What Is Andropause? | Entrepreneur

In recent years, an increasing number of successful, high-achieving men have begun to ask the same uncomfortable question: “Why don’t I feel like myself anymore?” Their once boundless energy is replaced by fatigue. Confidence dips. Focus becomes foggy. Libido wanes. The spark that once fuelled ambition starts to fade. For many, the cause lies not in the boardroom but in biology, a phenomenon sometimes referred to as the andropause.

What exactly is the Andropause?
The term “Andropause”, sometimes called male menopause, describes the gradual decline in testosterone and other androgens that occurs with age. Unlike the female menopause, which can happen abruptly, the andropause unfolds slowly and subtly, often over a decade or more. A man’s testosterone levels fall by about 1% per year (Harman et al., 2001) starting from as early as the mid-30s. By the time a man reaches his 50s, he may have 30–40% less testosterone circulating than he did in his twenties. Testosterone is far more than a “sex hormone.” It affects muscle mass, energy metabolism, red blood cell production, cognition, mood, and motivation (Bhasin et al., 2018). Declining levels therefore have a ripple effect through both body and mind, giving rise to symptoms that are often misattributed to stress, overwork, or simply “getting older.”

Common symptoms of this decline in Testosterone can include:

• Persistent fatigue or low energy
• Reduced libido or weaker erections
• Low mood, anxiety, or irritability
• Difficulty concentrating or remembering details
• Loss of muscle tone and increased body fat (especially abdominal)
• Poor sleep
• Reduced drive or confidence

Many of these symptoms overlap with the effects of chronic stress or burnout making the andropause easy to overlook in the context of a high stress job, particularly in men accustomed to pushing through discomfort.

Testosterone biology
Testosterone is produced mainly in the testes under control of the hypothalamic-pituitary-gonadal (HPG) axis. With age, this axis becomes less responsive. The testes produce less testosterone, and the brain releases less luteinising hormone (LH), the signal that triggers testosterone synthesis (Veldhuiset al., 2012).

At the same time, levels of sex hormone-binding globulin (SHBG) rise with age, reducing the amount of free (biologically active) testosterone (Travison et al., 2017). Inflammation, poor sleep, insulin resistance, and excess visceral fat further exacerbate decline. Fat tissue sees testosterone converted into estrogen via the enzyme aromatase, thus worsening the hormonal imbalance (Schneider et al., 1979). The result is a self-reinforcing cycle: as testosterone falls, energy drops, activity declines, fat accumulates, and testosterone production diminishes further.

Why high-achieving men are particularly affected
Paradoxically, the men who appear most in control of their lives, CEOs, founders, senior executives, may be at greatest risk of experiencing andropause symptoms earlier or more intensely.

The reasons for this are multiple:

1. Chronic stress and cortisol overload

C-suite life is characterised by long hours, relentless decision-making, financial pressure, and executive responsibility.This results in a constant activation of the body’s stress response elevating cortisol. Cortisol is our main stress hormone and it a keeps us alert and energised in short bursts but becomes damaging when sustained. Cortisol prepares us for the next emergency and as such suppresses sex steroids. Procreation is not a vital activity in the face of life-or-death emergencies.Chronic cortisol elevation suppresses testosterone production and does so at multiple levels. It interferes with Luteinising Hormone (LH) secretion in the pituitary gland. (LH normally acts upon testicular Leydig cells promoting testosterone synthesis). Chronic cortisol elevation also impairs Leydig-cell function. It promotes abdominal fat storage (Tilbrook et al., 2000; Cumming et al., 1983) lowering circulating testosterone levels further. High cortisol also disrupts sleep and increases inflammation, both of which blunt testosterone synthesis.

2. Sleep deprivation
Few executives sleep well. Travel, late-night emails, and constant device use undermine deep REM sleep, when most testosterone production occurs. Poor sleep has a profound suppressive effect on testosterone production. When sleep is restricted or fragmented the pulsatile gonadotrophin releasing hormone (GnRH) output from the hypothalamus diminishes. The pituitary then releases less LH and Leydig cell stimulation is reduced. Just one week of restricted sleep can reduce testosterone by up to 15% (Leproult & Van Cauter, 2011). The effect is cumulative and months or years of suboptimal rest can push levels into symptomatic territory.

