Low Male Testosterone (“male menopause”)

Low sex drive, increased body fat, and fatigue can be symptoms of low male testosterone, but they can also be signs of aging, a thyroid condition, infections, pituitary gland problems and injury to testicles.

Aging may cause levels of testosterone to naturally lower. Andropause, or male menopause, is an age-related cause of low testosterone: “a gradual and highly variable decline in the production of androgenic hormones and especially testosterone in the human male together with its associated effects that is held to occur during and after middle age but is often difficult to discriminate from the effects of confounding factors (as chronic illness, stress, or medication use) that can depress testosterone levels.”1 Another term is testosterone deficiency syndrome.

Some men have hypogonadism “in which the body doesn’t produce enough testosterone” and they are either born with it or “it can develop later in life, often from injury or infection,” according to mayoclinic.org. There is also an age-related form called “late-onset hypogonadism.”

Research is not definite or unanimous on the safety or effectiveness of testosterone therapy for men with age-related declines in testosterone, but organizations like the FDA and Mayo Clinic do not encourage the treatments for men with age-related symptoms. Usually only a laboratory test, and not symptoms or lack thereof, can determine if a man has low testosterone. Lifestyle changes may be beneficial for men with age-related symptoms.

The sourced articles below should provide more information on low testosterone, from what levels are normal to who may or may not benefit from testosterone therapy.

Footnote: 1. merriam-webster.com, 6/11/2018

  1. Does Male Menopause Exist?

    “Once women reach a certain age, they go through menopause — a time when menstrual cycles come to a permanent end and estrogen levels experience a decline. While this is common knowledge, many people may be surprised to hear about male menopause. While medical experts tend to use the term ‘andropause,’ this essentially describes a time when a man experiences a decrease in levels of the male hormone testosterone. It may be perceived as an equivalent to female menopause only to a certain degree as there are some notable differences between the two.”

    Sadhana Bharanidharan, medicaldaily.com, 1/22/2019; (Broken link removed 4/2023)

  2. What Is Low Testosterone?

    “Testosterone is the male sex hormone that is made in the testicles. Testosterone hormone levels are important to normal male sexual development and functions. During puberty (in the teen years), testosterone helps boys develop male features like body and facial hair, deeper voice, and muscle strength. Men need testosterone to make sperm. Testosterone levels generally decrease with age, so older men tend to have low blood testosterone levels. … Some men have low testosterone levels. This is called Testosterone Deficiency Syndrome (TD) or Low Testosterone (Low-T). Deficiency means that the body does not have enough of a needed substance. Syndrome is a group of symptoms that, together, suggest a disease or health condition.”

    Online Research, urologyhealth.org, accessed on 6/9/2018

  3. Low Testosterone

    “In the U.S. today, it’s estimated that more than fifteen million adult men have low testosterone, also known as hypogonadism or low lobido. … Testosterone deficiency is highly associated with multiple disease states including obesity, diabetes, hypertension, high cholesterol and asthma. Hypogonadism is also seen in men taking chronic narcotics, men with chronic pain and men with a history of head trauma.”

    Online Resource, ucla.edu, accessed on 6/9/2018; (Broken link removed 2/2023)

  4. Low Testosterone & Fertility

    “Risk factors for low T include advancing age, obesity, testicular injury, excessive alcohol consumption, chronic narcotic use, marijuana abuse, diabetes and cancer treatments such as chemotherapy. … Low testosterone does not always directly cause infertility. Men with low testosterone can still produce healthy sperm because sperm production is mainly stimulated by other hormones.”

    Online Resource, lomalindafertility.com, accessed on 6/9/2018

  5. The Highs And Lows Of Testosterone

    “Normal testosterone levels in men range from about 300 to 1,000 nanograms per deciliter of blood. Going from one number within the normal zone to another one may not pack much of a punch. … Beginning at age 30, testosterone levels drop, on average, about 1 percent a year. About 5 percent of men between the ages of 50 and 59 have low levels of testosterone along with symptoms like loss of libido and sluggishness, according to a few small studies.”

