Andropause · Telehealth for men · Canada & USA
Andropause vs menopause: what is the difference?
Menopause is a defined end point; andropause is a slow drift. In menopause the ovaries run out of follicles, estrogen falls and periods stop for good, on average at 51, and it happens to every woman. In men, testosterone falls gradually, about 1 percent a year from around 30 to 40, with no sudden stop, and only some men develop symptoms with truly low levels (late-onset hypogonadism). Menopause is usually recognized from symptoms and periods; low T needs symptoms plus two early-morning blood tests. We help men in Canada and the USA sort out which it is, by telehealth, and build a sleep, training, nutrition and stress plan around the results.
Part of our low testosterone and andropause guide for men in Canada and the USA.
Timing: a slow drift versus a defined end point
Menopause has a date. The Canadian Menopause Society defines natural menopause as the permanent end of periods caused by the loss of ovarian follicles, which brings low estrogen and the end of natural fertility. It is confirmed in hindsight, after twelve months in a row without a period, and the average age in Canada is 51, usually between 45 and 55; the US National Institutes of Health gives the same average. The run-up, called perimenopause, can begin several years earlier as estrogen and progesterone start to fluctuate. Male hormonal aging has no equivalent date. The NHS calls “male menopause” a misleading label because testosterone does not drop suddenly in midlife: it falls steadily, by about 1 percent a year from around age 30 to 40, and that slow decline is unlikely to cause problems by itself.
Menopause: one point in time
Confirmed after twelve months without a period, on average at 51 in Canada and the USA.
Perimenopause comes first
Hormones swing for several years before the final period, which is when many symptoms start.
Men: a gradual slope
Testosterone eases down about 1 percent a year from around 30 to 40, with no sudden drop.
Symptoms are not automatic
The slow decline alone rarely causes problems. Weight, sleep and health often matter more.
Not every man goes through andropause
Every woman reaches menopause. Symptomatic low testosterone in men is far less universal. The European Male Ageing Study (Wu and colleagues, New England Journal of Medicine, 2010) tested a random sample of men aged 40 to 79 in eight European centres and set a strict definition of late-onset hypogonadism: at least three sexual symptoms (poor morning erections, low sexual desire and erectile dysfunction) together with low total and free testosterone. About 2 in 100 men met it. The rate climbed with age, from about 1 in 1,000 men in their 40s and 6 in 1,000 in their 50s to about 3 in 100 in their 60s and 5 in 100 in their 70s, and it was higher in men with a larger body-mass index and more health conditions. The NHS likewise describes late-onset hypogonadism as an uncommon, specific condition that is not a normal part of aging, often seen with obesity or type 2 diabetes.
About 2 in 100 men
Aged 40 to 79 met the strict EMAS definition of late-onset hypogonadism.
More common with age
From about 1 in 1,000 men in their 40s to about 5 in 100 in their 70s.
Weight and health count
Rates were higher with a larger body-mass index and more health conditions.
Sexual symptoms lead
The three sexual symptoms were the ones that tracked most closely with low testosterone.
What actually changes in the body
In menopause the change starts in the ovaries. The NIH explains that during perimenopause the ovaries make less estrogen and progesterone, ovulation becomes less frequent and periods eventually stop; the Canadian Menopause Society ties natural menopause to the loss of ovarian follicles. The change is permanent. In men the testes keep making testosterone; the level just sits a little lower each decade. Part of the change is in how testosterone is carried: the Endocrine Society lists aging among the conditions that raise SHBG, the protein that binds testosterone in the blood, so free testosterone (the share not bound to SHBG) can fall more than total testosterone. The Endocrine Society also notes that testosterone is affected by age, obesity, diabetes, sleep apnea, acute illness, nutrition and medications such as opioids and glucocorticoids, which is why two men of the same age can have very different levels.
Ovaries wind down
Follicles run out, estrogen and progesterone fall and ovulation stops.