3. Sedentary pressure and inflammatory diets
Desk-bound working, poor diet, and alcohol, common in high-stress professions, exacerbate insulin resistance and systemic inflammation. These metabolic shifts blunt the body’s responsiveness to testosterone and increase Sex Hormone-Binding Globulin (SHBG), effectively neutralising what hormone remains (Kelly & Jones, 2013).

4. Psychological expectations
For ambitious men, a decline in drive or performance carries emotional weight. Testosterone underpins not just libido but assertiveness, motivation, and confidence (Zilioli & Bird, 2017). When those fade, men may feel they’re “losing their edge,” leading to anxiety or self-doubt, a cycle that magnifies physiological decline.

The modern masking of symptoms
In corporate culture, fatigue, irritability, and reduced concentration are often labelled “burnout” or “stress.” While those factors certainly play a role, hormonal depletion may be the unseen foundation. Many men compensate by working harder, exercising excessively, or relying on caffeine and alcohol, short-term fixes that further strain the endocrine system. The same resilience and drive that fuel success can delay recognition that the problem may be biological. Testing for andropause is not as simple as checking total testosterone. This does not tell us anything about the free and active testosterone level.

A meaningful assessment includes:

• Morning total and free testosterone (ideally before 10 a.m.)
• LH and FSH (to assess pituitary signalling)
• SHBG, estradiol, thyroid, and metabolic markers In addition the following should also be tested:
• DHEAs (Dihydroepiandrosterone-sulphate)
• Full blood count
• PSA

Interpretation of serum testosterone must be in context, and a “normal” result may still represent a steep personal decline. Optimal wellbeing is not defined by population averages but by how a man feels and functions (Wu et al., 2010).

Lifestyle factors that make a difference
Fortunately, there is much that can be done to support healthy testosterone production and mitigate the symptoms of andropause, such as:

• Prioritise Restorative Sleep

• Aim for 7–8 hours a night
• Keep devices out of the bedroom
• Maintain consistent sleep–wake cycles
• Magnesium glycinate is a useful supplement- aim for 300-400mg a night. Magnesium may also elevate free Testosterone.

• Manage Stress Proactively to lower cortisol

• Undertake regular physical activity
• Practice mindfulness
• Foster clear work–life boundaries
• Adaptogenic supplements such as Ashwagandha and Rhodiola may be helpful. Ashwagandha may also elevate free Testosterone.

• Strength training and HIIT enhance testosterone and insulin sensitivity (Kraemer & Ratamess, 2005).
• Excessive endurance training can have the opposite effect.

• Protein, healthy fats, zinc, magnesium, and vitamin D are essential cofactors for hormone synthesis
• Ensure B vitamin and Omega 3 supplements especially where burn out is suspected
• Reduce refined carbohydrates and alcohol to support metabolic balance.

• Limit Alcohol and Stimulants

• Alcohol raises estrogen and damages hepatic hormone regulation (Sarkola & Eriksson, 2003).
• Overuse of caffeine or energy drinks increases cortisol load.

• Seek Medical Evaluation When Needed

• Persistent symptoms warrant assessment by a qualified clinician experienced in male hormonal health.

Acknowledging andropause is not an admission of weakness but a step toward understanding one’s physiology. Testosterone does not define masculinity, but its decline can challenge a man’s expectations of himself and affect him physically, mentally, and emotionally. Maintaining Testosterone (and DHEA) means practising preventative medicine as Testosterone is most beneficial to bone and cardiovascular health. For high-performing men, the recognition that biology and psychology are intertwined can be transformative. Restoring balance is not about recapturing youth but rather sustaining vitality, focus, and wellbeing in a way that supports long-term goals of leadership and success.