Nobody told men about this part. There are conversations about cardiovascular health, prostate screening, and diet.
But what happens hormonally; to energy, drive, mood, sexuality, and identity; after 40? That conversation has been largely absent. This article is a practical guide to what andropause is, how it manifests, and what actually helps.
It is also, for the men who are ready for it, an invitation to look at what the chemistry is revealing.
“The man who understands what is happening to his body is the one who can do something about it. The one who doesn’t rationalises, withdraws, and waits for things to return to normal on their own.”
Is andropause real?
Yes, and it is increasingly well-documented. Starting around age 35, testosterone levels in men decline at roughly 1–2% per year. By the mid-forties or fifties, the accumulated drop is often significant enough to produce real, measurable symptoms. This is andropause; also termed late-onset hypogonadism, and it is recognised by endocrinologists, urologists, and the World Health Organization as a clinical condition.
Unlike menopause, which is a defined hormonal event, andropause is gradual. Testosterone does not fall off a cliff; it erodes. DHEA falls alongside it, cortisol tends to rise, and insulin sensitivity shifts. The combined effect is a cascade that hits the body, brain, and mood in ways that men frequently attribute to stress, overwork, or simply getting older. Most men rationalise each symptom separately. The pattern only becomes clear when viewed together.
Hormonal shifts across male ageing
Schematic representation; relative levels. Individual variation is significant.
DHEA
Vitality · mood · bone density Peaks at twenty-five, declines steadily. Rarely on standard panels but significant for energy and wellbeing.
Sexual Desire Libido · spontaneous desire The combined output of testosterone, DHEA, and psychological factors. Chemistry, not attitude.
Cortisol and testosterone are in direct opposition. Chronic stress in the forties doesn’t just exhaust; it actively suppresses hormonal recovery.
The vitality hormone that peaks at twenty-five. Its quiet decline contributes significantly to the flatness men describe but rarely name.
Low libido and flattened motivation in andropause are not attitude problems. They are the predictable result of this chemistry.
† Libido and sexual function are highly individual and influenced by psychological, relational, and vascular factors in addition to testosterone.
Andropause is not the end of vitality. It is a shift in the conditions under which vitality exists, and those conditions are changeable. The decline is real. So is the capacity to do something about it.
Symptoms; check what applies
These symptoms are clinically associated with testosterone deficiency. Tick anything you have been experiencing consistently for three months or more. Three or more warrants a hormone panel.
- Persistent low energy or fatigue Not fixed by sleep
- Fewer or no morning erections Previously regular
- Reduced sex drive Noticeably lower than your baseline
- Depression or flat mood Unexplained or prolonged
- Listlessness or lack of motivation Drive has flattened without explanation
- Irritability or low frustration tolerance Disproportionate reactions
- Body composition changes More fat, less muscle; especially abdomen
- Brain fog or difficulty concentrating Memory, focus, mental sharpness
- Reduced strength despite training Performance declining without lifestyle change
- Erectile dysfunction Less reliable or less spontaneous erections
Important: these symptoms overlap with thyroid disorders, sleep apnoea, depression, and metabolic disease. A checklist identifies a pattern; a blood panel confirms a cause. Do not self-diagnose or self-treat on symptoms alone.
What happens if it goes unaddressed
Andropause is not only a quality-of-life issue. Chronically low testosterone has documented long-term health consequences that develop over years and are largely preventable.
Cardiovascular disease Men with persistently low testosterone show higher rates of cardiac events. Testosterone regulates cholesterol, arterial health, and inflammation.
Osteoporosis Bone density loss is gradual and asymptomatic until a fracture occurs.
Men are significantly undertreated for this compared to women.
Type 2 diabetes & metabolic syndrome Low testosterone drives insulin resistance and visceral fat; the primary markers of metabolic disease.
Depression & suicide risk Men are already under diagnosed for depression. Andropause compounds this. The link between low testosterone and suicidality deserves more clinical attention than it currently receives.
Cognitive decline Emerging evidence links chronically low testosterone to increased risk of Alzheimer’s disease and age-related cognitive deterioration.
Accelerated muscle loss Sarcopenia accelerates significantly after 50 without intervention. It is a primary predictor of frailty and mortality in later life.
Your hormones have a way of showing you your life
Sometimes a hormonal shift is exactly that; biochemistry, addressed with clinical tools and lifestyle change. But hormones do not operate in a vacuum, and andropause has a particular way of lowering tolerances that were already being tested.
