Is ‘male menopause’ or andropause real? What does it really mean?

Some men reach midlife and feel unlike themselves — lower energy, poorer sleep, less interest in sex, mood changes, or erectile difficulties. It’s common for friends (or TikTok) to label it “male menopause”.

Here’s the clearer answer: the experience can be real, but the label is often misleading. In medicine, what people call “male menopause” is usually discussed as andropause or age-related testosterone deficiency — changes that tend to happen gradually, and not to every man.

Why the phrase “male menopause” sticks

Menopause has a specific meaning: a defined life stage marked by a permanent stop in menstruation.

For men, there isn’t a single biological “switch” that flips. Testosterone can decline with age, but this can stretch over years, even decades. That’s why many clinicians prefer “andropause” as a symptom-based conversation, not a one-size-fits-all milestone.

Testosterone levels can start to drop about 1% a year after age 40, and symptoms (if they show up) are often noticed in the 50s.

A local data point (not a national prevalence figure): HealthXchange cites a primary care clinic-based screening of 1,000 men in Singapore (2007–2009) where 26.4% had some form of androgen deficiency / low testosterone. It’s a useful signal that this concern shows up in real clinics, even if it doesn’t represent the whole population.

What is andropause, in practical terms?

Andropause is a cluster of symptoms linked to lower testosterone in some men as they age. Symptoms often overlap with stress, burnout, poor sleep, depression, chronic disease, and relationship strain which is why self-diagnosing based on a checklist alone can be risky.

Commonly listed symptoms include:

• low energy and fatigue

• mood changes, irritability, or feeling low

• reduced sex drive

• erectile dysfunction

• poor concentration or memory issues

• sleep problems

• reduced muscle mass/strength

  
  

Andropause's symptoms resulting from an age-related decline in testosterone, with evaluation and treatment guided by established protocols.

Why symptoms alone aren’t enough

Here’s the tricky part: many andropause-like symptoms overlap with everyday midlife pressure such as stress, burnout, weight changes, sleep apnoea, depression/anxiety, diabetes, medication effects, relationship strain.

That’s why reputable medical guidelines emphasise testing and confirmation (not guesswork).

The Endocrine Society recommends diagnosing testosterone deficiency only when both are present:

• symptoms/signs consistent with testosterone deficiency, and

• testosterone levels that are “unequivocally and consistently” low

  
  

It also recommends measuring fasting morning testosterone and repeating the test to confirm. Doctors prefer morning testing because testosterone typically peaks earlier in the day.

So… is “male menopause” real?

Andropause is a health issue worth discussing early, because it can affect mood, relationships, work and overall wellbeing

A simple way to put it:

• Real: Some men experience genuine physical and emotional changes linked to low testosterone or related health issues. It is a real set of symptoms linked to clinically low testosterone, sometimes called male hypogonadism

• Not quite real (as a mirror image of menopause): It’s usually gradual, varies widely, and shouldn’t be assumed without proper assessment. It is not something that should be diagnosed from symptoms alone, without proper testing and an automatic reason to start testosterone “just to feel younger”.

What to do if he/she suspects it’s happening

A sensible first step is a GP or polyclinic visit, where the doctor can look at the full picture - sleep, mental health, weight, medications, chronic disease risks and decide what tests make sense.

International clinical guidance from the Endocrine Society is clear: clinicians should diagnose hypogonadism only when (1) symptoms/signs are present and (2) testosterone is “unequivocally and consistently” low, confirmed by repeating a morning fasting testosterone test.

If you’re supporting a partner, colleague, friend, or family member, a helpful approach is: validate the experience, but don’t self-diagnose.

Questions worth asking a clinician

• Could symptoms be explained by sleep issues (including sleep apnoea), stress, depression/anxiety, or medication side effects?

• If testing is needed, can it be done with morning fasting blood tests and confirmed with a repeat?

• If testosterone is low, what’s the likely cause — and what are the options beyond hormones?

About testosterone therapy: Where Singapore draws the line

Testosterone replacement therapy (TRT) can be appropriate for men with confirmed deficiency and symptoms — but it’s not a casual “energy booster”.

A GP or polyclinic doctor can be a good first step; they can assess the “big picture” and refer to endocrinology/urology where needed.

Singapore’s Ministry of Health lists TRT without laboratory confirmation of testosterone deficiency as a restricted service item in its licensing conditions framework — a signal that hormone treatment should not be offered as a shortcut without proper evidence.

This caution is not theoretical. In October 2025, The Straits Times reported on a doctor suspended for inappropriately prescribing hormone therapies to patients who had normal hormone levels and no symptoms warranting them.

On the clinical side, SingHealth notes that men on TRT are monitored for side effects, including risks such as blood thickening (which can raise cardiovascular risk) and reduced sperm production.

When to seek help sooner (not later)

Encourage a medical review if there is:

• persistent low mood, anxiety, or signs of depression

• erectile dysfunction that is new or worsening

• severe fatigue affecting work, driving, or daily function

• fertility concerns (TRT may not be suitable for those trying to conceive)

“Male menopause” is a popular phrase because it’s easy to understand. But what matters more is the practical reality: If a man feels different in midlife, it’s worth taking seriously and worth doing properly. Start with a whole-person check (sleep, stress, health risks), confirm with the right tests if needed, and avoid hormone shortcuts without evidence.

At Surety Singapore, we see midlife as a shared life stage, one that impacts relationships, caregiving, work performance, and mental wellbeing. When we get the language right, we make it easier for him/her to ask for help early and for the people around him/her to respond with empathy, not stigma.

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Important Notes

This article is for informational purposes only and should not replace medical advice. Always consult a healthcare professional for individualized guidance.