that overlap
Sleep apnoea	Healthify estimates it affects 4 to 25% of adult men, and men are about twice as likely as women to have it.13 Linked with low testosterone.7	Snoring, waking up gasping, unrefreshing sleep, daytime sleepiness, irritability, low mood, poor attention and memory.14
Short sleep	In a small study of 10 young men, a week of five hours a night lowered daytime testosterone by 10 to 15%.15,16	Low energy, low sex drive, poor concentration and sleepiness can all come from lost sleep alone.16
Depression	Affects about 1 in 10 men at some point; men are more likely to notice tiredness than low mood.17 Ongoing depression went with falling testosterone in the five-year Australian study.9	Irritability, poor sleep, tiredness, loss of sexual desire.17
Waist size	For men, a waist of 94 cm or more raises health risk, and 102 cm or more raises it greatly.18	More body fat, less muscle, low energy.5
Type 2 diabetes	Men with diabetes are more likely to have low testosterone.15	Shares many non-specific symptoms with low testosterone.5
Alcohol	Long-term heavy drinking is linked with low testosterone, and recent drinking can lower a result for a while.5 Guidelines: Australia, no more than 10 standard drinks a week and 4 on any one day;19 New Zealand, for men, no more than 15 a week and 3 a day, with at least two alcohol-free days a week.20	Low mood (alcohol can be both a cause and a result of depression),17 and more snoring and sleep apnoea when drinking before bed.13
Medicines	Opioid pain relief and glucocorticoid (steroid) medicines are linked with possibly reversible falls in testosterone.6 bpac nz also lists some antipsychotics and anticonvulsants, 5-alpha-reductase inhibitors and anabolic steroids.5 Never stop or change a medicine without your prescriber.	Low libido and erection problems; some antidepressants affect sexual function.5
Underactive thyroid	Less common in men than women, and easy to miss because the symptoms look like other conditions.21	Tiredness, weight gain, low mood, feeling the cold.21
Stress and relationship strain	Can explain some of these symptoms and contribute to sexual problems.5	Low libido, erection problems.5

Coach's note: before looking at any hormone number, answer four questions honestly. How do you sleep? What do you drink in a normal week? What has your waist done since your 30s? What medicines do you take? It's a boring list, and it's the one the research keeps pointing to.

When should I see a GP straight away?

Some things shouldn't wait for a habit plan. See a GP promptly, or get emergency help where it says so, if you notice:

• pain, a lump or swelling in a testicle, or any other unusual change in one²²
• breast tissue that has grown recently, or a breast lump, pain or swelling²³
• headaches with changes to your vision, which can point to a pituitary problem^5,7
• erection problems that came on suddenly or keep happening. healthdirect says erection problems are often the first sign of heart and blood vessel disease, diabetes, high blood pressure or high cholesterol.²⁴
• chest pain that is severe, getting worse, lasts more than 10 minutes or comes with breathlessness. That's an emergency: call 000 in Australia or 111 in New Zealand.^25,26
• loud snoring with pauses in breathing, or getting very sleepy while driving^13,14
• thoughts of self-harm or suicide. In Australia call Lifeline on 13 11 14, or 000 in an emergency.¹⁷ In New Zealand call or text 1737, or call 111 in an emergency.²⁷

Our safety page lists everything a Teak coach sends straight to a doctor, including a total testosterone result below your lab's range on a repeat morning test. Who Teak isn't for covers men already on testosterone or other hormone medicines.

Is there a test for andropause?

No. There's no single test for "male menopause". Your GP can check testosterone properly and look for the other causes above.^3,5 If testosterone is checked:

• Morning, fasted. bpac nz says between 7 and 11 am, ideally after an overnight fast.⁵ healthdirect says morning, water only beforehand.²⁸
• One low result isn't enough. bpac nz says a result below the range should be repeated, preferably about four weeks later, with LH, FSH and prolactin added.⁵
• Test when you're well. Acute illness, a recent meal or alcohol can lower testosterone for a while.⁵
• Use your lab's range. Reference ranges vary a lot between labs.⁵

How does testing work in Australia and New Zealand?

