In recent years, society has made significant strides in raising awareness and combating the stigma associated with menopause. However, as the conversation evolves, it’s becoming clear that it’s not just women who can be affected by hormonal fluctuations.
Some men also experience changes in hormone levels that impact their mental, physical, and sexual health. Dr Sabah Salman, a GP at LloydsPharmacy Online Doctor, believes it’s time to raise awareness about low testosterone.
“When some men reach their 40s or 50s, they experience mental and physical symptoms such as depression, loss of sex drive and erectile dysfunction. There is some overlap between symptoms of menopause and low testosterone – mood swings, difficulty sleeping and changes in body shape,” she explains. “
The NHS discourages the use of the term ‘male menopause’. It says the term is unhelpful and misleading because it falsely suggests symptoms are the result of a sudden drop in testosterone in middle age.” “In reality, men experience a steady decline in testosterone. From around the age of 30 to 40, men’s testosterone levels reduce by about 1% each year.” Dr Salman said low testosterone doesn’t always result in symptoms, reports Surrey Live.
Common signs of low testosterone
Dr Salman said low testosterone doesn’t always result in symptoms. However, there are a range of signs associated with low testosterone:
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Mood swings and irritability
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Depression
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Loss of muscle mass and reduced ability to exercise
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Fat redistribution, such as developing a large belly or “man boobs” (gynaecomastia)
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A general lack of enthusiasm or energy
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Difficulty sleeping (insomnia) or increased tiredness
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Poor concentration and short-term memory
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Loss of sex drive
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Erectile dysfunction
Dr Salman explained: “Menopause affects women and people who menstruate, occurring when a sudden drop in hormone levels causes menstrual periods to stop. It usually affects women between 45 and 55, but can happen earlier.”
“There are over 30 recognised symptoms of menopause. Those impacting mental health can include anxiety, mood swings, and difficulty concentrating. Hot flushes, difficulty sleeping and changes in body shape are common physical symptoms. For women, symptoms of menopause can last for months or years, and some symptoms, such as joint pain, can continue after your periods have stopped.”
However, there is a lack of understanding about low testosterone, public knowledge of “male menopause”, or low testosterone, and its symptoms. According to a survey conducted by LloydsPharmacy Online Doctor, while 95% of UK adults had heard of the term ‘menopause’, almost half (49%) had heard of ‘male menopause’ and related terms.
Similarly, while 84% said they could define menopause, less than half said the same of male menopause. And while 92% were aware of some of the symptoms of menopause, just 60% could not name any “male menopause” symptoms.
Other factors that contribute to low testosterone include hypogonadism, which Dr Salman explained: “Hypogonadism is the medical term for testosterone deficiency, which can impact men of any age. Low testosterone can be caused either by an issue in the testes themselves (where testosterone is produced) or the part of the brain that controls the function of the testes.”
On the link between type 2 diabetes and low testosterone levels, Dr Salman remarked: “Health data suggests that there is a link between type 2 diabetes and low testosterone. NHS statistics indicate that around 16% of males with type 2 diabetes have lower-than-normal testosterone levels.”
Addressing the issue of obesity, Dr Salman noted: “Studies have demonstrated a link between obesity and low testosterone levels. In fact, it’s estimated that a one-point increase in BMI can lead to a 2% decrease in testosterone. Similarly, a four-inch increase in waist circumference is approximated to raise a man’s odds of having low testosterone by 75%.”
Exploring why diagnosing low testosterone can be difficult, Dr Salman explained: “Low testosterone can be hard to diagnose because low testosterone levels in men often go undiagnosed. Although testosterone levels can be easily checked by a blood test, tests aren’t routinely carried out.”
“Plus, the symptoms of low testosterone aren’t specific to the condition. Erectile dysfunction, low libido and mood swings, for example, may be the result of stress, anxiety or depression. But as these symptoms can interfere with everyday life and happiness, it is important to find the underlying cause and assess what can be done to resolve them.”
Dr Salman has highlighted the treatment options and increasing demand for Testosterone Replacement Therapy (TRT), which may be issued via injections or topical gels amid rising NHS prescriptions. He remarked: “If your own body does not make enough testosterone, testosterone replacement therapy (TRT) may be recommended. This can come in the form of injections or topical gels.”
Such insight comes as NHS data shows a 22% spike in TRT prescriptions during 2023, with expenditure crossing the £13.5 million threshold on testosterone in 2024.
Dr Salman further noted: “It’s worth noting that TRT isn’t just prescribed to men experiencing symptoms of low testosterone, it can also be recommended as a treatment for women who have a low sex drive during menopause and trans men as part of their transition. Like most medications, TRT carries some risks. Side effects may include increased appetite, weight gain, acne, excessive sweating and mood changes.”
He warned: “Taking testosterone can also thicken your blood, increasing your risk of heart attack, stroke and blood clots. It can also cause an enlarged prostate or other prostate disorders. TRT can also affect sperm production which could impact your fertility. If you are considering having children in the future, you should discuss this with your endocrinologist before starting treatment.”
In addition to these considerations, Dr Salman underscored: “Due to risks associated with TRT, it’s important you only take testosterone prescribed by a doctor. Anabolic steroids or testosterone boosters are manufactured drugs that copy the effects of testosterone.”
“There is a trend among gym-goers for taking this addictive, synthetic form of testosterone, believing they can increase muscle mass and decrease fat. But taking anabolic steroids carries serious health risks.”
“It is illegal to sell testosterone without a prescription in the UK – and for good reason. The potentially life-threatening risks associated with taking testosterone mean it should only be prescribed by a doctor after careful consideration. Regular monitoring, including blood testing, is required to screen for adverse side effects.”
