How Andropause Is Diagnosed: Tests Doctors Use and How It Differs From Menopause
Doctors use physical exams and blood work to diagnose andropause, which differs from menopause in several ways.
Men experiencing fatigue, low libido or mood changes with age often wonder whether andropause could be the cause. Doctors diagnose andropause through a combination of patient history, physical examination and blood tests that measure testosterone and related hormones.
How do doctors diagnose andropause?
Doctors diagnose andropause by taking a patient history, performing a physical examination and ordering blood work to measure testosterone. According to Anadolu Medical Center Hospital, the process begins with questions about symptoms, followed by a physical exam that evaluates the penis and testes. Laboratory tests then measure androgen hormone levels, primarily testosterone. If results show low testosterone, symptoms can be linked to that deficiency and to andropause.
Ali Dabaja, M.D., a urologist at Henry Ford Health, said screening is not routine. “We don’t usually test men for low testosterone levels unless they have symptoms or certain risk factors,” Dabaja said. “Men who have HIV, or who underwent chemotherapy or radiation for cancer treatment may be at risk of low testosterone, so screening in these populations makes sense.”
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What blood tests are used in an andropause diagnosis?
The main blood tests include total testosterone, luteinizing hormone (LH) and prolactin, according to Cleveland Clinic.
The total testosterone test is typically done before 10 a.m., when levels are highest. Providers may repeat the test on a separate morning to confirm results, and patients should report any illness because sickness can temporarily lower testosterone.
The LH blood test helps determine whether low testosterone stems from a problem in the testicles or in the pituitary gland, which controls hormone production. A prolactin test can flag pituitary conditions, including tumors, that may contribute to the deficiency. “If the patient’s testosterone level is consistently low, the next step is to pinpoint the cause,” Dabaja said. “Sometimes low testosterone happens because the testicles aren’t functioning to their fullest potential. Other times, the testes aren’t being stimulated with the proper hormones.”
How does menopause diagnosis differ from an andropause diagnosis?
Menopause diagnosis leans on symptoms and menstrual history, while andropause diagnosis depends heavily on blood tests. Mayo Clinic says most people can identify menopause through symptoms alone and tests are often unnecessary. When ordered, providers may check follicle-stimulating hormone (FSH), estradiol and thyroid-stimulating hormone, because an overactive thyroid can mimic menopause symptoms.
Cleveland Clinic notes that menopause is typically confirmed after 12 consecutive months without a period. Blood work is usually not required and can be misleading during perimenopause because of hormonal fluctuations. That contrasts with andropause, where lab results are central to confirming low testosterone.
Home FSH urine tests exist without a prescription, but Mayo Clinic warns they cannot reliably confirm menopause. “FSH levels rise and fall during your menstrual cycle. So home FSH tests can’t really tell you whether you’re in menopause,” the clinic says.
What happens after an andropause diagnosis?
After a confirmed diagnosis, doctors may recommend testosterone replacement therapy (TRT), lifestyle changes or a referral to a specialist. According to the NHS, patients with confirmed testosterone deficiency may be referred to an endocrinologist and offered replacement as an injection or gel. Henry Ford Health notes TRT is also available as oral pills, transdermal creams or patches, a nasal spray and implantable pellets that last three to six months.
Dabaja said lifestyle options should be tried first. “There are a lot of options patients can try before starting treatment,” he said. Those include a balanced diet rich in fiber and protein, strength training, weight management and mental health care.
Modern Thyroid Clinic cautions that “Andropause treatment requires careful clinical oversight because TRT has cardiovascular, fertility, and prostate considerations that need ongoing monitoring. Men experiencing symptoms should consult a clinician experienced in male hormonal health rather than self-treating with online testosterone products.”
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