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Krista DeMaio

Updated: 04/04/2022

When it comes to hormonal shifts, women have to deal with a lot — especially when they stop menstruating and reach menopause, prompted by a decline in estrogen (the female sex hormone) that can bring on full-body changes including loss of muscle mass, fatigue, hot flashes, dry skin and hair, lower sex drive, sleep disturbances and more.

Clearly, men don’t go through the same biological transformation as women, but they do have hormones, which begs the question: Do guys’ hormones go haywire in mid-life too? The answer: Kind of, but not really.

What Men Experience

Men’s hormones dip with age, but it’s not the abrupt change we see with menopause, says Karyn Eilber, MD, associate professor of Urology and Gynecology at Cedars Sinai in Los Angeles. “Some people use the term 'andropause' [androgens are male hormones], but this is misleading because it implies that male hormonal changes occur similarly to the way they do in females,” she says.

The male sex hormone testosterone plays a role in muscle mass and strength, facial hair, bone density, libido regulation and fat distribution, among other things that make a man, well, masculine. Testosterone does decline, starting in the 30s or 40s, says Dr. Eilber, but it’s not a dramatic drop like there is with menopause. “Because the hormonal decline is slow, some men may not even feel affected, while others may notice a decrease in libido and a loss in muscle mass and energy,” she explains.

Dr. Frank Lipman, MD, Chief Medical Officer of THE WELL, echoes these sentiments: "Men do go through their own hormonal change, but it's not as pronounced so they may not even notice. If they do notice any symptoms, the best treatment is often just taking good care of their overall health — eating nutrient-dense foods, getting enough sleep, exercising (outdoors, if possible) and reducing stress."

However, to complicate matters, a recent study published in Clinical Endocrinology suggested that hormone-related changes and symptoms men experience with age may not necessarily be due to dwindling testosterone but rising sex hormone-binding globulin (SHBG), a protein produced by the liver that binds to testosterone (as well as the other two sex hormones, estrogen and dihydrotestosterone, DHT). “The more SHBG there is, the less available testosterone (estrogen) there is circulating throughout the body,” says Dr. Eilber.

The above-mentioned study looked at changes in serum testosterone and SHBG in 6,500 men between 40 and 69 with a follow up period of 4.3 years. The researchers found that the change in serum testosterone was subtle, but there was a significant increase in SHBG. “High SHBG levels can result in low libido, erectile dysfunction, loss of energy and even hot flashes,” says Dr. Eilber.

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How men can get back into balance

None of us can halt the natural aging process, but it pays to find out if hormonal fluctuations are due to age or other factors.

Dr. Eilber says increased SHBG levels can be seen with specific conditions, such as thyroid disease and liver disease, and they can also increase due to alcohol consumption, stress and poor nutrition. Similarly, lower testosterone levels are associated with a sedentary lifestyle, alcohol, certain infections, poor sleep (and sleep disorders such as sleep apnea), stress and depression. “Like most ailments, living a healthy lifestyle can help counteract these changes,” she says.

If you suspect you’re dealing with a hormonal imbalance, a functional medicine practitioner can measure testosterone levels via a saliva or blood test. They can also do tests to determine how your gut health and other organs, such as your liver or pituitary gland, may be affecting your male hormones.

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So, “man-o-pause” may not be on par with menopause, but men do experience gradual hormonal shifts with age that can trigger a number of very real symptoms.

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