The Man-o-pause (The Male Menopause)

It is known as the ‘Andropause’, but according to Dr Tim Lebens, a private gp paddington, few men are aware that they are susceptible to the equivalent of the Female Menopause. The swell of interest amongst clinicians and the general public has made this a very topical area, leading to confusion, controversy and intrigue.

There has been a new trend towards replacing men’s testosterone in those who meet the criteria for Testosterone Deficiency Syndrome: A low blood Testosterone, along with a constellation of symptoms listed below.

In general, testosterone levels fall by less than 2% per year from the age of around 30-40, but due to the body’s natural reserve, it rarely needs replacing. However, it can drop too low and lead to substantial health consequences such as heart disease, sexual dysfunction and depression.

There are several different, non-specific symptoms of testosterone deficiency. Namely, fatigue, reduced libido/sexual performance, loss of physical strength and endurance, but also low mood, erratic sleep and poor concentration. The symptoms are subtle and may be indistinguishable from other health conditions, mental health problems and side effects to medications. The diagnosis is through a combination of symptoms and a positive morning blood test (Testosterone levels vary over the course of the day).


One also needs to be aware that the very time in a man’s life when the Andropause may surface, can coincide with the ‘mid-life crisis’ and the mental/physical effects of life’s burdening responsibilities. It is therefore important to tease out the differences, primarily through seeing your GP to discuss symptoms and arrange a blood test.

If the Testosterone requires replacement, the effects can be dramatic; boosting energy levels, improving mood and libido, as well as the redistribution of fat and muscle. It is important not to regard it as a panacea for symptoms which may be more related to general lifestyle. Once the diagnosis is established, it may be important to have follow-up with an Endocrinologist to initiate and monitor treatment.

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