Why hormones matter for men
Hormones are messenger substances that influence almost every area of the body: metabolism, muscles, bones, mood, concentration, sleep and sexuality. In men, testosterone plays a central role in particular, but thyroid hormones, cortisol, vitamin D and the hormone DHEA are also part of a finely tuned system. If this interplay becomes unbalanced, it can noticeably affect quality of life.
With increasing age, the hormonal balance gradually changes. While women experience the menopause relatively clearly, hormonal change in men tends to occur more slowly and less distinctly. Nevertheless, experts often speak of the "male menopause" (also referred to as andropause or late-onset hypogonadism) when testosterone levels gradually decline from middle age onwards.
Testosterone: more than just a "male hormone"
Testosterone is predominantly produced in the testes, with a smaller proportion in the adrenal glands. Among other things, it contributes to:
- Building and maintaining muscle mass and bone density
- Formation of red blood cells
- Libido and sexual function
- Drive, mood and cognitive performance
- Regulation of fat metabolism
From around the age of 40, testosterone levels decrease on average by about one per cent per year. This change varies considerably from person to person — not every man develops complaints as a result.
Symptoms of testosterone deficiency: what men can look out for
Low testosterone rarely shows itself through a single, clear sign. It is often a combination of physical, emotional and sexual changes. Possible indications of testosterone deficiency include:
Physical signs
- Persistent tiredness and exhaustion despite sufficient sleep
- Decrease in muscle mass and muscle strength
- Increase in abdominal fat
- Reduced physical resilience
- Hot flushes or increased sweating
- Sleep disturbances
Emotional and cognitive symptoms
- Low mood, feeling down
- Irritability or inner restlessness
- Problems with concentration and memory
- Lack of drive, loss of joy in life
Sexual changes
- Decreasing libido
- Erectile dysfunction
- Less frequent morning erections
Important: These complaints can also have many other causes — such as thyroid disorders, chronic stress, depression, sleep disorders, overweight, diabetes or certain medications. A careful medical assessment is therefore advisable before drawing any conclusions.
Male menopause: myth or reality?
Unlike the female menopause, in men there is no clearly defined stage of life with a distinct hormonal drop. The term "male menopause" rather describes a phase in which age-related hormonal changes may become more noticeable. Whether these actually lead to complaints requiring treatment depends on many factors: genetic predisposition, lifestyle, comorbidities, psychological strain and sleep quality.
Studies show that not every drop in testosterone automatically causes symptoms. Conversely, there are men with marked complaints whose levels lie in the lower normal range. The overall clinical picture is therefore always the priority in assessment — not a single laboratory value.
Male hormone status: how a medical work-up typically proceeds
Anyone who suspects that hormonal changes are affecting their quality of life can have their hormone status checked by a doctor. A thorough work-up usually involves several steps:
1. Detailed consultation (history)
In the initial consultation, complaints, lifestyle, pre-existing conditions, medications, family history and psychological factors such as stress or sleep are discussed. Structured questionnaires can help to record symptoms systematically.
2. Physical examination
This includes, among other things, measuring blood pressure, weight, waist circumference and body composition, as well as a general medical and, where appropriate, urological examination.
3. Laboratory tests
Blood is usually drawn in the morning between 7 and 11 a.m., as testosterone levels fluctuate over the course of the day. Commonly measured parameters include:
- Total testosterone (usually on two different days)
- Free or bioavailable testosterone
- SHBG (sex hormone-binding globulin)
- LH and FSH (pituitary hormones)
- Thyroid values (TSH)
- Blood count, liver and kidney values
- Blood sugar, HbA1c, blood lipids
- Vitamin D, and where appropriate cortisol and prolactin
- PSA value (prostate) where clinically indicated
4. Interpretation of the findings
The values are interpreted in the context of the complaints. A single borderline result is rarely meaningful — repeated measurements and the overall clinical picture are decisive.
Treatment options: lifestyle first
If a hormonal imbalance is identified, the first focus is on optimising lifestyle. Many studies show that even everyday changes can have a positive effect on hormonal balance:
- Exercise: Regular strength training and endurance exercise can have a positive effect on testosterone, metabolism and mood.
- Weight management: Reducing abdominal fat in particular can ease the burden on hormonal balance.
- Sleep: Seven to eight hours of restful sleep are considered an important foundation.
- Nutrition: A balanced, fibre-rich diet with sufficient protein and healthy fats supports metabolism.
- Stress reduction: Chronic stress can raise cortisol levels and unbalance sex hormones.
- Alcohol and nicotine: Both can place a strain on hormonal balance.
If lifestyle measures are not sufficient and a clinically relevant deficiency is present, hormone replacement therapy may be considered under medical supervision. This requires a prescription, regular monitoring and is not suitable for every man. Possible risks and contraindications — such as certain prostate or cardiovascular conditions — must be carefully weighed up.
When is a doctor's visit advisable?
A medical consultation can be helpful if:
- Exhaustion, lack of drive or mood changes persist for more than a few weeks
- Physical or mental performance noticeably declines
- Sexual complaints occur
- Body composition, sleep or resilience change noticeably
The earlier an assessment is carried out, the better other causes such as thyroid disorders, diabetes or cardiovascular problems can be identified.
Conclusion
Hormonal balance is an important building block for wellbeing and quality of life — including for men. Anyone who notices typical symptoms such as persistent exhaustion, lack of drive or sexual changes should take them seriously, without being unsettled by catchphrases like "male menopause". A structured assessment of hormone status, combined with an honest look at lifestyle, provides the basis for a well-founded decision on possible next steps.
This article does not replace medical advice.