Male Menopause Myth vs. Fact

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Bradley Anawalt, MD
Alvin M. Matsumoto, MD
Ronald Swerdloff, MD

Additional Resources
American Urological Association
Mayo Clinic

MYTH: Male menopause is real.

FACT: No, it’s not real. The term “menopause” only pertains to the female condition when the ability to reproduce is halted. Testosterone is the male sex hormone that is needed for growth of body hair, building strong bones and muscles, and producing sperm. As men age, testosterone levels (T-levels) can decline because of medication, illness, injury or lifestyle factors. This drop in testosterone is inaccurately classified as “male menopause,” when in fact, should simply be considered a symptom of male aging, more clinically referred to as testosterone deficiency syndrome, androgen deficiency of the aging male, and late-onset hypogonadism. Visit for more information.

Male Aging Facts  Female Aging Facts 
 Testosterone production/ levels decrease gradually beginning around age 30 Estrogen (female sex hormone) production drops rapidly beginning around age 40
 Sperm production does not stop Egg production stops completely
 Not all men experience low testosterone and sperm production All women experience low estrogen and egg production

What are the causes of low testosterone?

  • Certain medications
  • Hormone disorders
  • Radiation/chemotherapy treatment
  • Testicular injury
  • Genetic condition
  • Chronic illness (depression, diabetes, liver/ kidney disease, obesity, HIV/AIDS)

How is low testosterone diagnosed?

  • Physical exam by health care provider
  • Tests to rule out other health problems
  • Blood tests to check T-level. If T-level is low, you may be referred to an endocrinologist.

What are the possible symptoms of low testosterone?

  • Reduced energy
  • Enlargement of breasts
  • Loss of body hair
  • Decline in sexual function (erections, sex drive)
  • Decreased bone density
  • Increased body fat/reduced muscle
  • Hot flashes (rare)
  • Irritability; trouble remembering; trouble concentrating; depression

Not all men experience these symptoms. However, ones who do, encounter them for no apparent reason other than age, usually advanced age.

What are prescription treatment options?

  • Long-term benefits and risks are unknown
  • Patches/topical gels
  • Shots/injections
  • Tablets between cheeks and gums

You’ve seen the ads for over-the-counter supplements to help men with “low-T” (low testosterone), but do you really need them?

No. There are ways for aging men to help naturally maintain health:

  • Eat a healthy diet and maintain a healthy weight
  • Get plenty of exercise
  • Get enough sleep
  • Find healthy ways to cope with stress

These lifestyle factors have not been shown to maintain T-levels.

Long-term use of testosterone treatment can cause:

  • high red blood cell count
  • acne
  • breast enlargement
  • sleep apnea (rare)