Andropause erectile dysfunction affects many men in their 60s and beyond. Research shows that 2 in 10 men over 60 have low testosterone levels. This number rises to 3 in 10 for those in their 70s and 80s. People often call it 'male menopause', but andropause causes hormones to change gradually, unlike the sudden changes women experience.
Andropause in males happens when testosterone production naturally declines. Most men don't realise this process starts much earlier. The body produces 1-2% less testosterone each year after age 30, but the effects become much more visible after 60. Lower hormone levels can trigger several symptoms, especially erectile dysfunction. Male menopause and erectile dysfunction share a strong connection. Research points to this hormonal change as a key factor that leads to reduced libido, erectile problems, and less sexual satisfaction. Men over 60 who understand how andropause affects these symptoms can take better steps to find the right erectile dysfunction treatment.
What is Andropause and How It Affects Men Over 60
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Men's hormones change as they age, unlike the sudden changes women experience during menopause. Medical communities now pay more attention to this gradual decline in male hormones. Scientists better understand how it affects men's health, especially regarding andropause erectile dysfunction.
Understanding the term 'male menopause'
People often misuse the term 'male menopause' because it suggests a sudden drop in hormones like female menopause. Medical professionals call it 'andropause' or late-onset hypogonadism. Female menopause happens over a short time and ends reproductive years. Andropause takes much longer [1].
Most men experience andropause between ages 40 and 60, though it can start earlier or later based on health factors [1]. NHS experts say this label can mislead people since it wrongly suggests symptoms come from a sudden mid-life testosterone drop [2].
Men's testosterone levels decline steadily over time rather than dropping suddenly. Many men might not notice any symptoms, making this condition less common than female menopause.
How testosterone changes after age 60
Testosterone changes become more noticeable for many men after 60. Studies show about 20% of men over 60 have lower than normal testosterone levels. This number rises to 50% for those above 80 [3].
Men lose testosterone naturally by about 1.6% each year after their mid-30s [4]. A 75-year-old man typically has 30% less testosterone than he had at 25 [4]. Free and bioavailable testosterone - the body's most active forms - drop even faster at 2-3% yearly [3]. This happens partly because ageing increases Sex Hormone Binding Globulin (SHBG) levels, which bind testosterone and reduce its availability in the body.
Men in their sixties might notice these symptoms:
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Lower sex drive and sexual function
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Less muscle and more body fat
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Tiredness and low energy
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Mood swings with irritability and depression
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Poor sleep
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Memory and concentration problems
Is andropause the same as low testosterone?
Andropause and low testosterone share similarities but aren't the same thing. Age causes andropause, while low testosterone (hypogonadism) can happen anytime for various reasons [2].
"Andropause belongs to the ageing process but isn't a disease by itself," says Dr. Robert H. Eckel, professor of medicine emeritus at the University of Colorado [4]. Some health conditions like obesity, type 2 diabetes, and sleep apnea can cause bigger drops in testosterone than normal ageing [2].
Low testosterone without symptoms shouldn't worry you too much [4]. You might need medical help when low hormone levels combine with symptoms that affect your life quality, especially erectile dysfunction.
Doctors diagnose andropause through low testosterone measurements and clinical symptoms. Healthcare guidelines require several blood tests because testosterone levels change throughout the day, and "normal" means different things for different people [4].
Men worried about andropause symptoms, particularly those affecting sexual function, should talk about natural remedies for andropause with their doctors before trying hormone replacement.
Common Symptoms of Andropause and Erectile Dysfunction
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Men experience andropause symptoms in many ways. These symptoms affect their quality of life as they age. Most men dismiss these changes as "getting older" because the symptoms show up slowly. They don't realise these conditions can be treated.
Sexual symptoms: low libido and erectile issues
Sexual changes are the clearest signs of andropause in older men. About 28.4% of men who seek treatment for andropause symptoms have erectile dysfunction (ED) [5]. The numbers jump to 39-49% for men between 60-70 years [5]. These issues are the main reason men visit their doctors [6].