The flatness, the withdrawal, the sense that something is missing; these may be amplified by low testosterone, but they are not always created by it. The chemistry removes the anesthetic. What it exposes was already there.
The question worth sitting with is not only what to do about the testosterone. It is what this phase is making impossible to ignore. Relational distance that had become habitual. Work that stopped meaning something a while ago. A self-esteem quietly built on performance and output, which falters precisely when output starts to feel harder. A version of life that was supposed to feel like enough by now, and doesn’t.
These are not weaknesses to be fixed before addressing the hormones. They are part of the same picture. And addressing both; the biochemical and the existential; is what the men who come through this phase well actually do.
Is it your hormones; or is it your life?
You don’t have to have all of these. But if some of them land, they’re worth sitting with; not as problems to solve immediately, but as information.
- Your relationship feels more like logistics than partnership
- Your work stopped meaning something a while ago
- You’re not sure who you are outside of what you produce
- The version of yourself you planned to become hasn’t arrived
- You’re present in your life but not particularly in it
- The people closest to you would struggle to say what you actually need
- Your self-esteem is more fragile than you let on
- You’ve been waiting for things to feel different without changing anything
- You feel vaguely behind; on something you can’t quite name
- You are more alone in this than seems reasonable
This is not a diagnostic tool. It is an invitation. The men who use this phase well are the ones who let it point somewhere, not just the ones who manage the symptoms.
This is the second half of your life. Statistically, it is the shorter half. What is true for you in it, about your relationships, your work, your sense of purpose; matters more now, not less.
The question andropause is asking is not only medical. It is: what do you actually want this half to look like?
Strength training: non-negotiable
Resistance training is the most evidence-backed natural support for testosterone available. It directly counters andropause’s two most destructive physical effects; muscle loss and fat accumulation, and men who train consistently maintain better hormonal profiles, metabolic health, bone density, and cognitive function into their sixties and beyond.
How strong should you be?
Functional targets for men in their forties and fifties. Not personal bests. Benchmarks of adequate strength for hormonal and metabolic health.
Deadlift 1.5–2× bodyweight
Highest anabolic stimulus per lift. Critical for back health and real-world capacity.
Squat 1.25–1.5× bodyweight
Highest testosterone response per movement. Protects joints and bone density.
Bench press 1–1.25× bodyweight
Upper body push strength and muscle retention.
Overhead press 0.6–0.75× bodyweight
Shoulder and core stability. Reliable indicator of functional health.
Pull-ups 8–12 reps bodyweight
Relative strength and grip. Declines rapidly with testosterone drop and disuse.
Frequency 3–4× per week
Minimum effective dose for hormonal benefit. Consistency over intensity.
If starting from a low base, work toward these over 12–24 months with a qualified coach. Injury is the primary obstacle to consistency; begin conservatively.
Cortisol is the enemy of testosterone
Cortisol directly suppresses testosterone production and the relationship is bidirectional; low testosterone increases stress reactivity, and high cortisol lowers testosterone further. The goal is not stress elimination. It is navigating stress differently; building deliberate recovery into the system rather than absorbing it as a constant background load.
Default Patterns – Testosterone Suppressing
Absorbing work stress through the evening with no defined off time
Poor sleep hygiene; late screens, inconsistent wake times
Alcohol as the primary stress relief mechanism
Skipping meals or high-sugar reactive eating under pressure
No physical outlet; stress accumulates without discharge
Internalising everything; no relational processing
Functional Alternatives
Hard stop time for work; the boundary is physiological, not optional
Sleep as a non-negotiable health input: 7–8 hours, consistent wake time
Resistance training as the primary stress discharge mechanism
Protein-anchored meals; stabilises cortisol and blood sugar simultaneously
Deliberate recovery: walking, time outside, structured decompression
Talking; to a partner, a friend, or a therapist. Cortisol drops with connection
Not a personality change – A system change
Sleep is testosterone production time The majority of daily testosterone is produced during deep sleep. Consistently under 7 hours is sufficient to suppress levels on its own.
Alcohol has a higher cost after 40 It raises cortisol, disrupts sleep architecture, and directly suppresses testosterone. The hormonal cost of regular heavy drinking is measurable.
Meaning reduces cortisol Men with a sense of agency and purpose in their work show measurably better hormonal profiles. Chronic helplessness is one of the most potent cortisol drivers.
Recovery is not optional Rest days and sleep are when testosterone is produced. Treating recovery with the same discipline as training is part of the protocol.
