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Men’s sex hormones, like testosterone, can start to decline as they get older. But why is this and what should you know?
Summary
1What causes testosterone levels to decline?
It’s actually very uncommon and only happens to around 2% of cisgender men...
2Can men get hot flushes?
“They can – this decline in sex hormones can lead to circulatory issues, resulting in hot flushes, sweating and nervousness...
3What can I do about testosterone decline?
The first step is to look at your lifestyle. A balanced diet and regular exercise (especially weight training) are the best ways to...
From middle age through to a man’s twilight years, life can begin to catch up with you and testosterone levels naturally drop.1
Some men feel its effects more than others, and we’re always championing you at H&B, which is why we’ve asked the experts for the lowdown on why sex hormone levels decline, what causes it, how to spot its effects and what you can do about it.
Should we be calling it ‘andropause’?
Well, the NHS says using this term is unhelpful and misleading, because it incorrectly suggests that symptoms are similar to the female menopause.1 So from here on out, let’s talk about it in terms of hormone decline.
Later in life, “a man’s testosterone levels decline steadily as if they’re rolling down a hill,” says intimate health expert Dr Shirin Lakhani. Due to its gradual nature, most men won’t feel the effects of this lowering of testosterone until much later in life.
What causes testosterone levels to decline?
It’s actually very uncommon and only happens to around 2% of cisgender men.2 “It’s typically caused by lifestyle or psychological factors that come with age, such as increased stress or anxiety, smoking, drinking alcohol excessively and poor diet,” explains pharmacist Abbas Kanani.
“A lot of guys don’t connect the dots at first”
As the symptoms are wide-ranging and could be due to other underlying issues, it can be difficult for men to realise how they’re all related, especially as the process is so gradual, starting in your 30s or 40s, and usually not consciously felt until even later.
“A lot of guys don’t connect the dots at first blaming the fatigue or irritability on work, family or just getting older but sometimes it can be more than that,” says Dr Maria Knöbel. “You might feel a dip in energy, lose interest in activities you used to enjoy or even find yourself getting more easily frustrated. Sleep issues can pop up too, and the weight gain, particularly around the middle, becomes harder to shake off.”
What are the symptoms of testosterone decline?
As mentioned, there’s a wide range of potential symptoms1 such as:
- low energy
- mood changes
- lack of focus
- decreased sex drive
- sleep disturbances – ranging from insomnia to increased sleepiness
- change in muscle mass
- redistribution or increase in body fat
- hot flushes and sweating
- general aches and pains
- thinning of hair
Some of these symptoms may also be due to something completely different, so if any of these are bothering you, please speak to your GP to get the right diagnosis.
Does testosterone decline cause erectile dysfunction?
Libido is often shaped by hormones, but also by a variety of psychological and physical factors, so it makes sense that your sex drive, including erectile dysfunction, could be affected by this decline.
“It's important that both partners communicate during these chapters of life”
"During this decline, people can experience significant changes and this in turn will impact a sexual relationship,” explains Dr Lakhani. “These symptoms can impact a couple's sex life. It's important that both partners communicate during these chapters of life and navigate any hormonal changes as a couple – seeking advice from a medical practitioner specialising in this where necessary.”
Can men get hot flushes?
“They can – this decline in sex hormones can lead to circulatory issues, resulting in hot flushes, sweating and nervousness.3 They can also be caused by hormone therapy or a severe testosterone deficiency – so it’s always good to get them checked out.”
As a man in my 40s, why do I keep waking up at night?
This question needs a little more than this article to answer, but one reason that men wake up in the middle of the night is a result of lowering testosterone.4 This can cause sleep disturbances such as insomnia or oversleeping, but also light sleep and night sweats.1
Of course, there are other potential reasons for your late-night wake-up call, from stress and a poor sleep environment to caffeine and alcohol usage, too much screen time before bed or sleep apnea.