Sexual symptoms typically include:
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Decreased libido (sexual desire)
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Erectile dysfunction (difficulty achieving or maintaining erections)
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Reduced frequency of morning erections
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Decreased erectile strength
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General loss of interest in sexual activity [7]
These changes can strain previously happy intimate relationships. Many men look for natural remedies for male andropause when these symptoms begin.
Physical symptoms: fatigue, weight gain, muscle loss
Andropause does more than affect sexual function. Men often feel tired and have less energy [8]. Their bodies change too - they lose muscle mass and strength while gaining fat around their middle [9].
The NHS notes that men might develop a "large belly" or "man boobs" (gynaecomastia) [8]. Men find it frustrating when these changes happen even though they exercise regularly. Low testosterone can also reduce haemoglobin levels by 10-20%, which might lead to mild anaemia [9].
Mental symptoms: mood swings, memory problems
Andropause's psychological effects can be serious. Men often experience mood swings, feel irritable, and become unexpectedly depressed [8]. Japanese studies show that about half the men seeking andropause treatment have major depressive disorder [5].
Brain function usually declines. Men report problems with concentration and short-term memory [8]. Research shows that lower free testosterone levels lead to worse cognitive performance, especially in older men [9]. These mental symptoms can hurt work performance, relationships, and life satisfaction.
How symptoms differ between ages 60–70 and 70+
Age makes andropause symptoms worse. Two out of 10 men between 60-70 years have low testosterone levels [9]. The numbers rise to 3 in 10 for men in their 70s and 80s [9].
Research shows that 18.4% of men over 70 have hypogonadism, compared to just 3.1-7.0% of men aged 30-69 [9]. This shows how testosterone levels drop faster as men get older. ED becomes a bigger issue too, affecting almost half of men in their 60s [1].
Vitamins that boost testosterone levels might help men deal with these symptoms, especially as they get older.
What Causes Andropause and Erectile Dysfunction in Older Men
Why andropause causes erectile dysfunction is complex, with both biological processes and outside factors playing key roles. Men can find better treatments and lifestyle changes by knowing what causes these issues.
Natural testosterone decline with age
The gradual drop in testosterone production as men age drives most andropause symptoms. Testosterone levels start to drop by about 1-2% each year after age 40 [10]. This change happens slowly over time, not all at once. A healthy 75-year-old man has less than half the bioavailable testosterone compared to men between 20 and 30 years [11]. This happens because the hypothalamic-pituitary function and Leydig cells in the testes start working less effectively [12]. Most men notice changes in their sexual function by their 60s as testosterone levels drop.
Lifestyle factors: diet, alcohol, smoking, stress
Daily habits can affect hormone levels and erectile function. Men who eat poorly, skip exercise, drink too much, or smoke tend to have lower testosterone levels [13]. Alcohol raises sex hormone-binding globulin (SHBG) levels, which leaves less free testosterone in the body. The same happens to men who smoke more than 10 cigarettes each day [2].
Ongoing stress can disrupt sexual function. The body makes more cortisol when stressed, which blocks testosterone production - the key hormone for sex drive and erections [14]. Poor sleep from stress creates more problems, as lack of sleep affects testosterone levels, dopamine receptors, and blood flow [14].
Health conditions: diabetes, obesity, heart disease
Several health issues can affect both andropause and erectile function. Low testosterone shows up in 30% of overweight men, but only 6% of men at normal weight [12]. Type 2 diabetes also matters - 25% of men with diabetes have low testosterone, compared to 13% without it [12].
Heart problems often cause erectile issues because they share the same root cause - endothelial dysfunction [15]. Erectile dysfunction may predict cardiovascular events 2 to 5 years before they occur [15]. High blood pressure doubles the risk of ED in men with systolic pressure above 140 mmHg [15].
