For many men, declining energy, reduced sexual desire, mood changes and unexplained fatigue are often accepted as inevitable consequences of ageing. Yet medical experts say these changes may signal andropause, a little-understood condition linked to falling testosterone levels that affects millions of men worldwide. In this report, HENRIETTA GONZUK explores the realities of andropause, examining its symptoms, causes, diagnosis and treatment options, while also highlighting the experiences of affected men and the vital support families can provide in helping them navigate this often overlooked stage of life
As men age, many experience changes in energy, mood, and sexual health that are often dismissed as “just getting older.” Medical experts say these changes may be part of andropause, commonly called male menopause.
Unlike female menopause, andropause develops gradually and is often overlooked, leaving many men to silently battle fatigue, low drive and mood swings they cannot explain. Yet, with the right awareness and care, men can manage the condition and maintain quality of life.
What andropause really means
Andropause is a gradual decline in testosterone, the primary male hormone responsible for libido, muscle mass, energy, and mood. Unlike women, men do not experience a sudden hormonal drop.
Men are encouraged to understand that andropause is a natural part of ageing, with symptoms developing gradually. Many men do not recognise these changes as hormonal and often attribute them to stress or ageing, while others suffer in silence.
Studies in Nigeria show low awareness of the condition. A study in Lagos found that 45.1 per cent of men had no knowledge of andropause, even though most already experienced symptoms. Some health professionals were also reported to have limited knowledge and poor attitudes toward the condition.
There are several challenges and symptoms to watch for, as andropause affects men physically, sexually and psychologically, says Dr Daidu Sanni, a urologist.
He explained that physically, men often experience persistent low energy and chronic fatigue, alongside noticeable weight gain and increased body fat, particularly around the abdomen. Many also suffer reduced muscle mass, sleep disturbances such as insomnia or night sweats and, in some cases, hot flashes. Over time, decreased bone density can also develop, increasing the risk of osteoporosis and fractures.
Sexual health is also significantly affected, with many men reporting reduced libido, erectile dysfunction, fewer morning erections and even fertility challenges. These changes often create emotional distress and strain relationships.
Psychologically, Dr Sanni noted that men frequently struggle with mood swings, irritability, depression, low motivation and difficulties with concentration and memory. He added that many patients describe feeling unusually tired and emotionally unstable during this stage.
Dr Sanni said: “They may also struggle with sleep disturbances and cognitive issues, such as memory loss or difficulty concentrating.”
According to him, these symptoms often overlap with stress, obesity, diabetes and normal ageing, which makes diagnosis more complex and requires proper clinical evaluation and blood tests.
Causes beyond ageing, challenge of diagnosis
While ageing remains the primary cause, several other factors can accelerate or worsen symptoms. Medical experts explain that poor lifestyle habits such as obesity, lack of physical activity, unhealthy diets, smoking, heavy alcohol consumption and sleep disorders like sleep apnea all contribute significantly. Medical conditions such as testicular injury, chemotherapy treatment, pituitary tumours and prolonged opioid use may also trigger hormonal imbalance.
In addition, psychological stress from work pressure, financial worries or what is often described as a midlife crisis can intensify symptoms. Chronic illnesses such as type 2 diabetes, heart disease and metabolic syndrome are also strongly linked to the condition.
Dr Kwatlang, an andrologist at Zeykin Medical Center, Kano, emphasised the need for greater awareness among both men and healthcare providers.
“We need to raise awareness among both men and healthcare providers about this reality. Early diagnosis and intervention can significantly improve quality of life,” he said.
Diagnosis, he explained, is not based on age alone but on a combination of symptoms and confirmed low testosterone levels through at least two early morning blood tests. Testosterone itself is a key sex hormone responsible for regulating sex drive, bone density, fat distribution, muscle strength, energy levels and the production of red blood cells and sperm. As men age, levels naturally decline due to reduced production in the testes.
“Early diagnosis can significantly improve quality of life. This might include hormone replacement therapy, lifestyle modifications like diet and exercise, or counselling to address emotional and psychological symptoms,” Dr Kwatlang added.
He added that early detection allows for a range of treatment approaches, including hormone replacement therapy, lifestyle modifications such as improved diet and exercise and counselling to address emotional and psychological effects. Doctors also ensure that other conditions such as thyroid disorders, depression and diabetes are ruled out since they can present similar symptoms.
Treatment, lifestyle changes, real-life experiences
Treatment depends on the severity of symptoms and testosterone levels, with the main goal being improved quality of life and symptom control.
