Andropause? Exploring hormonal changes in Men

What is andropause?

Andropause refers to symptoms relating to the gradual decline in testosterone production in some men and is often termed the male version of the menopause. However, unlike the menopause, which is characterised by fluctuations and decline in hormones, andropause is a gradual decrease in testosterone production by around 1-1.6% per year around the ages of 30-35. (Qaseem, 2020)

Timeline

30-40 years

Testosterone gradually begins to decline in many men, often by around 1% per year, although the rate varies considerably. Sex hormone-binding globulin (SHBG) tends to increase with age, meaning free testosterone (the biologically active form) may decline more than total testosterone.

40-50 years

DHEA and DHEA-S (adrenal hormones) also gradually decline with age. Many men remain symptom-free despite these hormonal changes.

50-60 years

Increased body fat can increase the conversion of testosterone to oestrogen via aromatase enzyme.

60-70 years

Hormonal changes may become more noticeable, but symptoms vary between men.

Testosterone – what does it do?

• Heart and circulation – Helps maintain the cardiovascular system, healthy blood vessels and supports the production of red blood cells, which carry oxygen around the body.
• Brain - Contributes to libido, mood, motivation, concentration and aspects of memory and cognitive function.
• Muscles - Helps build and maintain muscle mass, strength and physical performance.
• Bones - Supports bone growth and helps maintain bone density, reducing the risk of osteoporosis and fractures as men age.
• Skin and hair - Influences facial and body hair growth, stimulates sebum (oil) production and contributes to healthy skin.
• Reproductive system - Essential for sperm production, sexual desire and normal erectile function.

(Nasser, 2023)

Why testosterone levels can decline

Testosterone levels are influenced by a range of factors, including age, sleep quality, chronic stress, obesity, certain medications, excessive alcohol consumption, and underlying health conditions. While testosterone levels generally decline gradually with age, the rate and extent of this decline vary considerably between individuals. Symptoms commonly attributed to andropause may also result from other medical conditions, nutrient deficiencies, poor diet, inadequate sleep, or lifestyle factors. Therefore, although age-related testosterone decline is common, not all men experience symptoms. (Lokeshwar et al., 2021)

Less production, less availability

The brain and testes work together to produce testosterone. With age, this communication becomes less efficient and the cells less responsive. Inflammation and oxidative stress may also affect these functions. Most testosterone travels through the bloodstream attached to SHBG.  As SHBG levels increase with age, less free testosterone is available for the body to use. (Nasser, 2023)

More testosterone is converted into oestrogen

Some testosterone is naturally converted into oestradiol (a form of oestrogen) by an enzyme called aromatase. Because aromatase is particularly active in fat tissue, carrying excess body fat can increase this conversion. Higher oestradiol levels may then signal the body to produce less testosterone, creating a cycle that can contribute to lower testosterone levels over time. This is one of the reasons why maintaining a healthy weight can help support healthy hormone balance. (Ahmed, 2025)

Health conditions and medications

Health conditions such as diabetes, ulcerative colitis, and heart attacks can influence testosterone levels, as well as medications such as corticosteroids and opioids. (Dudek, 2017)

Symptoms of low testosterone levels and the male andropause

Physical symptoms

Symptoms include fatigue, poor sleep, loss of muscle strength and mass, increased body fat, poor exercise performance, and slower recovery.

Emotional and cognitive symptoms

Lower testosterone may contribute to low mood, irritability, reduced motivation, difficulty concentrating, and changes in memory or mental clarity.

Sexual symptoms

Including reduced sex drive, fewer morning erections, difficulty achieving or maintaining an erection, and reduced sexual satisfaction.

Late-onset hypogonadism

Late-onset hypogonadism (LOH) is the medical term for a condition in which an older man has both symptoms of testosterone deficiency (such as reduced libido, fatigue, or loss of muscle strength) and consistently low testosterone levels confirmed by blood tests. Not all men with age-related testosterone decline develop LOH. (Wu, 2010)

Supporting healthy testosterone levels naturally

Eat a nutrient-rich diet

Testosterone production relies on a wide range of vitamins and minerals. Aim to eat a balanced diet based on whole foods, including vegetables, fruit, whole grains, lean protein, and healthy fats.

Maintain a healthy weight

Carrying excess body fat can increase the conversion of testosterone into oestrogen. Eating balanced meals that include protein, fibre and healthy fats can help support healthy blood sugar levels and weight management.

Support your body's natural hormone metabolism

The body naturally breaks down and eliminates hormones, including testosterone and oestrogen, to help maintain healthy hormone balance. The liver and digestive system play a central role in this. Staying hydrated, eliminating alcohol, and avoiding smoking all support your body's natural metabolic processes. Cruciferous veggies specifically contain indole-3-carbinol, a compound that supports hormonal balance and liver health.