“The key is that no man should suffer in silence if they’re experiencing symptoms”
Waking up to go for a wee? Men produce less of a hormone called antidiuretic5 as they age, meaning they could be more likely to need a 3am toilet trip. If you’re getting up multiple times in the night to go to the loo, however, it’s worth checking with your GP, as this could indicate another condition, such as prostate, bladder or diabetes issues.
What can I do about testosterone decline?
The first step is to look at your lifestyle. A balanced diet and regular exercise (especially weight training) are the best ways to fight the effects from both a physical and mental perspective.
Studies have shown6 that building testosterone levels is linked to building a leaner body and fighting age-related muscle deterioration. Of course, there’s a little chicken and egg about the situation: exercise is a great way to boost testosterone, but will cause you to lose any extra pounds regardless, resulting in those physical and psychological boosts.
“I’ve seen patients feel a real shift once they start prioritising their health,” says Dr Knöbel. “I also encourage finding healthy ways to manage stress, whether it’s picking up a hobby, practicing mindfulness or simply talking with someone. It’s about taking small, manageable steps that help you feel like yourself again.”
We suggest incorporating foods into your diet like:
- spinach
- beets
- whole grains
- red meat
- oily fish
- foods rich in vitamin D, zinc, magnesium7 and betaine8
There are more products than ever to give you a helping hand. Just make sure you discuss their benefits with an expert.
“The key is that no man should suffer in silence if they’re experiencing symptoms which are impacting them physically or psychologically,” concludes Dr Lakhani. “It’s important that we continue to break taboos around the subject of testosterone in order to help men seek appropriate treatment.”
The final say
Whist it’s rare, that doesn’t mean it can’t happen. The best way to improve the above is a good diet and plenty of exercise, along with lifestyle changes like cutting out smoking and confronting day-to-day stress. Take a look at why habit stacking can make healthy changes stick.
The advice in this article is for information only and should not replace medical care. Please check with your GP or healthcare professional before trying any supplements, treatments or remedies. Food supplements must not be used as a substitute for a varied and balanced diet and a healthy lifestyle.
- NHS . The “male menopause” [Internet]. NHS. 2019. Available from: https://www.nhs.uk/conditions/male-menopause/
- Huhtaniemi I, Forti G. Male late-onset hypogonadism: pathogenesis, diagnosis and treatment. Nature Reviews Urology. 2011 Apr 19;8(6):335–44.
- Male menopause (androgen deficiency in the ageing male) [Internet]. www.baus.org.uk. Available from: https://www.baus.org.uk/patients/conditions/7/male_menopause_androgen_deficiency_in_the_ageing_male/
- Luboshitzky R, Zabari Z, Shen-Orr Z, Herer P, Lavie P. Disruption of the Nocturnal Testosterone Rhythm by Sleep Fragmentation in Normal Men. The Journal of Clinical Endocrinology & Metabolism. 2001 Mar 1;86(3):1134–9.
- Nocturia - Patient Information [Internet]. NHS. [cited 2024 Nov 5]. Available from: https://www.wsh.nhs.uk/CMS-Documents/Patient-leaflets/Gynaecology/6497-1-Nocturia-getting-up-at-night-to-pass-urine.pdf
- Mouser JG, Loprinzi PD, Loenneke JP. The association between physiologic testosterone levels, lean mass, and fat mass in a nationally representative sample of men in the United States. Steroids. 2016 Nov;115:62–6.
- Wrzosek M, Woźniak J, Włodarek D. The causes of adverse changes of testosterone levels in men. Expert Review of Endocrinology & Metabolism. 2020 Sep 2;15(5):355–62.
- Arazi H, Aboutalebi S, Taati B, Cholewa JM, Candow DG. Effects of short-term betaine supplementation on muscle endurance and indices of endocrine function following acute high-intensity resistance exercise in young athletes. Journal of the International Society of Sports Nutrition. 2022 Mar 22;19(1):1–16.
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