What Is “Manopause” & How Does It Relate to Incontinence?

Older man and woman talking

Key Takeaways:

  • As men age, declining testosterone levels lead to physical and emotional symptoms known as andropause or male menopause.
  • Andropause weakens pelvic floor muscles, increasing the risk of urinary incontinence, an aspect of men’s health that’s frequently not addressed.
  • Seeking treatment for andropause and urinary incontinence symptoms is crucial for improving your quality of life and preventing complications.

As men age, they may experience something called male menopause. This gradual decline in testosterone levels can bring about a range of symptoms, from subtle changes in mood to more noticeable effects, like decreased libido and muscle mass. 

Understanding the causes and symptoms of male menopause, as well as its relationship with conditions like urinary incontinence, is crucial for maintaining overall well-being as you age. 

Infographic of how to treat male menopause and incontinenceInfographic of how to treat male menopause and incontinence

Jump To:

What Is Male Menopause?

Why Do Men Experience Low Testosterone?

Causes & Symptoms of Male Menopause

How Does Male Menopause Relate to Urinary Incontinence?

Risk Factors of Male Menopause & Urinary Incontinence

How Common is Urinary Incontinence During Male Menopause?

Treatments for Male Menopause & Urinary Incontinence

Why Is It Important to Treat Urinary Incontinence in Men?

How to Get Male Bladder Control Supplies Covered by Insurance


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What Is Male Menopause?

Male menopause, also called “manopause” or andropause, refers to the gradual decline in the hormone testosterone as men age. Andropause is age-related and can occur during your late 30s and early 40s. 

Why Do Men Experience Low Testosterone?

Subtle declines in male hormone levels naturally occur in older men as they age. However, andropause occurs when hormone production levels are below your lower threshold. 

These declining testosterone levels are caused by hormonal irregularities, with testosterone being converted to dihydrotestosterone (DHT). DHT is an essential hormone for masculinization, such as prostate growth, genital maturity, and facial hair.

Causes & Symptoms of Male Menopause


  • Aging
  • Hormonal changes with increasing sex hormone binding globulin, increased estrogen levels.
  • Lifestyle factors and certain health issues (sedentary activity level, high-fat diet, diet high in processed foods, high alcohol consumption, smoking / vaping, chronic stress).
  • Excessive body fat or obesity (especially visceral adipose tissue).
  • Comorbidities (hypogonadism, diabetes, hypertension, hyperlipidemia, sleep apnea, chronic obstructive pulmonary disease, chronic kidney disease, HIV / AIDS, pituitary disorders).
  • Certain medications (chemotherapy, radiation, long-term opioid use, corticosteroids).


Typically, the signs and symptoms of andropause are much more subtle than what women experience during female menopause.

  • Sleep disturbances or night sweats.
  • Hair loss.
  • Mood changes / irritability.
  • Fatigue or tiredness.
  • Decreased libido or sexual function. 
  • Erectile dysfunction or erection difficulties. 
  • Genital atrophy.
  • Loss of muscle mass or strength.
  • Redistribution of adipose tissue.
  • Decreased bone density.
  • Cognitive changes, like poor concentration. 
Man looking through incontinence productsMan looking through incontinence products

How Does Male Menopause Relate to Urinary Incontinence?

Changes in your testosterone levels cause muscle weakness / loss of tone and decreased functionality in your body and pelvic floor muscles. 

Your pelvic floor muscles act like a hammock, holding your pelvic organs in place and helping to control the bladder. When these muscles weaken during andropause, urinary incontinence (loss of bladder control) may occur. 

The most common type of urinary incontinence experienced with male menopause is urge incontinence, but stress, overflow, and functional incontinence may also occur. 

Risk Factors of Male Menopause & Urinary Incontinence

Sedentary lifestyles can exacerbate symptoms of male menopause and contribute to urinary incontinence. This is because andropause leads to pelvic floor muscle weakness and difficulty supporting the prostate and bladder, which can lead to urinary incontinence.

How Common is Urinary Incontinence During Male Menopause?