Psychological triggers and midlife stress
Mental and emotional health can trigger or worsen erectile problems. The "midlife crisis" brings career and personal anxieties that may lead to depression [8]. These worries create performance anxiety, starting a cycle where concern about erections leads to actual problems, causing even more worry [14].
Relationship issues can also affect erectile function. Poor communication or emotional distance creates stress that interferes with sexual performance [16]. Depression and ED are closely linked - men with erectile problems face three times the risk of depression [17].
How Andropause and Erectile Dysfunction Are Diagnosed in the UK
""Male hypogonadism in the older man is a challenging diagnosis to make," Eckel said, requiring "both biochemical measurements and a good history and physical examination."" — Robert H. Eckel, Professor of Medicine, University of Colorado; past president of the American Heart Association
Getting a proper diagnosis is the first crucial step for men who experience andropause erectile dysfunction. The UK healthcare system provides clear paths to assess symptoms and determine if they come from hormone changes or other conditions.
When to see your GP
You should see your GP if you notice ongoing symptoms like decreased sex drive, problems with erections, tiredness, or changes in your mood. Many men feel uncomfortable talking about these personal issues, but research shows that erectile dysfunction affects nearly half of all men over 40 [18]. The NHS recommends a doctor's visit to get the full picture since various factors beyond andropause can cause these symptoms [8]. Your GP will ask about your personal situation and lifestyle habits that might affect your health.
Blood tests: testosterone, SHBG, LH, FSH
We used blood tests to measure hormone levels:
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Total testosterone (treatment is needed if levels fall below 8 nmol/l) [3]
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Sex Hormone Binding Globulin (SHBG) helps calculate free testosterone
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Luteinising Hormone (LH) and Follicle Stimulating Hormone (FSH) show if the issue stems from testicular or pituitary problems
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Prolactin levels need checking when testosterone is very low [3]
Men with borderline results between 8-12 nmol/l might need more tests [3].
Other checks: BMI, PSA, ECG, bone density
Doctors perform several other important assessments among the blood tests:
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BMI calculations show your weight status
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PSA screening checks prostate cancer risk, especially in men over 50 [2]
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ECG readings measure heart function
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Bone density scans detect osteoporosis [2]
These complete checks help rule out other possible causes of your symptoms.
What to expect from a testosterone test in the UK
The NHS requires two blood samples from your arm [19]. The samples need collection at 9am when testosterone peaks naturally [19]. Your diagnosis depends on both samples showing testosterone levels at or below 8nmol/L [19]. Lab results usually come back within 24 hours, though some specialised tests take longer [20].
Treatment Options: From Natural Remedies to Hormone Therapy
A tailored approach works best to treat andropause erectile dysfunction. You can start with simple lifestyle changes before trying hormone therapy.
Lifestyle changes that support testosterone
Weight loss is the quickest way to naturally help with andropause symptoms. Your testosterone levels go up by about one point each time your BMI drops by one point [4]. Exercise also makes a big difference - resistance training can boost your testosterone levels by up to 21.6% [4]. Getting enough sleep is vital since your body produces most testosterone during REM sleep [21]. Lower stress levels help too, as they prevent cortisol from interfering with testosterone production [22].
Nutrition and supplements for men's health
What you eat directly affects your hormone balance. Your diet should include foods rich in zinc (shellfish, red meat), vitamin D, and healthy fats [21]. Taking supplements can help too. Men who took 3,332 IU of vitamin D daily for a year saw their testosterone levels rise by 25% [4]. Like in the case of vitamin D, magnesium supplements (450mg daily) increased testosterone by 24% in active people [4]. Zinc supplements work well too, especially if you have low zinc levels [23].
Image Source: emas-online.org
When is testosterone replacement therapy (TRT) needed?
The NHS usually suggests TRT if you show symptoms and have low testosterone levels [8]. You might need TRT if you experience sexual dysfunction and your testosterone drops below 8 nmol/l [24]. TRT can be extra helpful if you have type 2 diabetes, a BMI over 30, or take medications with certain side effects [2].