Manage stress and sleep

Long-term stress can affect hormone balance and energy levels. Regular relaxation techniques such as mindfulness, yoga, deep breathing or spending time outdoors can help support your overall wellbeing. Most testosterone is produced during sleep, making good sleep habits essential.

Stay physically active

Regular exercise is one of the best ways to support healthy ageing. Combining resistance training with aerobic exercise can help maintain muscle mass, support a healthy weight, improve mood, and promote overall metabolic health.

Key nutrients to support male health

Zinc

Zinc plays a key role in male reproductive health, contributing to the maintenance of testosterone, fertility and reproduction, and the protection of cells from oxidative stress. It plays a role in Leydig cell function, synthesising and secreting luteinising hormone (LH), reducing aromatase and improving immune function. Zinc supplementation has been shown to improve testosterone levels and reduce its conversion to oestrogen. (Te, 2023; Zamir, 2021)

Vitamin D

Vitamin D receptors are present in the testes, including Leydig cells, which produce testosterone, highlighting the role of vitamin D in maintaining normal testicular function. Studies have reported associations between low vitamin D status and lower testosterone levels, with some evidence that supplementation can improve testosterone in deficient individuals. Vitamin D may also support testosterone production indirectly by helping regulate inflammation and overall metabolic health. (Pilz, 2011; Zamir, 2021)

Selenium

Selenium is an essential antioxidant mineral that contributes to normal spermatogenesis (sperm production), normal thyroid function, and the protection of cells from oxidative stress. (Avery,2018)

Magnesium

Magnesium is involved in hundreds of enzymatic reactions throughout the body and plays an important role in muscle function, energy production, and normal hormone regulation. Adequate magnesium intake may help support healthy testosterone levels by reducing oxidative stress and inflammation, both of which can impair normal testicular function. Some studies also suggest that magnesium may increase the amount of free testosterone, possibly by influencing its binding to SHBG. (Maggio, 2014)

Herbs and botanicals

Several botanical ingredients may help support healthy testosterone metabolism and male reproductive health through complementary mechanisms. Saw palmetto is thought to inhibit the enzyme 5α-reductase, helping to reduce the conversion of testosterone to dihydrotestosterone (DHT). (Hammer, 2024) Nettle root may help maintain levels of free testosterone by binding to SHBG, potentially reducing the amount of testosterone that is bound and unavailable. (Chrubasik, 2007) Maca has traditionally been used to support libido, energy, and fertility, with studies suggesting benefits for sexual function. Beta-sitosterol, a naturally occurring plant sterol, supports prostate health and may contribute to the modulation of DHT activity. (But, 2024) Pumpkin seed extract is rich in phytosterols, zinc, and antioxidant compounds that help support prostate health and healthy testosterone metabolism. Lycopene, which is naturally concentrated in the prostate and testes, supports the body's own antioxidant defence systems and may help reduce inflammation, both of which are important for protecting testicular tissue and maintaining healthy sperm production. It may also help support mitochondrial function, the process by which cells generate energy, which is essential for healthy sperm development and function. (Vina, 2025) Ashwagandha is an adaptogen that can support stress, exercise performance, and healthy testosterone. (Smith, 2021)

Coenzyme Q10 (CoQ10)

CoQ10 is a naturally occurring compound that helps cells produce energy and protects them from oxidative stress. Because CoQ10 levels decline with age, maintaining adequate levels may help support healthy ageing by preserving mitochondrial function and reducing oxidative damage, processes that are important for maintaining normal testicular function and testosterone production.

Omega-3

Omega-3 fatty acids are well known for their anti-inflammatory properties and play an important role in supporting heart, brain and metabolic health. Emerging evidence also suggests they may support male reproductive health by helping to reduce oxidative stress and inflammation within the testes. Studies have associated higher omega-3 intake with improved semen quality, larger testicular volume, and a higher free testosterone-to-LH ratio. (Jensen, 2020)

Conclusion

Everyone's hormonal journey is different. While testosterone and other hormones tend to decline gradually with age, many men experience few or no symptoms. Lifestyle factors, including body weight, physical activity, sleep quality and overall health, can influence hormone levels and how men feel as they age. Many symptoms associated with andropause, such as fatigue, low mood, reduced libido, or weight gain, can have many other causes, including stress, depression, thyroid disorders, sleep apnoea, or certain medications. That's why healthcare professionals diagnose testosterone deficiency based on both symptoms and blood test results, rather than symptoms alone.

Practitioner insight comment box:

Testosterone levels can be influenced by factors such as age, illness, stress, sleep, medications, as well as diet and lifestyle. It is important to consider symptoms alongside blood test results, ensuring hormone levels are interpreted in the context of the whole person.

References

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