    Randi Hutter Epstein, nytimes.com, 3/27/2018

  6. The Testosterone Myth

    “Still, the industry continues to push the nebulous concept of ‘low T’ as the central problem haunting men. … By 2002, the National Institute on Aging and the National Cancer Institute began to express worries about the skyrocketing number of men using testosterone. … All told, the studies found that T did not improve men’s physical function or vitality.”

    Katrina Karkazis, wired.com, 3/27/2018

  7. FDA Drug Safety Communication: FDA Cautions About Using Testosterone Products For Low Testosterone Due To Aging; Requires Labeling Change To Inform Of Possible Increased Risk Of Heart Attack And Stroke With Use

    “The U.S. Food and Drug Administration (FDA) cautions that prescription testosterone products are approved only for men who have low testosterone levels caused by certain medical conditions. The benefit and safety of these medications have not been established for the treatment of low testosterone levels due to aging, even if a man’s symptoms seem related to low testosterone. We are requiring that the manufacturers of all approved prescription testosterone products change their labeling to clarify the approved uses of these medications. We are also requiring these manufacturers to add information to the labeling about a possible increased risk of heart attacks and strokes in patients taking testosterone. Health care professionals should prescribe testosterone therapy only for men with low testosterone levels caused by certain medical conditions and confirmed by laboratory tests.”

    Online Resource, fda.gov, page updated 2/26/2018

  8. What You Need To Know About Male Hypogonadism

    “Symptoms of adult-onset hypogonadism include:
    [1.] erectile dysfunction
    [2.] low sperm count
    [3.] depressed mood
    [4.] decreased libido
    [5.] lethargy
    [6.] sleep disturbances
    [7.] decreased muscle mass and strength
    [8.] loss of body hair …
    [9.] increased body fat”

    Kathleen Davis, FNP, medicalnewstoday.com, 11/23/2017

  9. Hypogonadism And Osteoporosis In Men

    “Hypogonadism is well established as a cause of bone loss and osteoporosis. In women, research has established a strong correlation between bone loss and decreased estrogen levels, particularly following menopause; however, less is known about the way age-related decreases in testosterone affect bone loss in men. … Contrary to expectation, however, the loss of bone quality among men with hypogonadism is not strongly correlated with testosterone levels.”

    “Michael Broder, PhD, Reviewed by Clifton Jackness, MD, medpagetoday.com, 10/5/2017”

  10. Low Testosterone Treatment: How to Know If You Need It

    “Men with testosterone deficiency syndrome, or androgen deficiency in aging men (ADAM), often have poor libido, erectile dysfunction, decreased muscle mass, fatigue, mental fogginess and depression. Those symptoms have many possible causes, though. A trial period of treatment and monitoring is often the only way to confirm a diagnosis. ‘Having Low T and one or two symptoms doesn’t mean one is causing the other,’ Dr. Shoskes says. ‘We treat for a few months to see if symptoms improve and your testosterone level comes up.'”

    Men’s Health Team, clevelandclinic.org, 9/5/2017

  11. Older Men With ‘Low T’ Can Improve Their Sex Lives With Testosterone Therapy, Study Says

    “In the study, published in the Journal of Urology, researchers enrolled roughly 650 men in their 50s and 60s. Some of the men had unexplained testosterone deficiencies, while others suffered from genetic hypogonadism (when gonads fail to produce testosterone). About 360 men received testosterone therapy for eight years (the remaining didn’t). … Those mortality rates suggested that testosterone therapy isn’t necessarily linked to a greater instance of heart attack or stroke, the researchers suggested.”

    Brittany Smith, muscleandfitness.com, 8/17/2017

  12. The Lowdown On Testosterone Replacement Therapy

    “If you’re considering testosterone replacement therapy, you might do well to start with a few healthy lifestyle changes that can offer even more benefits than hormone replacement. Being overweight or obese is closely associated with low testosterone. Losing weight can raise hormone levels. Regular exercise—even a brisk 30-minute walk a few times a week—can improve vitality, strengthen muscles and bones, lower heart disease risk, and possibly even improve your sex life. That’s far more than testosterone replacement therapy can promise.”

