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Male menopause: Is it real?

The human body undergoes many natural changes as you age, including changes in hormones. People with ovaries experience menopause, a series of hormonal changes that signals a person’s fertility coming to an end and that the ovaries have a low egg reserve. During this time, a person may undergo several physical and emotional symptoms, such as weight gain, reduced libido, and mood swings.

So, if people with ovaries experience menopause, do people with testes also experience menopause or something similar to it? Here, we walk you through everything you need to know about how menopause works and the pressing question many want to know: does male menopause exist?

Key takeaways:

  • People with testes experience a natural decline in testosterone as they age, which is sometimes referred to as “andropause.”
  • Unlike menopause, andropause does not indicate a cessation of fertility.
  • Although people with testes do not have an “age limit” on fertility, they still experience fertility decline as they age.
  • A healthy, active lifestyle and a nutrient-rich diet can help ease the symptoms of andropause and improve sperm health, but nothing can fully prevent the natural decline of sperm health that comes with age.

What is menopause? 

Menopause can be diagnosed when a person with ovaries has not menstruated for over 12 months. This usually occurs between the ages of 45 and 55, with the average age of menopause being 51.

Menopause indicates that a person is no longer fertile. People with ovaries are born with approximately one million eggs; they cannot produce more eggs and naturally lose eggs at a rate of about 1,000 per month. At puberty, there will be around 300,000 eggs. Menopause signals that there are very few eggs left and that the person is no longer ovulating.

During menopause, people will also experience major hormonal changes. The ovaries will no longer produce the same levels of estrogen, progesterone, and testosterone as they were before menopause. Decreased levels of these three key reproductive hormones can cause a variety of physical symptoms; this can also put a person at greater risk for certain health conditions. For example, low estrogen levels can increase the risk of developing osteoporosis and heart disease.

The three stages of menopause

Menopause actually occurs in three stages: perimenopause, menopause, and postmenopause. Perimenopause is a period during which the ovaries slow down the production of hormones and ovarian reserve nears zero. This period can last anywhere from a few months to a few years. Common symptoms are irregular menstrual cycles, mood changes, hot flashes and night sweats, and PMS-like symptoms. (It’s still possible, though unlikely, to get pregnant during perimenopause.)

This period ends at menopause: no menstrual periods for 12 months. After this point, someone is considered “postmenopausal.” Estrogen, progesterone, and testosterone levels will be at a constantly low level.

Do men go through menopause?

Whether you are born with ovaries or testes, it’s natural for your body to change as you age. So does that mean cisgender men go through menopause too? 

People with testes experience a fluctuation and decline of key reproductive hormones as they get older. In casual conversation, some refer to the natural decline of testosterone as “male menopause” — the scientific term is “andropause.”

Andropause is less defined than menopause. It generally refers to the point at which a person with testes begins to experience a decline in testosterone production, which typically begins around age 40. Although testosterone is a hormone that drives male fertility, people with low testosterone levels can still produce healthy sperm. Unlike menopause, andropause does not signal a full cessation of fertility, though sperm count and quality typically decline. People who are post-andropause can still naturally have children.

How does male fertility change over time?

Declining fertility goes hand-in-hand with declining testosterone over time.

While there isn’t an age limit on male fertility, people who produce sperm will experience changes in their fertility over time. There’s typically a small, gradual annual decline in sperm health and overall fertility starting around the age of 35.

There are four sperm quality parameters that are likely to naturally change with age: count, motility, morphology, and DNA fragmentation. One study shows that sperm motility, or movement, may decrease by about 0.8% per year of age; another study found that sperm morphology, or proper shape and size, decreases by about 0.65% per year of age. DNA fragmentation, a term that refers to the degree of DNA damage inside a sperm, has been shown to increase by 0.3% per year of age.

These cumulative changes in sperm quality cause a decrease in pregnancy rates, increased time to conception, greater miscarriage risk, and greater risk of adverse pregnancy outcomes, especially after age 40.

Symptoms of andropause (male menopause)

As your body naturally produces less testosterone with age, you may experience physical and emotional symptoms. Below are a few common symptoms of andropause.

  • Loss of libido/sex drive
  • Erectile dysfunction
  • Loss of muscle mass
  • Weight gain
  • Decreased bone density
  • Fatigue/lack of energy
  • Difficulty sleeping
  • Poor concentration
  • Mood swings
  • Irritability
  • Depression

If you are experiencing these symptoms — no matter your age — it’s important to have a conversation with your primary care physician. Depending on the symptoms you are experiencing and your health and fertility goals, they can recommend the best course of treatment for you.

Are there ways to improve or preserve fertility?

A healthy lifestyle can help you improve your fertility. There is some evidence that diet can affect testosterone levels. Certain nutrients, like selenium, zinc, and fenugreek can help increase testosterone, while high alcohol consumption and stress can have a negative impact on testosterone levels.

When it comes to sperm health, folate, omega-3s, selenium, vitamin C, vitamin E, and zinc are all important nutrients found in so-called “superfoods” for male fertility. Regular exercise can also help improve sperm health, while smoking, alcohol, drugs, and certain medications can poorly impact sperm health parameters. To learn more about how you can naturally improve your fertility, read our guide to sperm improvement.

Remember: while the tips in our guide can help improve your fertility and overall health, there is no way to completely prevent the natural effects of aging on sperm health and hormone levels. If you plan to have children later in life, or simply want the option just in case, the best way to preserve your fertility is through sperm freezing.

Learn more about how the sperm testing and freezing process works.

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