Risks and side effects of TRT
TRT benefits come with some risks, including higher chances of cardiovascular problems [25]. Oral TRT shows substantial cardiovascular risks, though injections or topical treatments seem safer [25]. You should also know about other risks like prostate enlargement, worse sleep apnea, and possible polycythaemia (too many red blood cells) [24]. TRT isn't safe if you have breast cancer, prostate cancer, untreated sleep apnea, or class III/IV heart failure [2].
Monitoring and follow-up care
Regular monitoring is a must once you start TRT. Blood tests check if your testosterone stays at normal levels [2]. Your doctor will also do PSA tests and rectal exams to keep track of your prostate health [2]. These checkups include lipid profiles and red blood cell counts since treatment can affect them [24]. Most patients see their doctor twice a year to adjust dosages as needed [26].
Conclusion
Many men over 60 experience andropause erectile dysfunction, yet they don't know why it happens. Andropause shows up as a slow decrease in testosterone levels, which makes it different from female menopause's sudden hormone changes. The effects on daily life can be just as severe, especially when erectile dysfunction shows up among other symptoms.
Men who notice ongoing symptoms should talk to their GP right away. Many feel hesitant to bring it up, but erectile dysfunction affects nearly half of men over 40. This condition is nowhere near as rare as most people think. The UK healthcare system provides detailed testing options. These include hormone tests and health checks to find the right treatment approach.
Your personal situation determines which treatment works best. Simple lifestyle changes often help without needing medicine. Weight loss, exercise, less stress, and good sleep help your body make testosterone naturally. Natural approaches to natural remedies for andropause show good results. Supplements like vitamin D can help improve hormone levels.
Some men have low testosterone levels and troublesome symptoms. For them, testosterone replacement therapy might help, but they need to think over the potential risks and get regular checkups. Each person's experience with andropause is unique, so personalised treatment works best.
Learning about andropause is a vital step to keep your sexual health and overall wellbeing as you age. Talking about erectile dysfunction might feel awkward, but dealing with it early helps men find effective solutions instead of suffering quietly. Remember, andropause symptoms are common but they don't have to control your later years.
Key Takeaways
Understanding andropause and its connection to erectile dysfunction empowers men over 60 to take proactive steps towards better health and quality of life.
• Andropause affects 2 in 10 men over 60, rising to 3 in 10 for those in their 70s and 80s, causing gradual testosterone decline rather than sudden hormonal shifts.
• Erectile dysfunction occurs in 28-49% of men aged 60-70 with andropause, alongside fatigue, weight gain, mood changes, and cognitive difficulties.
• Lifestyle changes like weight loss, regular exercise, and adequate sleep can naturally boost testosterone levels by up to 25% without medication.
• NHS diagnosis requires two morning blood tests showing testosterone below 8 nmol/L, plus comprehensive health assessments including PSA and cardiovascular checks.
• Treatment ranges from natural remedies and supplements to testosterone replacement therapy, with regular monitoring essential for optimal outcomes and safety.
Men experiencing persistent symptoms shouldn't suffer in silence—nearly half of men over 40 face similar challenges, and effective solutions exist through proper medical consultation and personalised treatment approaches.
FAQs
Q1. What are the main symptoms of andropause in men over 60? The main symptoms include decreased libido, erectile dysfunction, fatigue, weight gain (especially around the midsection), reduced muscle mass, mood swings, and cognitive issues like poor concentration and memory problems.
Q2. How is andropause diagnosed in the UK? Diagnosis typically involves blood tests to measure hormone levels, particularly testosterone. The NHS usually requires two morning blood samples showing testosterone levels of 8 nmol/L or less. Additional assessments may include BMI calculation, PSA screening, ECG, and bone density scans.