Testes keep working
Testosterone production carries on through life at a slowly lower level.
SHBG rises with age
More testosterone is bound, so free T can fall more than total T. That is why it gets measured.
Health shifts the level
Obesity, diabetes, sleep apnea, illness and some medications all lower testosterone.
Symptoms: where they overlap and where they differ
The two share more symptoms than people expect. The NHS lists sleep problems, mood changes and low mood, poor memory and concentration, weight gain around the stomach, loss of bone density and reduced sex drive for menopause, alongside the hallmark changes to periods, hot flushes and night sweats, vaginal dryness and more urinary infections. Its list for the “male menopause” covers low sex drive, erectile dysfunction, mood swings and irritability, loss of muscle, a larger belly, low energy, poor sleep and poor concentration. For men, the European Male Ageing Study found the three sexual symptoms (fewer morning erections, low sexual desire and erectile dysfunction) were the ones that tracked with low testosterone. The Endocrine Society also lists hot flushes and sweats among the signs of testosterone deficiency, in a list based on men with severe deficiency, so they are not a typical part of ordinary male aging. The NHS adds that in many midlife men these symptoms have nothing to do with hormones and come from stress, depression, anxiety, poor sleep, diet, inactivity, alcohol or smoking. See the full list in low testosterone symptoms in men.
Shared: drive and sleep
Lower sex drive, poor sleep, low mood and brain fog show up in both.
Shared: body changes
Weight moving to the belly and lower bone density happen in both.
Men: sexual signs lead
Fewer morning erections, low desire and erectile dysfunction track most closely with low T.
Often not hormones
Stress, low mood, sleep, alcohol and inactivity drive many of the same symptoms in men.
Andropause vs menopause at a glance
The key differences side by side, drawn from the guidelines and studies cited on this page.
| Andropause (men) | Menopause (women) | |
|---|---|---|
| What it is | A popular term. The medical term is late-onset hypogonadism: symptoms plus consistently low testosterone. | The permanent end of periods, caused by the loss of ovarian follicles. |
| How it happens | Gradual: testosterone falls about 1 percent a year from around 30 to 40. | A defined end point after a transition (perimenopause) that can last several years. |
| When | No set age. Low T with symptoms becomes more common from the 60s. | Usually 45 to 55, average age 51 in Canada and the USA. |
| Who | Not universal: about 2 in 100 men aged 40 to 79 in EMAS. | Every woman. |
| Hormones | Testes keep producing testosterone; SHBG rises with age, so free T can fall more. | Estrogen and progesterone fall and ovulation stops. |
| Main symptoms | Lower sex drive, fewer morning erections, erectile dysfunction, fatigue, less muscle, low mood. | Period changes, hot flushes, night sweats, poor sleep, mood changes, vaginal dryness. |
| How it is confirmed | Symptoms plus two fasting, early-morning total testosterone tests. | From age 45: symptoms and periods, usually without blood tests. |
| What shifts it | Weight, sleep and sleep apnea, illness, medications, training and stress. | Smoking can bring it earlier; surgery or some medical treatments can cause a sudden menopause. |
How each one is confirmed
Here the two work in opposite directions. For women aged 45 or over with typical symptoms, NICE guidance (NG23) says perimenopause and menopause are identified from symptoms and periods without lab tests, because hormones such as FSH swing too much in the years before menopause to give a useful single reading; an FSH test is kept for women aged 40 to 45 or younger. For men, a blood test is the whole point. The Endocrine Society recommends diagnosing low testosterone only when symptoms line up with unequivocally and consistently low levels, measured fasting in the early morning and repeated to confirm, because testosterone peaks in the morning, food lowers it and about three in ten first results in the low range come back normal on repeat. The American Urological Association uses a total testosterone below 300 ng/dL on two early-morning tests, and the Canadian Urological Association recommends a draw between 7 and 11 a.m. and suggests below 10 nmol/L as a reasonable threshold. Free testosterone, SHBG and LH then show whether the issue is binding, the testes or the brain’s signal. See low testosterone labs to ask for.
