A man looking tired after a run

‘Manopause’ Sounds Like A Joke. It’s Not.

Mid-life hormone shifts can make your irritable, tired, and more.
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Fast Facts

  • Manopause—or male menopause—is the common term for andropause. It describes age-related changes in male hormones, particularly testosterone.
  • Unlike female menopause, not all men experience manopause. But dropping hormone levels can contribute to low libido, weight gain, irritability, and fatigue.
  • If a blood test indicates that your testosterone levels are low, testosterone replacement therapy can help alleviate symptoms of andropause.

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You’ve probably heard of menopause, the natural but abrupt decline in women’s reproductive hormones that typically happens as a woman enters her 50s. But what about manopause? No, it’s not a punchline. Manopause, or male menopause, is a real medical condition that can affect men in middle age.

Also known as andropause, manopause is marked by declining levels of the male sex hormone testosterone. While this might not result in the same hot flashes and mood swings that menopausal women experience, the condition is linked with its own menagerie of unpleasant symptoms.

Fatigue, weight gain, loss of libido, low energy, erection issues, and other symptoms may gradually set in among men in the throes of manopause, says Stanton Honig, M.D., clinical professor of urology and director of men’s health at Yale School of Medicine.

While symptoms can worsen with age, you’re not necessarily doomed: Treatment can help you feel more like yourself. Here’s what you need to know about manopause and how to feel better.

What Is Manopause?

Clinically speaking, manopause is defined by a drop in testosterone in men in their 50s—a big deal considering the male hormone plays a vital role in regulating hair growth, body fat, sperm production, sex drive, energy, and mood.

Related: Low Mood? It Might Be Low T.

While the effects of such a change can surely trigger symptoms, your testosterone level has to measure less than 300 ng/dL to be officially diagnosed with low testosterone, according to The American Urology Association.

Testosterone levels often peak around 1,200 ng/DL in adolescence, drop to between 252-916 ng/DL by age 40, and sink to 215-878 ng/DL by age 50.

If you’re in your 50s and feeling any of the above symptoms, blood testing can analyze whether or not your testosterone levels are lower than they should be for your age.

What Causes Manopause?

Manopause is thought to be age-related, says Honig. Testosterone levels naturally decline as men age. That said, andropause may be more related to weight gain and metabolic syndrome than aging, says Honig.

The connection between excess weight and testosterone is a classic case of chicken-or-the-egg: As men gain weight, research has found their testosterone levels drop. At the same time, low testosterone can contribute to increased body fat, “a self-perpetuating cycle of metabolic complications,” according to the authors of a 2014 review published in the Asian Journal of Andrology (1)

But manopause isn’t solely linked to an increasing number on the scale. Chronic disease, genetic autoimmune disease, testicle injury or infection, certain tumors, and cancer treatments can also cause testosterone levels to tank as you age (or independent of aging).

Lifestyle factors can also influence testosterone levels. Lack of exercise and poor eating habits can contribute to weight gain. Poor sleep could also be a culprit—particularly in the case of obstructive sleep apnea, a sleep disorder characterized by breathing interruptions during sleep, which impacts as many as one in four men, according to Cleveland Clinic. Other contributors to low testosterone include alcohol and opioid abuse, says Honig.

Related: How to Talk To Your Doctor About Low Testosterone

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Could You Have Low T?

The only way to know it to test your levels. Hone’s at-home assessment measures your T. If your levels are low, you can speak a Hone physician about treatment options and start feeling better, fast.

Manopause Symptoms and Signs

Because manopause is marked by a gradual decline in testosterone rather than a drop off the cliff, symptoms may set in gradually. And then one day—boom—you might look in the mirror and wonder where the old you has gone. Look out for the symptoms below and seek out testing through your doctor or Hone if they feel too familiar.

  • Fatigue
  • Loss of libido or erectile issues
  • Low energy
  • Increased body fat
  • Weakness or loss of muscle mass
  • Breast tissue swelling
  • Loss of body hair
  • Hot flashes
  • Irritability and/or depression
  • Difficulty concentrating

Andropause symptoms can be very treatable, even reversible.

How to Treat Manopause

Because the risk of andropause increases with age and increased weight, it can feel like an inevitability. The good news: not every man experiences andropause—and among those who do, the symptoms can be very treatable, even reversible in many cases, says Honig.

If a blood test confirms that low testosterone is the source of your symptoms, the following solutions can shift your hormone levels to alleviate and even eliminate your most common complaints.

Drop 10 

A 10-pound weight loss can increase your testosterone by as much as 75 ng/dl, says Honig. Science backs this up: In a year-long study of 891 middle-aged men, when 293 took up 150 minutes of weekly exercise and cut back on fat and calories, the group lost an average of about 17 pounds each and the prevalence of low testosterone dropped by 46 percent (2).

While weight loss itself can help boost testosterone levels, exercise can also boost T levels, regardless of weight loss. Use free weights rather than weight machines; minimize the time between weight training sets, and opt for high-intensity exercise over low-intensity. All of these approaches have been shown to maximize testosterone levels immediately after exercise, according to a 2020 review of 43 studies published in the Journal of Functional Morphology and Kinesiology (3).

Sleep It Off

Insufficient sleep doesn’t just contribute to crankiness—it’s associated with low testosterone and related symptoms such as erectile dysfunction, according to a 2019 review of nearly 40 years of research on the topic (4).

Related: Track Your Zs With The Best Sleep Trackers

Getting more or better quality rest can do your body good, particularly with the use of of continuous positive airway pressure (CPAP) therapy for men with obstructive sleep apnea, a condition that affects up to 25% of men, where breathing stops for a few seconds repeatedly during the night.

Replace Lost T

Declining testosterone levels can be mediated by giving the body an artificial boost of that very hormone. “Testosterone replacement is not necessarily the fountain of youth,” says Honig. “But can be helpful in the appropriate patient.”

If you and your doctor agree that testosterone replacement therapy is warranted, there are several ways to supplement your testosterone levels with additional T.

Injections (see our complete guide to self-injections), topical treatment including cream, gel, and patches, and under-the-tongue lozenges can help increase T levels and decrease the symptoms of manopause.

The Bottom Line

Many men experience andropause—male menopause—in their 50s. Symptoms include weight gain, fatigue, low libido, irritability, and difficulty putting on muscle. Andropause is caused by low testosterone levels. If a test indicates that your T levels are low, your physician can suggest treatment including TRT.

1. Fui, Mark Ng Tang et al (2014). Lowered testosterone in male obesity: mechanisms, morbidity and management. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3955331/
2. Endocrine Society (2012). Overweight men can boost low testosterone levels by losing weight. www.sciencedaily.com/releases/2012/06/120625124914.htm
3. Riachy, Ruba et al (2020). Various Factors May Modulate the Effect of Exercise on Testosterone Levels in Men. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7739287/
4. Peter Y Liu (2019). A Clinical Perspective of Sleep and Andrological Health: Assessment, Treatment Considerations, and Future Research. https://academic.oup.com/jcem/article/104/10/4398/5481939

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