Andropause and thyroid health

Sex hormones in males — particularly testosterone — decline with age, this is known as andropause. Although thyroid conditions predominantly affect females, 15 in 100 people affected by them are male. Thyroid conditions have an impact on andropause.

Aging and decreasing hormone levels

The rate by which testosterone levels decline varies from person to person. It’s affected by many chronic conditions, including obesity, as well as severe emotional stress a person might experience (1).

Testosterone decline is very gradual. It usually takes many years for a person to start experiencing symptoms.

The hormones that start to decline when males are in their mid-twenties include (2, 3):

  • Thyroid hormones
  • Growth hormone (GH)
  • Dehydroepiandrosterone (DHEA, a precursor of testosterone and estrogen)

Andropause symptoms arise in men when they’re in their mid-thirties to early forties.

By the time males are in their eighties, their hormone levels are typically the same as pre-puberty levels (3).

Hypothyroidism and low testosterone levels

An underactive thyroid can cause low testosterone levels (4, 5). When hypothyroidism is treated with thyroid hormones, free testosterone levels should normalize (6).

The thyroid usually becomes less active as people age. Aging males — with a combination of low testosterone, thyroid hormones, GH, and DHEA — might experience (2, 7):

  • Anxiety and nervousness
  • Reduced potency and decreased libido
  • Fatigue
  • Problems with memory
  • Decreased muscle mass and increased fat mass
  • Depression
  • Poor sleep
  • Hot flashes
  • Gynecomastia (an enlargement or swelling of breast tissue in males)

Testosterone replacement therapy for andropause

If andropause symptoms are severe, testosterone replacement therapy can be prescribed. It’s generally helpful.

Testosterone replacement therapy can help with (8–18):

  • Reducing the risk of heart conditions
  • Reducing the risk of obesity
  • Reducing insulin resistance
  • Improving red blood cell count

In certain cases testosterone replacement therapy is not permitted — like if a person has prostate or breast cancer (1). Testosterone levels should be checked 3–6 months after beginning treatment.

Patients’ symptoms should be evaluated at every check-up appointment with a doctor — especially mood, libido, fever, and pain.

How we write: our information is based on the results of peer reviewed studies using the National Library of Medicine platform. It is written by scientists and reviewed by external experts. If you believe we might have overseen crucial scientific information, please contact us at

Disclaimer: This information is not intended to mitigate, prevent, treat, cure or diagnose any disease or condition. If you want to change your treatment, lifestyle, your diet, include supplements in your diet or have concerns about your health, please consult your doctor before trying new approaches.


  1. Travison TG, et al. Relative contribution of aging, health, and life-style factors to serum testosterone decline in men, 2007
  2. Singh P. Andropause: Current concepts, 2013
  3. Schwarz ER, et al. Andropause and the development of cardiovascular disease presentation — more than an epi-phenomenon, 2011
  4. Buvat J, et al. Testosterone deficiency in men: systematic review and standard operating procedures for diagnosis and treatment, 2013
  5. Dumoulin SC, et al. Opposite effects of thyroid hormones on binding proteins for steroid hormones (sex hormone-binding globulin and corticosteroid-binding globulin) in humans, 1995
  6. Donnelly P, et al. Testicular dysfunction in men with primary hypothyroidism; reversal of hypogonadotrophic hypogonadism with replacement thyroxine, 2000
  7. Matsumoto AM. Andropause: Clinical Implications of the Decline in Serum Testosterone Levels With Aging in Men, 2002
  8. Isidori AM, et al. Effects of testosterone on body composition, bone metabolism and serum lipid profile in middle-aged men: A meta-analysis, 2005
  9. Tracz MJ, et al. Testosterone use in men and its effects on bone health. A systematic review and meta-analysis of randomised placebo controlled trials, 2006
  10. Travison TG, et al. The relationship between libido and testosterone levels in aging men, 2006
  11. Greenstein A, et al. Does sildenafil combined with testosterone gel improve erectile dysfunction in hypogonadal men in whom testosterone supplement therapy alone failed, 2005
  12. Dhindsa S, et al. Frequent occurrence of hypo-gonadotropic hypogonadism in Type 2 diabetes, 2004
  13. Kapoor D, et al. Clinical and biochemical assessment of hypogonadism in men with type 2 diabetes: Correlations with bioavailable testosterone and visceral adiposity, 2007
  14. Kupelian V, et al. Low sex hormone-binding globulin, total testosterone, and symptomatic androgen deficiency are associated with development of the metabolic syndrome in nonobese men, 2006
  15. Kapoor D, et al. Testosterone replacement therapy improves insulin resistance, glycaemic control, visceral adiposity and hypercholesterolaemia in hypogonadal men with type 2 diabetes, 2006
  16. Basu R, et al. Effect of 2 years of testosterone replacement on insulin secretion, insulin action, glucose effectiveness, hepatic insulin clearance, and postprandial glucose turnover in elderly men, 2007
  17. Malkin CJ, et al. Testosterone therapy in men with moderate severity heart failure: A double-blind randomized placebo controlled trial, 2006
  18. Claustres M, et al. Androgen and erythropoiesis: Evidence for an androgen receptor in erythroblast from human bone marrow cultures, 1988

Photo: Unsplash; Design: VLM Health



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Dr. Vedrana Högqvist Tabor

Dr. Vedrana Högqvist Tabor

CEO @Boost_HealthApp|| TEDx speaker || Cancer hunter || Hashimoto’s patient|| Parentpreneur || Learning from own mistakes since 1977