    Health After 50 staff, berkeleywellness.com, 8/3/2017; (Broken link removed 4/2024)

  13. It May Not Be Low T, But It Is High Reward

    “I was careful to distinguish low T from hypogonadism, a disease that is also characterized by low testosterone levels but stems from causes other than aging. … I believe that the story of testosterone supplementation in older men may end up being similar to that of estrogen supplements in postmenopausal women: Lots of early hype, but ultimately limited benefits and significant potential harms.”

    Kenny Lin, MD, MPH, thedoctorweighsin.com, 4/15/2017

  14. Does Low-T Mean Less Sex?

    “Despite all the hype over the benefits of testosterone therapy, previous research has shown testosterone to only mildly improve sexual performance and mood. And now new results derived from the same research have found something more: that testosterone treatment doesn’t actually improve older men’s memory or mental function despite the anti-aging claims of popular supplements.”

    Lindsey Tanner, aarp.org, 2/28/2017

  15. Testosterone Therapy In Men With Testosterone

    “The purported adverse effects of T therapy on cardiovascular health is based on flawed studies and remains questionable, at best.”

    Abdulmaged Traish, ncbi.nlm.nih.gov, 11/7/2016

  16. Is There A Male Menopause?

    “Testosterone levels tend to decline in middle-aged men, often causing problems with sleep, sex, weight, and mood. But is ‘male menopause’ just a myth? … More and more researchers are beginning to agree that the natural decline in testosterone men tend to experience as they age can result in a cluster of symptoms known as ‘late-onset hypogonadism,’ which is commonly referred to as male menopause, or andropause.”

    Krisha McCoy, Medically reviewed by Pat F. Bass III, MD, MPH, everydayhealth.com, 7/27/2016

  17. Do You Need A Testosterone Booster?

    “Most older men won’t feel better or see health benefits from taking a testosterone booster. In fact, older men who are prescribed it appear to have a higher risk of dying from any disease as well as from a heart attack or stroke, according to a 2013 JAMA study. … If you’re feeling as though you have low energy or are having sexual problems, don’t assume that low testosterone is the cause, or that a testosterone booster is the solution.”

    Hallie Levine, consumerreports.org, 5/19/2016

  18. What Is Male Menopause?

    “Male menopause’ is the more common term for andropause. It describes age-related changes in male hormone levels. The same group of symptoms is also known as testosterone deficiency, androgen deficiency, and late-onset hypogonadism. … You may also experience swollen or tender breasts, decreased testicle size, loss of body hair, or hot flashes. Low levels of testosterone associated with male menopause have also been linked to osteoporosis. This is a condition where your bones become weak and brittle. These are rare symptoms. They typically affect men at the same age as women entering menopause.”

    Brian Krans, Medically reviewed by Graham Rogers, MD, healthline.com, 3/18/2016

  19. 5 Myths And Facts About Low Testosterone

    “But all the hype has led to many misconceptions about ‘low T’ and its treatment, says Robert Brannigan, MD, a urologist at Northwestern Medicine in Chicago. ‘There’s been a real uptick in the use of testosterone replacement therapy, so there is a lot of confusion out there.’ … Not everyone needs testosterone therapy. The condition, also known as hypogonadism, affects approximately 39 percent of men over age 45, with men in their 60s and 70s more at risk than men in their 40s and 50s, according to the American Urological Association. Even a doctor’s recommendation doesn’t mean supplementation is appropriate. … Always insist on a blood test to assess your testosterone levels before you begin any supplements. … Being overweight or obese can produce a similar effect, Brannigan adds.”

    Jennifer Acosta Scott, Medically reviewed by Pat F. Bass III, MD, MPH, everydayhealth.com, 4/17/2015