Andropause: The Silent Hormonal Shift Men Can’t Afford to Ignore

Men do not have a menopause moment. There is no dramatic, all-at-once hormonal cliff like women experience in midlife. Instead, there is a quieter, slower change, a gradual decline in testosterone that can take decades to unfold. For many men, it creeps in so subtly that it is brushed off as “just getting older.” But this stage of life has a name, and it can carry serious consequences: andropause.

Testosterone levels naturally drop about 1% a year starting in a man’s 30s or 40s. That might sound insignificant, but over time it can mean a major difference in energy, mood, strength, and overall health.

Dr. Anju Mathur, Medical Director at Angel Longevity Medical Center and a specialist in bioidentical hormone replacement therapy, says the misconception around “male menopause” keeps too many men from seeking help. “Andropause is real, but it is not the male equivalent of menopause. It is a gradual process that can span decades, which is why so many men suffer in silence. They notice they are not feeling like themselves: less energy, decreased motivation, changes in body composition, but they are told it is just part of getting older. The truth is, optimal hormone levels are crucial for men’s health and vitality at every age.”

Beyond the Bedroom

While loss of sex drive is often the headline symptom, andropause affects much more than libido. Men may experience:

• Decreased muscle mass and strength
• Increased belly fat
• Lower bone density
• Fatigue and poor sleep
• Mood changes, depression, or irritability
• Brain fog and memory issues

Some men even get hot flashes and night sweats, symptoms they never expected to share with women in menopause.

Why It Matters for Long-Term Health

Untreated low testosterone is not just uncomfortable. It is linked to higher risks of heart disease, type 2 diabetes, osteoporosis, and even premature death. A large Veterans Affairs study found that men who restored testosterone to normal levels had a lower risk of heart attack or stroke, while those left untreated faced a 56% higher mortality rate.

The Diagnostic Gray Zone

Pinpointing andropause can be tricky. Symptoms overlap with stress, depression, poor sleep, and chronic illness. Blood tests help, but testosterone levels fluctuate throughout the day and can be affected by illness, medications, and lifestyle. The best evaluations go beyond total testosterone to include free testosterone, SHBG (sex hormone-binding globulin), and other hormone markers that influence function.

Treatment: More Than a Prescription

For some men, lifestyle changes such as more exercise, better sleep, and improved nutrition can make a meaningful difference in hormone balance. When testosterone therapy is necessary, it is available as gels, injections, patches, or pellets.

Dr. Mathur stresses a whole-body approach. “I do not just prescribe testosterone and send men on their way. I look at adrenal function, thyroid health, insulin sensitivity, vitamin D levels, and lifestyle factors. Sometimes optimizing those areas can naturally improve testosterone production. When replacement is needed, I use bioidentical hormones and monitor closely to ensure we are achieving optimal levels safely.”

The Functional Medicine Edge

Addressing andropause from a functional medicine perspective means getting to the root of hormone decline and addressing overall wellness. That can mean correcting nutrient deficiencies, improving sleep, reducing inflammation, and managing stress. Zinc, vitamin D, and magnesium play a particularly important role in testosterone production.

Reclaiming Vitality

Andropause does not have to signal the beginning of decline. With proper diagnosis, targeted treatment, and smart lifestyle shifts, men can maintain strength, focus, and energy well into later life.

If you are feeling unusually tired, unfocused, or unlike yourself, do not chalk it up to age. It could be your body’s way of telling you something important. Addressing andropause is less about turning back the clock and more about making the years ahead some of your best yet.