You may have not even heard of perimenopause in women, but it is the period of time leading up to menopause- which is when a woman’s period has not happened for 12 months.  Do men have the same time period and then just nothing? No, men do not have a true “menopause” type situation that occurs with age BUT they do have a gradual decline in their testosterone over time- very similar to the gradual changes that happen in perimenopause.  So, yes it is a peri-andropause of sorts- andro being the root of the word for the male sex hormone- there is just not a complete stop like women have.


A man’s testosterone can decline by 1% per year after age 40, but most men actually maintain normal testosterone levels, just lower than before.  Only 10-25% actually eventually have levels that register below normal ranges.  This is in contrast to women who will have estrogen and progesterone levels that are non-measurable when given enough time, usually by their mid 50s at the latest.


Taking a deeper look into the symptoms of low androgen, or low testosterone, there are some overlaps between how men feel when their testosterone drops, and how women feel in perimenopause and menopause.  Here are some examples of symptoms that are felt by both sexes:


  • Lower libido
  • Weaker bones or height loss
  • Hot flashes or sweats
  • Breast discomfort or swelling
  • Fatigue
  • Brain Fog
  • Loss of muscle mass
  • Increased body fat
  • Depression
  • Insomnia



Unique to male hormone loss are:

  • Male pattern baldness can occur vs when women lose hair in perimenopause and menopause it is more like shedding of the hair and it does not happen in patches
  • Decreased erections (well you could have guessed that one was unique to men right?)


So, what makes some men experience this and others not? It can be as nuanced and variable as the differences between women of the same age as they go through hormone changes.   However, there are a few chronic conditions that can make testosterone loss more likely to occur and these include- diabetes, obesity, heart disease and high blood pressure.  Often this is related to inflammation, and in the case of obesity it is related also to the excess fat tissue increasing male estrogen levels.  In turn, when testosterone drops to a certain low level, men can have an increased risk for heart disease and diabetes and osteoporosis.  A diet of processed carbs, high in sugar, low in fiber and/or inadequate clean protein or fats, as well as excess alcohol and/or smoking can all contribute too.


It’s important to understand that not just women are going through hormonal shifts with age, and that men can have their hormone levels followed by their physician through a simple blood test.  In fact it is easier to track and address this pattern change with men than it is with women.  This is because women experience a “roller coaster” of hormone changes in perimenopause- at times having estrogen surges and at times having plummets vs men having a slow and very gradual decline.


At our functional medicine practice, Highlands Health and Wellness, we offer help with hormones, not just for women, but for men too.  We look at hormone imbalance through a wide lens- examining nutrition, labs, lifestyle, and mind-body paths to help design an individualized plan that addresses nourishment, improving fitness, building healthy mindsets and relationships, and providing a holistic treatment plan made just for you!