Menopause: the calendar
From 45, symptoms and twelve months without a period are usually enough.
Low T: early morning
Fasting, early-morning draws, because testosterone peaks in the morning.
Always repeat
About three in ten first low results are normal on repeat, so one test is not enough.
Free T, SHBG and LH
These explain a borderline result and point to the cause.
What men can do about andropause symptoms
Because male hormonal aging is gradual and strongly tied to health, men have more levers than a fixed timeline suggests. The Canadian Urological Association lists causes to address first: obesity, sleep apnea, acute illness, opioids and glucocorticoids, extreme dieting and extreme exercise. In the European Male Ageing Study’s follow-up, men who lost weight saw testosterone rise in proportion and men who gained weight saw it fall. Short sleep lowers testosterone too, and the American Urological Association recommends lifestyle counselling on weight and activity for every man with low testosterone. The Endocrine Society suggests against routinely prescribing testosterone to all men 65 or older with low levels, which makes the first step a clear picture of your symptoms, labs and habits. If you are weighing testosterone therapy, read TRT or fix the causes first and low T from aging or from weight, sleep and stress.
Weight
Weight loss goes with higher testosterone; weight gain with lower.
Sleep and sleep apnea
Short sleep and untreated sleep apnea both go with lower testosterone.
Training, not overtraining
Regular training supports weight and energy; extreme exercise and extreme dieting are listed causes of low T.
Medications and alcohol
Opioids and glucocorticoids lower testosterone; heavy drinking drives the same symptoms.
How Odin helps men with andropause symptoms
Odin Health Labs is telehealth for men in Canada and the USA with andropause and low testosterone symptoms. If your partner is going through menopause and you are wondering whether something similar is happening to you, this is a good place to start. On video or phone consults, we take your symptoms, go through your lab results with you in plain language (two early-morning total testosterone results, free T, SHBG, LH and the metabolic markers that affect energy and weight) and look for the causes above. Then we build a plan around the levers that move symptoms day to day: sleep, training, nutrition and stress, with follow-up check-ins and repeat labs so you can see what is changing. See how our health coaching works.
Telehealth consults
Video or phone, anywhere in Canada or the USA, at a time that fits your week.
Labs review
Your symptoms read alongside total and free T, SHBG, LH and metabolic markers.
Coaching
Sleep, training, nutrition and stress steps matched to your real schedule.
A written plan
Clear weekly actions, check-ins and repeat labs. See supplements for targeted support.
From questions to a plan
Here is how we work with you, start to finish.
- Step 1
Talk it through
We go through your symptoms, sleep, stress, training, weight and medications on a free call.
- Step 2
Get the right labs
Two early-morning total testosterone results, free T, SHBG, LH and the markers that explain the pattern.
- Step 3
Tune the levers
Sleep, training, nutrition and stress steps set up around your real week.
- Step 4
Track and adjust
Regular check-ins and repeat labs show what is shifting, and we adjust the plan with you.
Sources
- NHS. The “male menopause”. nhs.uk male menopause
- NHS. Symptoms of menopause and perimenopause. nhs.uk menopause symptoms
- Canadian Menopause Society. Definition and stages of menopause. canadianmenopausesociety.org
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (NIH). About menopause. nichd.nih.gov menopause
- National Institute for Health and Care Excellence. Menopause: identification and management (NG23). nice.org.uk NG23
- Wu FC, Tajar A, Beynon JM, et al; EMAS Group. Identification of late-onset hypogonadism in middle-aged and elderly men. N Engl J Med 2010;363(2):123–135. doi.org/10.1056/NEJMoa0911101
- Bhasin S, Brito JP, Cunningham GR, et al. Testosterone Therapy in Men With Hypogonadism: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab 2018;103(5):1715–1744. doi.org/10.1210/jc.2018-00229
- Mulhall JP, Trost LW, Brannigan RE, et al. Evaluation and Management of Testosterone Deficiency: AUA Guideline (2018). American Urological Association. auanet.org testosterone deficiency guideline
- Grober ED, Krakowsky Y, Khera M, et al. Canadian Urological Association guideline on testosterone deficiency in men: Evidence-based Q&A. Can Urol Assoc J 2021;15(5):E234–E243. doi.org/10.5489/cuaj.7252
- Camacho EM, Huhtaniemi IT, O’Neill TW, et al; EMAS Group. Age-associated changes in hypothalamic–pituitary–testicular function in middle-aged and older men are modified by weight change and lifestyle factors: longitudinal results from the European Male Ageing Study. Eur J Endocrinol 2013;168(3):445–455. doi.org/10.1530/EJE-12-0890
Frequently asked questions
Is andropause the same as menopause?
