Male Menopause and Andropause: Tracking Hormonal Decline and Inflammation in Men

Male menopause (also called andropause) refers to symptoms some men experience during the gradual decline in testosterone that begins in midlife, with levels falling by less than 2% a year between the ages of 30 and 40. That decline isn't only a hormonal story: testosterone is a precursor for estrogen, and estrogen helps regulate inflammatory activity in the immune system. When testosterone and estrogen fall, the inflammatory glycan markers that drive biological ageing tend to rise alongside them. Tracking those markers directly, rather than testosterone alone, gives a fuller picture of what's actually happening inside the body.

Hormonal decline and biological age are closely linked, in men and women alike. For the full picture of how hormones shape long-term ageing, see our guide: Menopause, HRT & Biological Age: The Definitive Guide to Tracking Hormonal Aging.

Context: what andropause is

Andropause refers to the general hormone decline that happens during midlife. Testosterone levels decline gradually from around age 30 onwards, and most men never reach a level low enough to be classed as a deficiency (hypogonadism). Where deficiency does occur in adulthood, it's usually linked to declining testicular function or disrupted signalling from the pituitary and hypothalamus, as well as to common chronic conditions such as obesity and diabetes. This pattern, occurring later in life and often alongside metabolic disease, is known as late-onset hypogonadism (LOH).

The inflammation-hormone loop

The reason andropause is worth tracking closely isn't just the mood and energy symptoms it's associated with. Testosterone is converted into estradiol (a form of estrogen) by an enzyme called aromatase, and estradiol is one of the mechanisms that keeps IgG antibody glycosylation, a marker of immune regulation and chronic inflammation, in an anti-inflammatory state.

This was demonstrated directly in a controlled study where men had their testosterone production blocked with goserelin. Men who received testosterone replacement maintained stable testosterone and estrogen levels, while a placebo group did not, and the placebo group showed a rise in pro-inflammatory IgG glycans. A second arm of the same study gave men an aromatase inhibitor, blocking the conversion of testosterone into estrogen specifically. Those men also showed a rise in pro-inflammatory glycans, confirming that it's the testosterone-derived estrogen, not testosterone on its own, that keeps this inflammatory pathway in check.

In practical terms, this means men going through andropause, with lower testosterone and lower estrogen, tend to show higher GlycanAge scores and a higher Glycan Mature index, a pattern consistent with rising chronic inflammation rather than a purely subjective symptom picture.

"Men are protected from ageing by testosterone, but only if the aromatase enzyme, which converts testosterone to estrogen, isn't blocked. People taking testosterone often try to keep their levels high by blocking aromatase, because testosterone is naturally converted to estrogen. If you do that, yes, you have high testosterone, but your GlycanAge score increases, because you actually need the estrogen. In both women and men, IgG glycosylation is controlled by estrogen."

— Prof. Gordan Lauc, Professor of Biochemistry and Molecular Biology, University of Zagreb, and Co-Founder & Chief Scientific Officer, GlycanAge

Why biological age tracking says more than a testosterone number alone

A single testosterone reading captures one hormone at one point in time. Testosterone secretion follows its own daily rhythm, generally peaking in the early morning, and normal reference ranges vary considerably between laboratories, so one number drawn at the wrong time of day can be misleading.

A biological age test built on IgG glycan analysis works differently. Because it reads the downstream inflammatory signature that hormonal decline produces, rather than the hormone level itself, it reflects how the immune system is actually responding, across indexes such as Glycan Shield, Glycan Youth and Glycan Mature. You can see how these indexes are structured in more detail.

"When your doctor looks at your BMI, blood pressure and cholesterol ratios and tells you you're red, green or amber, that's actually a presentational problem. If instead you're told your heart age is 50 when you're 40, that's something people understand and can act on. Coming up with a readily usable measure of biological age, communicated well, is one way to move clinical practice forward."

— Dr. Peter Joshi, Chief Scientist, Humanity Health; University of Edinburgh

This distinction has been tested directly. A 2025 study of men with obesity and low testosterone, published in GeroScience, found that testosterone therapy produced a statistically significant reduction in biological age as measured by the GlycanAge index, alongside lower agalactosylation, higher digalactosylation and higher sialylation of IgG, all markers of reduced inflammatory activity. Metformin, given to the same population, produced no statistically significant change in glycosylation. That's a meaningful contrast: the intervention that changed sex hormone levels changed the inflammatory glycan profile, while the one that didn't, didn't. It's the kind of distinction a single testosterone or blood glucose panel wouldn't show on its own.

Treatment and monitoring

Men whose symptoms are linked to a genuine testosterone deficiency may be offered testosterone replacement therapy (TRT), available as tablets, patches, gels, implants or injections, with an endocrinologist advising on the right option. TRT can have a measurable anti-inflammatory effect in men with lower testosterone, and has been associated with a reduction in GlycanAge score and improvements across the Glycan Shield, Glycan Youth and Glycan Mature indexes.

"Testosterone is really three hormones. It's directly anabolic to muscle, meaning it builds muscle and reduces body fat. Its conversion to estrogen is important for brain function, vascular and artery health, bone health, and immune health. And its conversion to dihydrotestosterone helps with libido and mood. You want all three dialled in just right, it's something of an art."

— Joseph Raffaele, MD, Founder, Raffaele Medical

Because hormone-driven interventions like TRT can shift the inflammatory glycan profile within months, retesting a few months after starting or adjusting treatment gives a clearer read on whether it's working than waiting for annual bloodwork.

Proactive monitoring

Rather than waiting for symptoms to prompt a GP visit, the more useful approach is ongoing monitoring of the biomarkers that actually shift with hormonal decline. A GlycanAge home testing kit measures that inflammatory signature directly, and you can book a Result Interpretation Call with one of our specialists to talk through what your results mean for you.

External sources

• Male menopause. NHS. Link: https://www.nhs.uk/conditions/male-menopause/

• Sizar O, Leslie SW, Pico J. Male hypogonadism. StatPearls. Treasure Island (FL): StatPearls Publishing; 2024. Link: https://www.ncbi.nlm.nih.gov/books/NBK532933/

• Nieschlag E. Late-onset hypogonadism: a concept comes of age. Andrology. 2020;8(6):1506-1511. Link: https://doi.org/10.1111/andr.12719

• Ercan A, Kohrt WM, Cui J, Deane KD, Pezer M, Yu EW, et al. Estrogens regulate glycosylation of IgG in women and men. JCI Insight. 2017;2(4):e89703. Link: https://doi.org/10.1172/jci.insight.89703

• Tyagi V, Scordo M, Yoon RS, Liporace FA, Greene LW. Revisiting the role of testosterone: are we missing something? Rev Urol. 2017;19(1):16-24. Link: https://doi.org/10.3909/riu0716

• Vinicki M, Pribić T, Vučković F, Frkatović-Hodžić A, Plaza-Andrades I, Tinahones F, et al. Effects of testosterone and metformin on the GlycanAge index of biological age and the composition of the IgG glycome. GeroScience. 2025;47:1777-1788. Link: https://doi.org/10.1007/s11357-024-01349-z