Does Male Menopause Exist?
Andropause or "male menopause” refers to age-related hormonal changes involving declining testosterone levels, though it differs significantly from female menopause. Here, Dr Sohere Roked GP, Functional Medicine & Hormone Doctor, discusses the process of identifying and treating symptoms of the Manopause.
In clinic, I see a variety of male patients seeking support for gut health and stress management, but more often than not it is for testosterone replacement therapy (TRT). Many of these men share the same story, their energy is depleted, their mood has taken a nosedive, and they are struggling to keep up with the demands of daily life. They feel older, more irritable, and worn out.
A natural decline in testosterone is something many men experience as they age. While it may not be as dramatic as menopause in women, it is completely normal. If a man is feeling less motivated, fatigued, or like they’re not firing on all cylinders, it may be worth checking their testosterone levels with a GP or hormone specialist.
When assessing all patients, I take a comprehensive and personalised approach. My first priority is to rule out any underlying health conditions and ensure that the liver is functioning optimally to process subsequent therapy. This includes an in-depth conversation about lifestyle habits, stress levels, and how these factors may be contributing to hormone imbalances. Additionally, I conduct a series of medical checks, including blood pressure, cholesterol levels, diabetes markers, prostate health, heart health and liver function.
In some cases, I’ll refer patients to a cardiologist or liver specialist to ensure that their heart and liver health are in good shape before we begin any treatment.
Tailored Testosterone Therapy
Testosterone has faced criticism in some circles, largely due to its misuse by gym-goers and bodybuilders looking to boost muscle mass. However, my approach is entirely different. The goal isn’t to push levels above what is physiologically normal, it is to restore balance and help men regain their natural vitality.
Testosterone therapy comes in several forms, each designed to fit different needs and lifestyles. I work closely with patients to determine the best approach for their unique circumstances, which may involve: -
Topical Gel or Cream: Applied to the arms or legs daily for consistent absorption.
Injections: Options include long-acting injections every 9–12 weeks or shorter-acting doses every few weeks.
Clients experiencing the andropause often do not realise that their changing hormones are affecting mood. It is so little talked about. I find that a combination of talking about feelings and thoughts alongside working with Dr Sohere can lead to overall improvements in just a few sessions. We need to spot this earlier and talk about it more. Awareness around the andropause is lagging behind menopause awareness and we need to catch up.
The results of testosterone therapy can be transformative. I’ve seen patients achieve dramatic improvements in their energy levels, mood, and overall sense of wellbeing. For some, testosterone therapy has even contributed to better heart health. Despite concerns that testosterone might harm the heart, studies suggest this risk is only present in those with pre-existing heart issues. For many men, balanced testosterone levels can actually support cardiovascular health.
One ingredient, two regulatory timetables and shelves full of near-identical bottles. The new TPO rules call for a forensic look at stock, suppliers and lamps, not a panicked exit from gel. On a salon shelf, the change is almost invisible. The same orderly rows of builder gels, bases, top coats and colour remain in place, their labels as polished as ever. Yet a single line in an ingredient list now determines whether a product may enter the Great Britain market, how long existing stock may be supplied and what a salon should replace next. The three letters causing the stir are TPO. Online, the story has already been compressed into the sort of headline that travels quickly and explains very little: gel has been banned; every bottle must be binned; TPO and HEMA are the same problem but none of those statements are accurate.