Male Menopause Blood Test UK: What Andropause Is, and What to Check

1. Is the male menopause real?

Yes and no, which is why doctors tend to avoid the term. The female menopause is a defined event: the ovaries stop releasing eggs and oestrogen falls sharply over a few years. Nothing equivalent happens in men. Testosterone does not switch off, and there is no fixed age at which it drops.

What is real is that some men develop a genuine testosterone deficiency with age, with symptoms that respond to treatment. The NHS recognises this, while pointing out that the “male menopause” label is misleading because the changes are gradual and not universal. The honest framing is that a blood test, not the calendar, decides whether low testosterone is part of your picture.

2. What actually changes with age

From roughly the age of 30 to 40, total testosterone falls slowly, on the order of around 1 to 2 percent a year on average. That is a population trend, not a rule, and many men in their sixties still have levels well inside the healthy range. Our testosterone levels by age guide sets out the typical figures.

Two things make the picture more complex than a single number. First, the amount of testosterone you can actually use depends on SHBG, the protein that binds testosterone in the blood, which tends to rise with age and leaves less free hormone available. Second, weight gain, poor sleep, heavy drinking and chronic illness all lower testosterone independently of age, so a low reading is not automatically “just getting older”.

3. The symptoms

The symptoms attributed to the male menopause are real but non-specific, meaning they overlap heavily with stress, depression, thyroid problems and poor sleep. The ones most consistently linked to low testosterone are:

• Reduced sex drive and fewer spontaneous erections.
• Persistent fatigue and low energy.
• Low mood, irritability or loss of motivation.
• Loss of muscle mass and strength, and gain in body fat.
• Poor concentration, sometimes described as brain fog.
• Hot flushes or sweats, in more pronounced cases.

The sexual symptoms, particularly reduced libido and morning erections, are the most strongly associated with measured low testosterone. The low testosterone symptoms guide goes through each in more detail. Because so many other things cause the same symptoms, testing is what separates a hormone problem from the alternatives.

4. Which blood tests to consider

A proper assessment looks at more than one hormone. The markers usually checked together are:

• Total testosterone— the headline number, measured on a morning sample.
• Free testosterone and SHBG — how much hormone is actually available, which matters most when the total sits in the grey zone.
• LH and FSH — the pituitary signals that tell you whether the problem is in the testes or higher up in the brain.
• Prolactin — raised prolactin can suppress testosterone and points to a treatable pituitary cause.
• Oestradiol — men make oestrogen too, and the testosterone to oestrogen balance shifts with rising body fat.
• Thyroid and HbA1c— an underactive thyroid and undiagnosed diabetes both mimic low testosterone, so they are worth ruling out.

This combination is exactly what a dedicated male hormone panel is built to cover, which is why a single hormone result in isolation is rarely enough to act on.

5. Reading the results and the grey zone

The British Society for Sexual Medicine, whose guidance UK clinicians follow, uses total testosterone as the starting point. As a rough guide, a level below about 8 nmol/L in a man with symptoms usually indicates testosterone deficiency, while a level comfortably above 12 nmol/L makes it unlikely. Between roughly 8 and 12 nmol/L is the grey zone, where free testosterone and the wider markers help decide.

A genuinely low result should be confirmed on a second morning sample before any conclusion is drawn, because testosterone varies day to day and a single low reading can be a fluke. The pattern of LH and FSH then adds meaning: high values alongside low testosterone suggest the testes are struggling, whereas low or normal values point higher up, towards the pituitary.

None of this is something to interpret alone. What a set of results means for you depends on your symptoms, your history and the full picture, which is why a qualified clinician reviews them rather than a number on a page making the call.

6. Why timing of the test matters

Testosterone follows a daily rhythm, peaking in the morning and drifting down through the day. For that reason the sample should be taken before 11 in the morning, and ideally fasting. A test done in the afternoon can read artificially low and send you down the wrong path.

It is also worth avoiding testing during an acute illness or in the days after very heavy training, both of which temporarily depress the result. Our testosterone blood test guide covers how to prepare so the number you get is the number that counts.

7. What you can do about it

If testing shows low testosterone, the first step is usually to address the things that suppress it. Losing excess weight, sleeping properly, cutting back on alcohol and training regularly can all lift levels measurably, and sometimes that is enough. The natural ways to raise testosterone guide separates what has evidence behind it from what does not.

Where deficiency is confirmed and symptoms persist, testosterone replacement therapy may be considered, always under medical supervision and with its own monitoring. The TRT blood test guide explains the markers tracked before and during treatment. Whatever the route, it begins with knowing your numbers rather than guessing from how you feel.

8. NHS and private testing

A GP can test testosterone where there are clear symptoms, and will often check it alongside thyroid and general bloods to look for other explanations first. If deficiency is found, they may refer to an endocrinologist. NHS testing is appropriate and free, though it can be a slower, step-by-step process.

Privately, the full male hormone set, total and free testosterone, SHBG, LH, FSH, prolactin and oestradiol, can be measured together from a single morning sample and read in context. Seeing them side by side is the most useful way to tell whether falling testosterone, rather than something else, is behind how you feel.

9. Frequently asked questions