Q3. Can lifestyle changes help with andropause symptoms? Yes, lifestyle changes can significantly improve andropause symptoms. Weight loss, regular exercise (especially resistance training), stress reduction, and getting adequate sleep can all help support natural testosterone production and alleviate symptoms.
Q4. When should testosterone replacement therapy (TRT) be considered? TRT is typically recommended when a man experiences significant symptoms of andropause alongside confirmed low testosterone levels (below 8 nmol/L). It may be particularly beneficial for men with type 2 diabetes, those who are overweight, or those at risk of side effects from certain medications.
Q5. Are there any risks associated with testosterone replacement therapy? Yes, TRT carries potential risks including an increased risk of cardiovascular issues, prostate gland enlargement, worsening of sleep apnoea, and possible polycythaemia (excessive red blood cell production). Regular monitoring is essential to manage these risks effectively.
References
[1] - https://www.bupa.co.uk/newsroom/ourviews/sexual-health-ageing-men
[2] - https://www.baus.org.uk/patients/conditions/7/male_menopause_androgen_deficiency_in_the_ageing_male/
[3] - https://www.endocrinology.org/media/1454/10-12-01_uk-guidelines-androgens-male.pdf
[4] - https://goldmanlaboratories.com/blogs/blog/natural-remedies-andropause?srsltid=AfmBOorrccWG7eA4ock774LRNuoH1nihT_hd6PkGVMY4qq1KpMbFtKBU
[5] - https://pmc.ncbi.nlm.nih.gov/articles/PMC3677807/
[6] - https://thriva.co/hub/mens-health/male-menopause
[7] - https://hormoneclinic.uk/male-menopause-causes-signs-symptoms-diagnosis-and-treatment/
[8] - https://www.nhs.uk/conditions/male-menopause/
[9] - https://goldmanlaboratories.com/blogs/blog/andropause-men-over-60?srsltid=AfmBOoqUlsjs3F9xLF01Tr1Vc1-nmKW_LgYyCxp08IgfZAf69SDDfkf3
[10] - https://www.hss.edu/health-library/move-better/muscle-mass-testosterone
[11] - https://pmc.ncbi.nlm.nih.gov/articles/PMC10021096/
[12] - https://my.clevelandclinic.org/health/diseases/15603-low-testosterone-male-hypogonadism
[13] - https://www.topdoctors.co.uk/medical-articles/andropause-understanding-male-menopause/
[14] - https://healthymale.org.au/health-article/how-do-stress-and-anxiety-affect-sexual-performance-and-erectile-dysfunction/
[15] - https://pmc.ncbi.nlm.nih.gov/articles/PMC3976909/
[16] - https://www.oxfordonlinepharmacy.co.uk/blog/what-is-psychological-erectile-dysfunction
[17] - https://pmc.ncbi.nlm.nih.gov/articles/PMC8766276/
[18] - https://www.livi.co.uk/your-health/man-o-pause/
[19] - https://www.optimale.co.uk/articles/how-to-get-a-testosterone-test-on-the-nhs/
[20] - https://www.gloshospitals.nhs.uk/our-services/services-we-offer/pathology/tests-and-investigations/testosterone/
[21] - https://www.va.gov/WHOLEHEALTHLIBRARY/tools/improving-low-testosterone-naturally.asp
[22] - https://www.health.harvard.edu/mens-health/lifestyle-strategies-to-help-prevent-natural-age-related-decline-in-testosterone
[23] - https://www.healthline.com/nutrition/8-ways-to-boost-testosterone
[24] - https://pmc.ncbi.nlm.nih.gov/articles/PMC1472881/
[25] - https://www.healthspan.co.uk/advice/body/the-real-side-effects-of-testosterone-replacement-therapy-for-men/?srsltid=AfmBOorMj5v8-EHiCIFKwhOEuF6y5aadAopflj2mtJ0v-0uCI67zi9cV
[26] - https://www.meliorclinics.co.uk/treatments/bhrt-for-men/
