Even though all men will biologically experience a decline in testosterone, not all men will experience the symptoms related to low testosterone that get referred to as “male menopause” — or require diagnosis or treatment.
Many men who start out with testosterone levels that are average or within the healthy range when they’re younger will still have normal levels as they get older, even as testosterone declines with age, Ghayda says.
“It’s the men who start out in the lower end of the normal range and then go through that steady decline of 1 percent a year as they age who can end up with such a substantial decline that they wind up with ‘male menopause,’” Ghayda says — or symptoms of age-related low testosterone that require treatment.
- Testicular injury or infection
- Radiation or chemotherapy treatment for cancer
- Some medications such as opiate painkillers or injected corticosteroids
- Hormone disorders such as pituitary tumors or diseases or excessive production of the hormone prolactin that reduce testosterone production
- Chronic conditions such as liver or kidney disease, obesity, sleep disorders, type 2 diabetes, or HIV/AIDS
- Genetic conditions such as Klinefelter syndrome, hemochromatosis, or Kallmann syndrome
- Anabolic steroid use
Doctors will rule out these things before considering a diagnosis of age-related low testosterone, or male menopause, Ghayda says.
Men can’t completely prevent male menopause because it’s an age-related process and it depends on how much testosterone they naturally produce. But they can take steps to potentially slow down how rapidly their testosterone levels decline over time, Ghayda says. “Anything that’s good for your overall health and well-being is also going to be good for your testosterone levels.”
Both these risk factors and aging can independently depress testosterone. That means for some men, losing weight or achieving healthy blood sugar levels might be enough to raise testosterone so that when they do start to lower naturally with age, they don’t dip so low that they cause symptoms, Ghayda says.
He advises everyone to focus on healthy eating (meaning load up on greens, and limit or avoid added sugar, trans fat, and processed food), focus on managing stress, getting enough sleep, and exercise (including muscle-building activities). He also suggests abstaining from smoking and limiting alcohol. “All these things can help prevent chronic diseases and also help with testosterone levels,” Ghayda says.