Andropause Explained: What Happens to Men Over 45

While menopause dominates the conversation about midlife hormonal change, men undergo their own gradual hormonal transition. It's less dramatic than menopause, less discussed, and often less recognised — but for many men over 45, it's real and it's affecting their daily life.

What Is Andropause?

Andropause refers to the gradual decline of testosterone (and related hormones) that occurs in men from their 30s onwards. Unlike menopause, which has a defined endpoint, andropause is a slow, continuous process. Testosterone declines at roughly 1–2% per year after age 30. By 50, many men have significantly lower levels than they did at their peak.

The clinical term for a more severe form is late-onset hypogonadism — where testosterone levels drop below the normal reference range. But many men experience significant symptoms at levels that are technically within the normal range, because their individual setpoint was higher.

Common Symptoms

• Fatigue and reduced energy, especially in the afternoon
• Reduced libido
• Mood changes — increased irritability, lower motivation, reduced confidence
• Loss of muscle mass and increased body fat, particularly around the abdomen
• Disrupted sleep
• Reduced ability to concentrate
• Reduced exercise performance and recovery

Why It Goes Unrecognised

These symptoms overlap significantly with stress, overwork, depression, ageing, and relationship problems — all of which are also common at this life stage. Men frequently attribute them to one of those causes and don't connect them to hormonal change. GPs don't always test or discuss it proactively.

What to Do

A fasting testosterone blood test is the starting point. If levels are low-normal or below reference range, there are lifestyle interventions (sleep, resistance training, alcohol reduction, stress management) and, where appropriate, medical options (testosterone replacement therapy). Talk to your GP.