Many men notice subtle changes as they enter their 40s and 50s.
Energy isn’t what it used to be.
Workouts become harder.
Muscle mass gradually disappears.
Sleep becomes less refreshing.
Sex drive declines.
Erections become less reliable.
Mood changes. Motivation fades.
Most men simply accept these changes as “part of getting older.”
While ageing certainly plays a role, these symptoms may also be caused by testosterone deficiency, medically known as late-onset hypogonadism (LOH). Although many people refer to this as andropause or male menopause, these terms are not entirely accurate because testosterone declines gradually over many years rather than stopping abruptly as female hormones do during menopause.
What is Andropause?
Unlike menopause in women, there is no sudden switch-off of hormone production.
Instead, testosterone levels generally decline slowly—approximately 1% per year after the age of 40—although not every man develops symptoms or clinically significant testosterone deficiency.
Many men continue to have normal testosterone levels throughout life.
Others develop late-onset hypogonadism, where testosterone levels become low enough to produce symptoms that affect quality of life.
Common Symptoms
Every man is different, but common symptoms include:
Sexual Symptoms
- Reduced libido
- Difficulty achieving or maintaining erections
- Fewer morning erections
- Reduced sexual satisfaction
Physical Symptoms
- Fatigue
- Reduced stamina
- Loss of muscle mass
- Increased abdominal fat
- Weight gain
- Reduced strength
- Reduced exercise performance
- Hot flushes (less common)
Mental & Emotional Symptoms
- Poor concentration
- Brain fog
- Irritability
- Low mood
- Loss of motivation
- Reduced confidence
Long-Term Health Effects
Persistently low testosterone may also contribute to:
- Reduced bone density (osteoporosis)
- Increased fracture risk
- Anaemia
- Reduced physical function
- Reduced quality of life
These symptoms can also result from conditions such as obesity, diabetes, thyroid disease, depression, medication side effects, chronic stress, or obstructive sleep apnoea. This is why proper medical assessment is essential before considering treatment.
Who Is Most At Risk?
Several factors increase the likelihood of testosterone deficiency:
- Age over 40
- Obesity
- Type 2 diabetes
- Metabolic syndrome
- High blood pressure
- Chronic illness
- Poor sleep
- Obstructive sleep apnoea
- Long-term opioid medications
- Previous testicular injury or surgery
Lifestyle factors such as poor sleep, inactivity and excess body fat may also suppress testosterone production.
How Is Andropause Diagnosed?
Diagnosis is not based on symptoms alone.
International guidelines recommend confirming:
- Symptoms consistent with testosterone deficiency
- Low morning testosterone levels on at least two separate blood tests
Additional blood tests are often required to identify the cause of low testosterone and to distinguish whether the problem originates in the testes or the pituitary gland.
At Catalyst Clinic, assessment may include:
- Detailed medical consultation
- Lifestyle assessment
- Comprehensive blood testing
- Total Testosterone
- Free Testosterone (when indicated)
- SHBG
- LH & FSH
- PSA (where appropriate)
- Full blood count
- Liver and kidney function
- Thyroid profile
- Diabetes screening
- Lipid profile
Is Testosterone Therapy Right for Everyone?
No.
Current international guidelines recommend testosterone replacement only for men who have:
- Symptoms of testosterone deficiency and
- Confirmed persistently low testosterone levels.
Testosterone therapy is not recommended simply because a man is getting older or has a single low testosterone reading without symptoms.
Some men should not receive testosterone therapy, including those with:
- Prostate or breast cancer
- Elevated haematocrit
- Untreated severe obstructive sleep apnoea
- Recent heart attack or stroke
- Men actively trying to father children, as testosterone therapy can reduce sperm production.
Lifestyle Still Matters
Even when testosterone is low, improving overall health remains a cornerstone of treatment.
Evidence supports:
- Weight reduction
- Resistance exercise
- Better sleep
- Managing diabetes
- Reducing excess alcohol
- Treating sleep apnoea
- Stress management
In some men, improving these factors can increase testosterone levels naturally and improve symptoms.
How Catalyst Clinic Can Help
At Catalyst Clinic, we believe that men’s health is about much more than prescribing testosterone.
Our comprehensive Men’s Health Assessment aims to identify why you are feeling different—not simply treat a blood test result.
Your assessment may include evaluation of:
- Hormone health
- Erectile dysfunction
- Sexual performance
- Cardiovascular risk
- Metabolic health
- Diabetes risk
- Weight management
- Sleep quality
- Mental wellbeing
- Lifestyle factors
If testosterone deficiency is confirmed, we’ll discuss evidence-based treatment options, their expected benefits, potential risks, and the ongoing monitoring needed to ensure therapy remains safe and effective.
Don’t Ignore the Signs
If you’ve been telling yourself,
“I’m just getting older,”
it may be worth finding out whether there’s more to the story.
A comprehensive medical assessment can help identify whether low testosterone—or another treatable condition—is affecting your health and quality of life.
Early assessment allows you to make informed decisions about your health rather than simply accepting symptoms as an inevitable part of ageing.
References
- Endocrine Society Clinical Practice Guideline (2018): Testosterone Therapy in Men with Hypogonadism. Endocrine Society Guideline
- Bhasin S, et al. Testosterone Therapy in Men With Hypogonadism. Journal of Clinical Endocrinology & Metabolism, 2018. PubMed Abstract
- Wu FCW, et al. Identification of Late-Onset Hypogonadism in Middle-Aged and Elderly Men. New England Journal of Medicine, 2010. NEJM Study
- Mayo Clinic: Male Menopause: Myth or Reality? Mayo Clinic Overview
- Current National and International Guidelines for the Management of Male Hypogonadism (2020 review). Review Article (PMC)
This article is written to align with current clinical guidance and avoids overstating the benefits of testosterone therapy.