	Australia	New Zealand
Getting the test	Usually a GP referral to a pathology collection centre.28 Medicare covers all or part of most common blood tests, and many are bulk billed.29	A GP or other provider requests the test. If you're eligible for public health services and the sample is collected at the lab, there's no cost; there may be a cost if it's taken at your GP's practice. From 16 you can request some tests yourself, but you pay.30
Free testosterone	The Endocrine Society of Australia says SHBG can be informative but calculated free testosterone isn't recommended for clinical decisions.6	bpac nz prefers calculated free testosterone if doubt remains after two morning results. Some regions only fund it when total testosterone is inconclusive (for example 7 to 15 nmol/L) or an endocrinologist recommends it.5
How doctors read it	The Endocrine Society of Australia separates two groups: men with disease of the hypothalamus, pituitary or testes, where treatment is a doctor's decision at any age, and older men with low levels but no such disease, where it says high-quality trial evidence is limited.6	bpac nz reports local expert opinion that the diagnostic threshold should be low, under 8 nmol/L (about 231 ng/dL), because many older men sit below 12 nmol/L without needing treatment. It suggests GPs consider discussing two morning results between 8 and 12 nmol/L with an endocrinologist.5

These are guideline figures for doctors, not a verdict on any one result. Take the testosterone blood test checklist to the appointment, and see free testosterone and SHBG, blood tests for men over 40 and testosterone test costs in Australia and NZ.

Is testosterone treatment the answer for male menopause?

That's a doctor's decision, and for men whose only issue is vague symptoms and a slowly falling level, Australian and New Zealand guidance is cautious.

• healthdirect says it's unclear whether testosterone therapy helps older men with low testosterone but no testicular or pituitary problem.³
• bpac nz says testosterone treatment isn't appropriate for ageing men with non-specific symptoms and slowly declining levels. It reports 6,620 NZ males were dispensed testosterone in 2023, up 37% on 2018. The data doesn't show why it was prescribed and may include gender-affirming treatment, but bpac is concerned some of that use may not be appropriate.⁵
• Healthify says the risks may outweigh the benefits for older men whose levels are slowly falling.⁷

Coaching isn't a substitute for any of this. If your GP finds a genuine hormone problem, that's their care. See testosterone coaching vs TRT for who does what.

Where does coaching fit?

Teak is a coaching service, not medical care. A coach can't diagnose or treat andropause, low testosterone or anything else. The medical items on the checklist above, such as sleep apnoea, depression, diabetes, thyroid problems and medicines, belong with your GP. What a coach works on is the everyday side: sleep, training, body fat, alcohol, stress and pelvic floor.

Open the WhatsApp chat on the site and answer two quick questions. Send an existing blood test as a PDF or photo in WhatsApp, or we'll tell you which markers to ask your GP or lab for. A coach reads every marker in plain English, ranks the habits most likely costing you and writes a plan. Anything that looks medical goes to your GP, plainly and straight away. More on how it works.

No anti-ageing promises, and no promise that any number moves. We don't sell testosterone, supplements or tests, and we take no commission from labs or prescribers. For the habits themselves, see how to increase testosterone naturally.

Option	What's included	Australia	New Zealand
Baseline, 4 weeks	Full panel read line by line, one 45-minute call, habits ranked, written four-week plan, honest answer on whether you need more	A$297	NZ$329 incl. GST
12-week programme	Everything in Baseline, twelve weekly check-ins and WhatsApp access, nutrition, sleep and training plan, pelvic floor programme, week-12 retest read in full	A$1,497	NZ$1,649 incl. GST

Blood tests are ordered and paid for separately through your GP or a private lab. Chatting first costs nothing. Upgrade from Baseline to 12 weeks within 60 days and the Baseline price comes off. Instalments: ask in chat. Prices last checked 30 September 2026.^31,32,33

How we source and check these guides is set out in our editorial policy.