While research has shown increased odds of andropause associated with urinary incontinence, not many studies have looked at andropause as being a risk factor for urinary incontinence.  

With andropause typically occurring in the 40s and 50s, urinary symptoms are seen in the early 60s. Urinary incontinence significantly increases from around 5% between the ages of 19 and 44 to around 11% between the ages of 45 and 64 and doubles to around 20% of men over the age of 65.

Treatments for Male Menopause & Urinary Incontinence

Treatment options for andropause and urinary incontinence include: 

  • Hormone replacement therapy (HRT). Addressing low testosterone levels with HRT can be an effective treatment for both male menopause symptoms and urinary incontinence. However, before treating urinary incontinence with testosterone therapy, your healthcare provider should ensure that your levels of testosterone are low.
  • Pelvic floor therapy. A pelvic floor physical therapist can assess your pelvic floor muscles and help improve their function, coordination, and strength, reducing urinary incontinence symptoms.
Male bladder control products in bagMale bladder control products in bag
  • Lifestyle changes. Increasing daily movement, weight lifting, decreasing fat intake, exercising pelvic floor muscles, getting adequate sleep, and reducing stress can all help improve symptoms of andropause and urinary incontinence. 
  • Male bladder control products. Managing leakage inside and outside the home can feel embarrassing if you don’t have protective products. Thankfully, your insurance plan may cover male protective underwear and male bladder pads if you’ve been diagnosed with urinary incontinence. We offer some of the highest-quality male supplies; finding out if you qualify for free products only takes about 2 minutes. Complete our Eligibility Form today to find out if your insurance may cover supplies for you.

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Why Is it Important to Treat Urinary Incontinence in Men?

While it may feel shameful to speak with a healthcare provider about your andropause or urinary incontinence symptoms, it’s essential to treat these conditions. Long-term effects associated with untreated incontinence can include: 

  • Social isolation.
  • Depression
  • Anxiety
  • Urinary retention.
  • Urinary tract infections (UTIs).
  • Kidney disease.
  • Other comorbidities.
Man wearing male incontinence underwearMan wearing male incontinence underwear

If your healthcare provider dismisses you after discussing your concerns of andropause or urinary incontinence, find another provider who will listen to your concerns and investigate the root of the symptoms.

Addressing the symptoms of male menopause, including urinary incontinence, is vital for maintaining not just physical health but also mental and emotional well-being. 

Whether through hormone replacement therapy, pelvic floor exercises, lifestyle adjustments, or the use of specialized bladder control products, seeking appropriate treatment can significantly improve your quality of life and mitigate potential long-term complications. 

Remember, discussing your concerns with a healthcare provider is the first step towards effective management, ensuring a healthier and happier journey through the aging process.

Aleece Fosnight

Aleece Fosnight, MSPAS, PA-C, CSC-S, CSE, NCMP, IF, HAES is a Medical Advisor and Writer for Aeroflow Urology and a board-certified physician assistant specializing in sexual medicine, women’s health, and urology. In 2019, she opened up her own private practice, the Fosnight Center for Sexual Health, and implemented the sexual health grand rounds curriculum at her local hospital and residency program.

Aleece is also the founder of the Fosnight Foundation, a non-profit organization dedicated to the education and training of professionals in the sexual health field and providing funding for access to healthcare services in her local community.

About the Author

Marlee Septak is the Senior Content Specialist at Aeroflow Urology. She brings a deep understanding of incontinence and health conditions associated with it to her writing. She graduated from Columbia College Chicago and holds a Bachelor's degree in Journalism. Marlee has contributed to various magazines and blogs, including Borgen Magazine, Echo Magazine, Chicago Ideas Week, Assuaged, and Peaceful Dumpling. In her spare time, she enjoys traveling, trying new restaurants, and just sitting down with a good book.


Information provided on the Aeroflow Urology blog is not intended as a substitute for medical advice or care from a healthcare professional. Aeroflow recommends consulting your healthcare provider if you are experiencing medical issues relating to incontinence.