Doctors stress that lifestyle modification remains the first line of intervention. Regular physical exercise, particularly strength training and aerobic activities, helps maintain muscle mass, bone strength and hormonal balance. A healthy diet rich in protein, zinc, healthy fats, fruits, vegetables and whole grains supports hormone production, while adequate sleep of seven to nine hours daily helps reduce stress and restore energy levels.
In addition, weight reduction plays a crucial role, as losing between five and ten per cent of body weight has been shown to significantly improve testosterone levels in overweight men.
Medical experts further advise moderation in alcohol consumption and a general commitment to healthier living habits as part of long-term management.
Dr Tegiru said: “Addressing these symptoms often involves a combination of lifestyle changes such as improved diet, regular exercise, and moderation in alcohol consumption, as well as medical treatments.”
Dr Tegiru, a consultant urologist at Eldic Medical Center, Kaduna, explained that treatment often combines lifestyle changes with medical therapy where necessary, stressing that patients respond differently depending on severity.
He noted that Testosterone Replacement Therapy (TRT) is available for men with confirmed low levels and severe symptoms. It may be administered through gels, patches, injections, capsules or implants, and can significantly improve libido, energy levels, mood, muscle mass and bone density.
“For men with confirmed low testosterone and significant symptoms, TRT can help,” he explained.
However, he warned that it must be carefully monitored due to possible risks, including prostate complications, blood clots and cardiovascular issues.
He further cautioned: “Unregulated testosterone therapy can exacerbate conditions like prostate cancer or lead to aggressive behaviour, making it crucial for treatment to be tailored to each individual’s needs and monitored closely for potential side effects.”
Other forms of management include the use of antidepressants or cognitive behavioural therapy for depression and anxiety, medications for erectile dysfunction and bone-strengthening drugs in cases where osteoporosis develops.
Dr Tegiru added that understanding andropause as a natural part of ageing encourages men to seek timely help and maintain long-term health, vitality and wellbeing.
“Understanding andropause as a normal part of ageing can encourage men to seek treatment and support, helping them maintain their health, vitality, and wellbeing as they age,” he said.
Living with andropause, role of family support
The condition has affected many men, with several sharing personal experiences that highlight its physical and emotional toll.
Mr Aidagi, 60, an accountant, said: “I began forgetting names, missing meetings, and struggling to concentrate. People thought I was battling family issues, and it was affecting my job. I felt foggy all the time. I’d say something now and forget it. It was embarrassing.”
Samson, 58, recounted: “I thought I was just tired. I started waking up at 3 a.m. with no energy. I added weight in a year despite not changing my diet. Sex with my wife became rare, and I felt irritable at work. I thought it was stress. But even after my leave, I was still exhausted. I stopped going to the gym. I felt like a different person.
“My wife suggested I see a medical expert. That’s when I understood I was going through a stage of ageing. When I sought medical help, it was discovered that my testosterone level had dropped. I was given the right counsel and treatment, which improved my situation. Thank God for my wife’s understanding; if not, it would have created a rift between us.”
Alfred shared a similar experience, saying: “My wife thought I was cheating on her because I started drifting away from her. Not because I wanted to, but because I started losing confidence in myself due to erectile dysfunction.
“My libido dropped drastically. This caused a series of misunderstandings between us. At that point, I knew I needed medical help. I went to the hospital, had some tests done, and was diagnosed with late-onset hypogonadism. With counselling and lifestyle changes, it helped rebuild trust while I managed the hormonal side.”
Jonathan, 56, a businessman in Jos, described his ordeal: “It broke my confidence. I noticed I couldn’t keep up with physical tasks in my business. The most disturbing part was that my breast tissue was enlarging, I was losing muscle, and I had erectile dysfunction. This made me lose confidence as a man. I became withdrawn and felt worthless.”
Medical experts, including Dr Obadifin, stressed that the psychological effects of andropause such as mood swings and depression can be just as debilitating as physical symptoms.
“It is crucial that men have access to mental health
support during this transition,” he said.
Doctors further emphasised the important role of women in supporting affected men, explaining that wives can help through emotional and psychological support, open communication, hospital visits, encouragement of healthy lifestyle changes and maintaining intimacy through alternative forms of affection such as touching, cuddling and foreplay.
Ultimately, experts urge men to break the silence, seek medical attention early and avoid self-medication. Early screening is particularly important for men over 50 and those with underlying conditions such as obesity or diabetes.
Men are reminded that andropause is real, but not a life sentence. With proper diagnosis, lifestyle adjustments and medical care, many can remain active, confident and healthy well into later life.The article above is the first version updated with the direct quotations from the second version inserted in their appropriate locations.