andropause

Andropause is the slow fade of testosterone as men age, sometimes loosely called the male menopause. The comparison is misleading, though: unlike the abrupt shutdown of the ovaries at menopause, a man's testosterone usually drifts downward by a small amount each year, and most men remain fertile.

From around the third or fourth decade, average testosterone declines gradually, by roughly one to two percent per year, and the fraction bound to SHBG tends to rise, lowering the active free hormone further. Some men develop symptoms attributable to low testosterone, such as reduced libido, fatigue, low mood, loss of muscle and bone, while many others stay symptom-free despite similar numbers. Coexisting illness, obesity, and poor sleep can lower testosterone too, so the decline is not purely a function of age.

The honest clinical picture is nuanced. The diagnosis of late-onset hypogonadism requires both genuinely low testosterone on morning testing and consistent symptoms, not a number alone. Testosterone therapy can help selected, well-evaluated men, but it carries risks and suppresses sperm production, so it is reserved for clear cases rather than offered as a routine anti-aging fix.