Hormone therapy: what to know
Testosterone Replacement Therapy (TRT) is a legitimate, well-studied intervention for men with clinically confirmed hypogonadism. It is neither a silver bullet nor something to avoid; it is a tool that requires proper diagnosis and appropriate monitoring, and it should follow, not replace, lifestyle change.
Before starting: What your doctor needs to test
Blood Panel: Total testosterone, free testosterone, LH, FSH, SHBG, oestradiol, thyroid, full metabolic profile, PSA if over 45.
Delivery options: Injections (most common), gels, patches, or pellets. Each has different absorption profiles and trade-offs
What it treats: Energy, libido, body composition, mood, bone density, erectile function, when driven by confirmed testosterone deficiency
During treatment: What requires monitoring
Haematocrit: TRT increases red blood cell production. Elevated haematocrit raises clotting risk and requires management
Fertility: TRT suppresses natural production. If fathering children is a consideration, discuss alternatives; hCG, clomiphene; first
Oestrogen Balance: Testosterone converts to oestradiol. Levels need monitoring to avoid water retention, mood changes, and other side effects
Do not accept “your testosterone is normal” without seeing the number in context of your symptoms, your age, and your full hormonal picture. Normal for a 70-year-old is not normal for a 45-year-old with significant symptoms.
What your partner is experiencing
The behavioural changes of andropause; withdrawal, irritability, reduced libido, flattened motivation; land on partners without explanation. She reads emotional distance as rejection. Reduced libido as loss of attraction. Quietness as indifference. None of those interpretations are accurate, but all of them cause real damage if left unnamed.
Partners often describe living with
Someone who has withdrawn without explanation; present but not engaged. Someone whose irritability feels disproportionate and unpredictable. Someone whose interest in sex has changed in ways that feel personal, even when they aren’t. Someone who has lost the drive and energy that once defined him.
Partners frequently internalise these changes as their own failing; questioning their attractiveness, their adequacy in the relationship, whether something is fundamentally wrong. That misreading compounds the isolation for both people.
The most useful thing a man can do is name what is happening; not as an excuse, but as information. “I’m dealing with something hormonal that’s affecting my energy and mood” changes the dynamic from personal failure to shared problem.
What to do; in order
1. Get a full hormone panel
Total testosterone, free testosterone, LH, FSH, SHBG, oestradiol, thyroid panel, full metabolic profile, PSA if over 45.
Morning draw; testosterone peaks in the morning.
2. Start resistance training now, regardless of results
You do not need a diagnosis to start. Three to four sessions per week of compound lifts is the most effective non- pharmacological testosterone support available.
3. Address sleep as a clinical priority
The majority of daily testosterone is produced during deep sleep. Consistently poor sleep is sufficient on its own to suppress levels meaningfully.
4. If indicated, consider TRT with a specialist
If your panel confirms low testosterone and lifestyle changes haven’t been sufficient, TRT is a clinically appropriate option.
Find a specialist who monitors the full hormonal picture.
5. Address the psychological and existential dimension
Hormones alone do not resolve the identity shift that andropause produces; nor the questions it surfaces about relationships, purpose, and what the second half of life is actually for. Individual and couples therapy is an aid on route, not a last resort.
6. Address sexual health directly
Erectile dysfunction and reduced libido respond to hormonal correction, psychological work, and where appropriate, PDE5 inhibitors. These changes are treatable; not simply something to accept.
The second half is shorter. Make it count.
Andropause is a biological process. It is also, for the men who are paying attention, an invitation. The flatness, the questions, the things that have become harder to ignore; these are not signs that something has gone wrong. They are signals pointing toward what needs to change, what deserves more attention, and what has been deferred long enough.
The men who navigate this well are not the ones for whom it was easy. They are the ones who chose to treat it as information rather than inconvenience, who addressed the chemistry, and then looked honestly at what the chemistry was revealing.
The decline is real. So is the opportunity inside it.
Reach out sooner rather than later
Persistent low mood, loss of drive, significant sexual changes, a relationship under strain; these are beyond ordinary difficulty and beyond what any man should navigate alone. A sexologist or relationship therapist who understands male hormonal health is an aid on route, not a last resort. You don’t have to manage this in silence, and you don’t have to let it cost more than it already has.
The man who comes through this with his vitality and his relationships intact is not the one for whom it was easy. He is the one who chose to navigate it.
This article is for informational purposes and does not constitute medical advice. Consult a qualified clinician for diagnosis and treatment decisions.
Lynett Olivier
Need support? The Society of Sexual Health offers confidential online sexology and relationship therapy. Useful next steps: confidential therapy support.
