The tiredness gets blamed on work. The waist on age. The flat drive on stress.

For a lot of men, it is one number nobody ever measured.

I spend most of my time on women's hormones, so let me be clear about why I am writing this one. The same dismissal women receive for perimenopause, men receive for testosterone, only the wording changes. A man's testosterone declines slowly from around the age of 30, by roughly 1 per cent a year, and most men stay within the normal range as it happens. The problem is the men who do not. About a third of men over 45 sit below what is normal for their age, and the symptoms, fatigue, irritability, weight gain, low libido and lost motivation, are so easily filed under "just getting older" that the hormone behind them never gets checked.

There is a second layer that should give anyone pause.

Across whole populations, average testosterone has been falling for decades, by roughly 1 per cent a year since the 1980s, independent of individual ageing. A man today often carries lower levels than a man of the same age a generation ago. The drivers are still debated, with weight, sedentary living, poor sleep, chronic stress and environmental exposures all in the frame, but the downward trend itself shows up consistently across studies in different countries.

I want to be careful here, because this is exactly the territory where hype takes over. I am not writing this to sell testosterone therapy. The evidence on treating age-related low testosterone is genuinely mixed. The benefits are real for some men, modest or absent for others, and the decision belongs in proper clinical hands after proper testing. What I will say plainly is that "just stress" and "just age" are not measurements. They are guesses, and they are the same guesses that keep women undiagnosed for years.

A man who is flat, heavy and foggy at 48 deserves the same thing a woman in perimenopause deserves. The actual data before the shrug. Test first, then decide, rather than deciding by default that this is simply what midlife feels like.

Picture knowing your real numbers, then making a sharp, informed call about your energy and performance, instead of writing another year off to age.

The data comes first. Book a DUTCH Test consultation → https://www.sannalife.health/dutch-test

Sources: 

• Cleveland Clinic and Mayo Clinic on age-related testosterone decline; 
• Massachusetts Male Aging Study and follow-up generational analyses; ColumbiaDoctors on male hormonal change; 
• T-Trials on testosterone therapy outcomes in older men.