No. Menopause is a defined event: the ovaries run out of egg follicles, estrogen falls and periods stop for good, confirmed once there has been no period for twelve months in a row. The average age is 51 in Canada and the USA. Andropause, or the “male menopause,” is a popular term for something quite different. The NHS describes testosterone falling steadily by about 1 percent a year from around age 30 to 40, with no sudden drop and no end point, and calls the “male menopause” label misleading. The medical term for symptoms plus low testosterone later in life is late-onset hypogonadism.
When does andropause start, and do all men get it?
Testosterone starts drifting down slowly from around age 30 to 40, but that decline on its own is unlikely to cause problems, according to the NHS. Not every man develops symptomatic low testosterone. In the European Male Ageing Study of men aged 40 to 79, about 2 in 100 met a strict definition of late-onset hypogonadism (three sexual symptoms plus low total and free testosterone). That rose from about 1 in 1,000 men in their 40s to about 5 in 100 in their 70s, and it was more common with a higher body-mass index and more health conditions. Menopause, by contrast, happens to every woman.
Can men get hot flashes like women in menopause?
They can, but it is not typical of ordinary aging. The Endocrine Society lists hot flushes and sweats among the signs of testosterone deficiency, in a list it bases on men with severe deficiency. The signs most closely tied to low testosterone in middle-aged and older men are sexual: lower sex drive, fewer morning erections and erectile dysfunction. See low testosterone symptoms in men.
How is andropause diagnosed compared with menopause?
For women aged 45 or over, NICE guidance says menopause is identified from symptoms and periods, usually without blood tests. For men it works the other way round: low testosterone is confirmed only when consistent symptoms line up with low results on two separate fasting, early-morning total testosterone tests. The American Urological Association uses a total testosterone below 300 ng/dL on two early-morning tests, and the Canadian Urological Association suggests below 10 nmol/L as a reasonable threshold. Free testosterone, SHBG and LH help explain borderline results and the cause. See which labs to ask for.
What can men do about andropause symptoms?
Start with the things that move testosterone and symptoms. Guidelines name obesity, sleep apnea, acute illness, opioids, glucocorticoids, extreme dieting and extreme exercise as causes to address first, and in the European Male Ageing Study men who lost weight saw their testosterone rise in proportion. Short sleep, stress, heavy drinking and inactivity drive many of the same symptoms. The Endocrine Society suggests against routinely prescribing testosterone to all men 65 or older with low levels, so the first step is a clear picture of your symptoms, labs and habits. See TRT or fix the causes first.
How does Odin Health Labs work with my doctor?
Odin Health Labs is a telehealth service for men in Canada and the USA with andropause and low testosterone symptoms. We work alongside your own doctor: we go through your symptoms and lab results with you, build your sleep, training, nutrition and stress plan, and track your progress with follow-up check-ins and repeat labs. We can share your symptom list, plan and results with your doctor if you choose. See our low testosterone overview and our Privacy Policy.
Wondering if it is andropause?
A free call is the first step: we go through your symptoms, plan the right labs and map out sleep, training, nutrition and stress steps with you.