Andropause: The Male Menopause No One Talks About (But Should)

Dr. Bilkisu Gaye

We’ve talked a lot about perimenopause and menopause. But this week, it’s all about the men—our partners, fathers, brothers, and sons. Let’s talk andropause, the gradual decline in male hormones that impacts energy, strength, mood, and even libido.


And yes—it’s real.



 What Is Andropause?


Andropause (sometimes called “male menopause”) is the slow, steady decline of key male hormones—especially testosterone—as men age. Unlike menopause in women, which happens over a shorter time frame, andropause creeps up quietly.


Symptoms can include:

  • Low energy
  • Irritability or depression
  • Decreased muscle mass
  • Belly fat gain
  • Low libido
  • Difficulty sleeping
  • Brain fog



Many men just chalk it up to “getting older.” But there’s more to the story—and help is available.



The Hormones That Matter Most


Here are three main androgens (male hormones) we look at and often replace in functional medicine:


1. DHEA

  • Acts as a precursor to both testosterone and estrogen
  • We check DHEA-S on labs
  • The DHEA-to-cortisol ratio gives a better picture of stress and hormone balance


Note: DHEA is banned by some sports organizations, and we don’t prescribe it for bodybuilders


2. Testosterone

  • The main male hormone—but not the whole story
  • As men age, Sex Hormone Binding Globulin (SHBG) increases, which lowers free testosterone
  • We want to keep a healthy testosterone-to-estrogen ratio (ideally 10:1)


Note for fertility: Testosterone therapy reduces sperm production. If fertility is a goal, we may consider other approaches.


3. DHT (Dihydrotestosterone)

  • A powerful form of testosterone
  • Plays a role in male pattern baldness and enlarged prostate (BPH)
  • If needed, we can block excess DHT with natural 5-alpha-reductase inhibitors like:
  • Zinc (with copper)
  • Avoiding plastics and processed soy
  • Weight loss is also key!



Testosterone Therapy (TRT): Safe or Risky?


This is where things get controversial. The FDA issued a black box warning about TRT and cardiovascular disease (CVD), but recent large prospective studies tell a different story:


No increased risk of heart disease in men treated with testosterone—up to age 80

❌ It didn’t show heart protection either, but the risk concerns appear overstated


  • As always, we inform patients of both sides so they can make empowered decisions.



What to Know Before Starting TRT


If testosterone replacement is right for you, we start slow and smart:


  • Begin with short-acting options (like creams or injections)
  • Never start with pellets—they last 3 months or more and make adjusting your dose harder early on
  • We fine-tune your dose until your levels stabilize
  • Then, if desired, pellets can be a convenient long-term option



Final Thoughts for Men (and the Women Who Love Them)


If you or the man in your life is feeling "off"—tired, moody, or just not like himself—it could be andropause.

There’s nothing weak or unmanly about wanting to feel good, think clearly, and enjoy life again.


At Designed4Wellness, we’re now offering BHRT (Bioidentical Hormone Replacement Therapy) as part of our functional medicine services. Our approach is personalized, evidence-based, and designed with your whole health in mind.



 💬 Ready to Feel Like Yourself Again?


📲 Text “ANDROPAUSE” to us on what’s app (678-595-7674) to learn more

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