Hormones . Symptoms guide
Andropause (Male Menopause): Symptoms and Testing
Quick answer
Andropause (late-onset hypogonadism) describes the gradual fall in testosterone that begins in many men from their late 30s onward. Whether symptoms appear depends on the rate of decline and individual sensitivity. Morning testing of total and free testosterone, SHBG, LH and thyroid distinguishes andropause from other causes of the same symptoms. SHBG calculates the bioavailable testosterone fraction and LH helps separate testicular versus pituitary causes.
This patient information is being clinically reviewed by our team. The factual content draws on UK guidance (NHS, NICE, British Association of Dermatologists, and other specialist society guidance where cited).
What this might be
- Age-related decline. Roughly 1 percent per year fall after age 30 to 40; symptoms appear at variable thresholds.
- Obesity and metabolic syndrome. Adipose tissue converts testosterone to oestrogen, accelerating apparent decline.
- Sleep apnoea. Disrupts overnight testosterone production; worth assessing if symptoms persist.
- Medication and substance contributors. Opioids, glucocorticoids, alcohol and anabolic steroid use all suppress production.
Common features that suggest this
- Reduced energy and motivation
- Lower libido or erectile changes
- Mood changes or irritability
- Reduced muscle bulk despite training
- Increased abdominal fat
- Hot flushes (uncommon but reported)
Recommended tests
Same-day appointments at our Harley Street clinic, results clinician-reviewed.
Need a marker not in these panels? Build a custom panel and a GMC-registered clinician will design one for you.
Markers your clinician will commonly look at
These are the individual blood markers in the recommended panels above. Click any to read what it measures, its UK reference range, and what high or low values mean.
Testing advice
Morning appointment strictly between 7:00 AM and 11:00 AM. Fast (water only) for at least 8 hours before the draw, as food intake can drop testosterone by up to 30 percent and produce a misleading low result. Repeat testing on two separate days is best practice before considering treatment.
Common questions
When should I consider testosterone replacement?
Only after confirmed low levels on two morning fasted samples plus consistent symptoms, and after a clinical discussion of risks and monitoring. Bloodwork is the foundation but not the whole decision.
Is private testing better than NHS?
Private testing bypasses standard primary care triage barriers, providing rapid access to a comprehensive profile (total and free testosterone in the same draw, plus LH, FSH, prolactin and SHBG where indicated) without needing to meet strict NHS testing criteria first.