The treatment of male menopause aims to alleviate symptoms, restore hormone balance, and improve the overall quality of life. Because male menopause, or andropause, is often linked to declining testosterone levels and a host of physical and psychological effects, a tailored, evidence-based approach is essential. Treatment of male menopause usually combines hormone replacement therapy, lifestyle changes, management of comorbidities, and psychological support.
This section outlines the most effective strategies, including testosterone therapy, natural methods, and when medical intervention becomes necessary.
Understanding the Treatment Approach
Before starting treatment, it’s important to confirm that testosterone levels are consistently low. A proper diagnosis requires both symptoms and lab-confirmed hormonal deficiency. Treating without these can create unnecessary risks.
Several factors guide the treatment plan:
- Age and general health
- Symptom severity
- Testosterone levels
- Co-existing health conditions
- Personal preferences
The most effective results come from a team approach. This may include GPs, endocrinologists, and mental health professionals working together.
1. Testosterone Replacement Therapy (TRT)
The most common medical treatment of male menopause is testosterone replacement therapy (TRT). Its goal is to restore testosterone to normal levels and reduce symptoms.
Main forms of TRT include:
- Gels or creams: Applied daily to the skin. Easy to use but must be kept away from others.
- Injections: Given every few weeks. Can cause hormone level swings.
- Patches: Applied daily, though they may irritate the skin.
- Pellets: Implanted under the skin every few months. Requires a simple procedure.
- Oral tablets: Rarely used due to liver effects and inconsistent results.
TRT may improve:
- Sex drive and erections
- Energy and focus
- Muscle mass and bone strength
- Sleep quality and overall mood
However, there are risks:
- May worsen prostate cancer
- Can raise red blood cell count
- Might trigger sleep apnoea
- Could cause acne, breast tenderness, or infertility
Doctors monitor patients on TRT with blood tests. These track prostate health, liver function, and blood thickness to ensure treatment remains safe.
2. Natural and Lifestyle-Based Treatments
For mild cases or borderline hormone levels, lifestyle changes can be enough. These strategies may naturally support hormone balance and ease symptoms.
Effective habits include:
- Exercise: Strength training and interval workouts boost testosterone and reduce fat.
- Diet: Whole foods, healthy fats, and plenty of vegetables support hormone health.
- Sleep: Getting 7–9 hours of rest helps regulate hormones and mood.
- Stress reduction: Chronic stress lowers testosterone. Use mindfulness or therapy.
- Avoiding alcohol, smoking, and drugs: These weaken hormone function.
- Weight loss: Belly fat increases oestrogen and lowers testosterone. Losing it helps.
Useful supplements (with medical approval):
- Zinc
- Magnesium
- Vitamin D
- Ashwagandha or fenugreek
- DHEA (only under supervision)
While these won’t replace medical treatment, they can support it—especially when combined with lifestyle changes.
3. Treating Related Medical Conditions
Sometimes, the symptoms of male menopause come from other health issues. In these cases, fixing the root cause can relieve symptoms without testosterone therapy.
Examples include:
- Diabetes or metabolic syndrome: Managing these often boosts hormone levels.
- Thyroid problems: Correcting these can lift mood and energy.
- Sleep apnoea: Treatment improves sleep and testosterone production.
- Mental health issues: Addressing depression or anxiety may improve libido and motivation.
When low testosterone is a result—not a cause—of another condition, treating that condition first may be best.
4. Emotional and Relationship Support
Emotional symptoms like low mood, irritability, and loss of confidence are common. These often affect relationships, work, and daily life.
Men can benefit from:
- Individual therapy: Especially cognitive behavioural therapy (CBT).
- Couples counselling: Helpful when low libido or mood swings cause tension.
- Support groups: Talking with others facing similar issues reduces isolation.
Encouraging open conversations helps break stigma and promotes healthier coping.
5. When TRT Isn’t the Right Choice
Testosterone therapy doesn’t suit everyone. In fact, it should be avoided in some cases.
TRT is not recommended for men who have:
- Prostate or breast cancer (past or present)
- Untreated sleep apnoea
- High red blood cell counts
- Uncontrolled heart failure
- Fertility concerns (TRT can lower sperm count)
- Normal testosterone with mild or no symptoms
In these cases, lifestyle changes or targeted treatment of underlying issues are safer and more appropriate.
Monitoring and Long-Term Care
The treatment of male menopause is not a one-time fix. Ongoing medical supervision is key to keeping symptoms under control and avoiding risks.
Doctors should:
- Reassess symptoms regularly
- Check hormone levels
- Monitor side effects and health markers
- Adjust treatments as needed
Follow-ups are usually scheduled 3–6 months after starting therapy, then once a year. This ensures that benefits continue and risks stay low.
Conclusion
The treatment of male menopause involves more than just replacing testosterone. It’s about supporting the whole person—physically, mentally, and emotionally. While TRT helps many men, it’s not always needed. Some improve through lifestyle changes, stress reduction, and treating related conditions.
Ongoing medical care, open communication, and a commitment to healthy living offer the best path to recovery. With the right approach, men can regain energy, confidence, and quality of life.
