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Male menopause

Some men develop physical and emotional symptoms when they reach their late 40s to early 50s.

Symptoms common in men this age are:

  • depression
  • loss of sex drive
  • erectile dysfunction
  • mood swings and irritability
  • loss of muscle mass and reduced ability to exercise
  • fat redistribution, such as developing a large belly or 'man boobs' (gynaecomastia)
  • a general lack of enthusiasm or energy
  • difficulty sleeping (insomnia) or increased tiredness
  • poor concentration and short-term memory

These symptoms can interfere with everyday life and happiness. It's important to find the underlying cause and work out what can help to resolve it.

Male menopause causes

Male menopause is a term that is sometimes used, but it is misleading.

It suggests the symptoms are because of a sudden drop in testosterone in middle age, similar to what happens in female menopause. This is not true.

Testosterone levels do fall as men age. But the decline is steady at less than 2% a year from around the age of 30 to 40. This is unlikely to cause any problems.

But often the symptoms of 'male menopause' are nothing to do with hormones.

Personal or lifestyle issues

Lifestyle factors or psychological problems are often responsible for many of these symptoms.

For example, erectile dysfunction, loss of libido and mood swings may be the result of either:

There are also physical causes of erectile dysfunction. These may happen alongside any psychological cause.

Psychological problems can be brought on by work or relationship issues, divorce, money problems or worrying about family.

A midlife crisis can also be responsible. This can happen when men think they have reached life's halfway stage.

Anxieties over what they have accomplished so far in their job or personal life can lead to a period of depression.

Other possible causes of these symptoms include:

Late-onset hypogonadism

Sometimes the symptoms of male menopause may be the result of hypogonadism. This is where the testes produce few or no hormones.

Hypogonadism is sometimes present from birth. It can cause symptoms like delayed puberty and small testes.

Hypogonadism can also develop later in life, particularly in men who are obese or have type 2 diabetes.

This is known as late-onset hypogonadism. It can cause these male menopause symptoms.

But this is an uncommon and specific medical condition that is not a normal part of ageing.

A diagnosis of late-onset hypogonadism can usually be made based on your symptoms and the results of blood tests used to measure your testosterone levels.

Where to get help

If you're experiencing any of these symptoms, talk to your GP. They'll ask about your work and personal life. This is to see if your symptoms may be caused by a mental health issue, such as stress or anxiety.

If stress or anxiety are affecting you, you may benefit from medication or a talking therapy.

Exercise and relaxation can also help.

Read about:

Hormone replacement therapy (HRT)

Your GP may also order a blood test to measure your testosterone levels.

If you have a testosterone deficiency, you may be referred to an endocrinologist. This is a specialist in hormone problems.

Your specialist may offer you testosterone replacement to correct the deficiency. This should relieve your symptoms.

This treatment may be:

  • tablets
  • patches
  • gels
  • implants
  • injections

Content supplied by the NHS and adapted for Ireland by the HSE

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This project has received funding from the Government of Ireland’s Sláintecare Integration Fund 2019 under Grant Agreement Number 123.

Page last reviewed: 19 May 2022
Next review due: 21 May 2025