Testosterone often falls gradually with age, but there is no universal male "andropause" comparable with menopause. Age alone is not a reason to treat. Diagnosis still requires compatible symptoms and repeatedly low testosterone.
Does testosterone fall as men get older?
On average, yes, but the change is gradual and varies greatly between men. SHBG often rises with age, so free testosterone may fall more than total testosterone. Weight, general health, physical activity, sleep and medicines can influence levels as much as age itself.
What does "andropause" really mean?
It is a popular term but can be misleading because it suggests an abrupt and universal transition like menopause. Men do not pass through one hormonal event that affects everyone. When diagnostic criteria are met, late-onset hypogonadism is a more useful medical term.
Does age justify TRT?
No. Age alone is not an indication. An older man with compatible symptoms and repeatedly low levels may be a candidate after individual assessment; another man of the same age without symptoms or with adequate levels does not benefit from "treating age".
What should be reviewed before blaming age?
- Sleep apnoea and sleep quality.
- Obesity, diabetes and metabolic syndrome.
- Depression, alcohol and chronic illness.
- Opioids, glucocorticoids and other medicines.
- Physical activity, diet and recent weight change.
What changes when making a decision in an older man?
The balance of benefits and risks becomes particularly important. Symptoms, frailty, haematocrit, cardiovascular health, prostate risk, fertility where relevant and the ability to attend follow-up all matter. The goal is to treat a clinical deficiency, not restore a "young man's" number.
There is no single "ideal level for your age"
Laboratory ranges are useful, but diagnosis and treatment decisions still depend on symptoms, reproducible results and the clinical context.