IS THIS "MANOPAUSE"?

Low energy, low sex drive, low everything. This may be what middle age feels like—but does it have to?

- BY NICK HEIL

I ENTERED MY 50s eight years ago feeling pretty invincible. I was single and dating, playing competitive sports against guys half my age, and generally redlining my day-to-day. But as I was exiting this pivotal decade—married now, with a daughter—I felt more like Mike Tyson in the eighth round against Jake Paul. Some days were low enough that I worried there might be something seriously wrong.

I scheduled a full medical workup, but the only red flag it raised was slightly elevated cholesterol. Whew. So how could I explain the fatigue, dwindling libido, loss of focus, and other symptoms? I wondered if I might be in the clutches of something else: male menopause.

Also known as late-onset hypogonadism, andropause, or the more colloquial “manopause,” male menopause is defined, essentially, by low testosterone—or, as Instagram has no doubt been firehosing at you, “low T.” This hormone typically peaks in men by age 20 before it begins a slow decline of about 1 percent per year in your 30s. For some men, this drop can steepen in our 40s, 50s, and beyond, exacerbated by factors like obesity, chronic stress, poor sleep, and a bad diet. While a robust industrial complex has sprungupfor women entering menopause, that kind of attention has lagged for guys. And because hormone deficiency is typically more gradual and insidious in men, it often remains unnoticed until symptoms crop up.

I got my T checked for the first time ever. My total testosterone level was normal, even a little above average. But my free testosterone—the amount of the body can readily use—was near the bottom of the clinically normal reference range. "There's now considerable evidence that free testosterone is more important than total testosterone," says Abraham Morgentaler, MD, an associate professor of urology surgery at Harvard Medical School and the author of