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IBX Insights

Understanding Menopause and Andropause

A woman talks to a physician about menopause symptoms in an office.

We go through a lot of major changes in our 40s, 50s, and 60s. Our sex hormone levels start to decrease, which can affect our bodies and minds in far-reaching ways.

Some of these changes vary based on our reproductive anatomy, but others can affect all of us. It’s important to understand these changes and how to deal with them.

Perimenopause and Menopause

The changes that affect most women and people with ovaries and a uterus are called perimenopause and menopause.

  • Perimenopause is the natural transition to menopause. This is when your menstrual period begins to change and can become more irregular. It can start as early as in your 30s, but usually begins between the ages of 40 and 44.
  • During this transition, ovaries stop releasing eggs and estrogen levels decrease rapidly.
  • When you haven’t had a period for 12 or more consecutive months, you’re considered to be in menopause. This usually happens when you’re in your 40s or 50s; in the U.S., the average age is 51.
  • Menopause also affects people who have had their ovaries and fallopian tubes removed.

Many people know very little about perimenopause and menopause. According to one survey, more than 90 percent of respondents never learned about these life changes in school, and 60 percent didn’t feel well-informed about them. That’s a shame, because they really are life-changing events.


There is a change, very similar to menopause, that can affect men or people who have testicles and a penis. It’s called andropause. Like menopause, it’s caused by a natural decline in hormone levels — in this case, testosterone.

This decline is normal, but it affects people differently, and at different ages. Not everyone notices it happening. But if they do, it’s usually when they’re in their 40s.

Many people don’t even know that andropause is a thing, but they should. Otherwise, they may blame themselves for what they’re experiencing — even though it’s completely natural, and not some kind of a personal failing.

What May Happen During These Life Changes?

To Everyone

To Women and People with Ovaries and a Vagina

To Men and People with Testicles and a Penis

  • Trouble getting/maintaining an erection

Easing Your Symptoms

Talk to your doctor before trying to “do something” about perimenopause, menopause, or andropause. They can do a blood test to confirm that you are actually going through one of these changes. Other health issues could be causing your symptoms. For example:

So, have a conversation with your doctor. Explain what you’re experiencing. Ask them to help you find the cause and what you should do about it.

If you are experiencing one of these changes, usually lifestyle changes are the first place to turn for symptom relief. These include:

  • Quitting smoking
  • Eating a healthy diet and maintaining a healthy body weight
  • Avoiding alcohol, caffeine, and spicy foods
  • Reducing your stress level through things like meditation
  • Getting more sleep
  • Exercising

Strength training, in particular, can help boost testosterone levels, increase muscle mass, accelerate metabolism, and actually help prevent osteoporosis. This can counteract many of the effects of both menopause and andropause.

In addition to these lifestyle changes, there are other solutions your doctor may suggest. For instance, certain antidepressants are commonly used to treat hot flashes. (Antidepressants have been shown to benefit a wide variety of health conditions, not just mental health issues.) And you can use a variety of moisturizers and lubricants to counteract vaginal dryness.

Hormone Replacement Therapy

If your sex hormone levels are low, your doctor may recommend hormone replacement therapy (HRT). This approach has some benefits, but there are also some risks you should be aware of.

So, talk to your doctor about whether HRT is a safe option for you.

Aging Gracefully

A lot of people find going through these changes to be depressing. They see it as a sign of getting older. But getting older is something we all go through and it’s not a bad thing. With age comes a lot of experience, maturity, wisdom, and perspective.

And remember, just because you’re getting older, that doesn’t mean your sex life has to end. A lot of people are sexually active into their 80s and beyond, and many report that their sex life has gotten better with age. You deserve to have a healthy and fun sex life if you want one. Talk to your doctor if you’re struggling to achieve this in your life.

People with a positive attitude about aging tend to live longer, happier lives. So, you get to decide where you go from here. You get to decide how to make the most of it and continue to live with passion and joy. And that’s what I hope you’ll do.

Dr. Nuria Lopez-Pajares

Dr. Nuria Lopez-Pajares joined Independence Blue Cross in 2018 after practicing primary care and population health for 18 years. With a background in public health and preventive medicine, she is now a medical director involved in utilization management, case management, and quality improvement. What she loves about this job is the opportunity to put prevention into practice and educate.