For as long as we have discussed hormonal imbalance, mood swings, irritability, it’s always in regards with women. Whereas, for men, such changes are usually blamed on stress and burnout. The fact is that hormones are running the show for men too, but the dialogue has rarely been a part of the discussion. The truth is hormonal imbalance isn’t a term coined just for women. “When we hear the phrase hormonal imbalance, most of us think of women—periods, PMS, or menopause. But the truth is, men also experience hormonal fluctuations that can deeply affect their bodies, minds, and day-to-day lives. The difference is, we rarely talk about it,” Dr David Chandy, Director, Endocrinology, Sir HN Reliance Hospital.
In men, it dictates the energy levels, sex drive, mood, muscle mass and even how clearly one thinks. The real picture lies in the levels of testosterone. “The male body depends on a fine balance of hormones like testosterone, cortisol, insulin, thyroid hormones, and even estrogen. Any disturbance in these can trigger physical and psychological changes,” says Dr Chandy.
The levels of testosterone aren’t also fixed; according to research by Western Michigan Urological Associates, ‘one out of four men over the age of 30 have low testosterone levels.’ However, it not only naturally declines with age but is also affected by stress, obesity, lifestyle and chronic diseases which can affect younger men too. “The most common indicator of hormonal imbalance in is low or fluctuating testosterone, sometimes called male hypogonadism. This can happen due to natural ageing (testosterone levels drop 1 per cent every year after age 30), stress and poor sleep, obesity and lifestyle-related metabolic issues, and certain medications or medical conditions (diabetes, pituitary disorders, testicular problems),” explains Dr Chandy. Think of your hormones as an ecosystem so, if one element, like stress hormone, spikes too high, it can throw testosterone and everything else off balance. Apart from illnesses, even some medications like opioids or antidepressants can push levels down.
This is where things get real; hormonal imbalance shows up in ways you can feel. Physically, loss of muscle mass, increased belly fat, reduced stamina, low libido, fatigue are all because of hormonal imbalance in men. “Mood swings, irritability, poor concentration, sleep problems, changes in blood sugar, cholesterol, and overall energy balance are other emotional and behavioural changes that men may experience,” says Dr Chandy. In the same research by Western Michigan Urological Associates, it’s also mentioned that low testosterone is also linked to higher rates of fatigue, low mood, and brain fog. You might drag yourself through the workday, then collapse with zero energy for any social life.
While one might dismiss these changes as just burnout or ‘getting older,’ these hormones touch almost every system in the body. Low testosterone is tied to bone density loss, which raises fracture risk later. It affects how your body stores fat and uses sugar, increasing the odds of metabolic syndrome and diabetes. It even influences heart health. Mentally, it’s connected with depression, motivation, and memory. In other words, this isn’t only about sex drive or muscle, it’s about whole-body health. “Low testosterone is linked with a higher risk of cardiovascular disease, diabetes, osteoporosis, and depression. Elevated cortisol can weaken immunity, raise blood pressure, and worsen abdominal obesity. Thyroid dysfunction can cause weight changes, fatigue, or even fertility issues,” adds Dr Chandy.
Is The Irritable Male Syndrome or Male PMS Real?
The effect of hormonal imbalance is not just on the surface. There exists a phenomenon called the male menopause—medically called andropause, it is a drop in the testosterone levels due to age and mirrors menopause in women. Men do face hormonal fluctuations, which do affect their mood and behaviour but because it’s much less physically visible when those things are happening, and because men are attuned to not acknowledge their emotional state, it’s not as recognised socially.
And then there is Irritable Male Syndrome which is compared to pre-menstrual syndrome (PMS). Men do face hormonal fluctuations which do affect their mood and behaviour but because it’s much less physically visible when those things are happening, and because men are attuned to not acknowledge their emotional state, it’s not as recognised socially.” “Men experiencing IMS may feel constantly “on edge” or uncharacteristically reactive. It’s sometimes compared to PMS in women, but in men, it tends to be more persistent and tied to both biology and lifestyle,” says Dr Chandy. Researchers first noticed it in animals, when testosterone dropped seasonally, males became grumpy, lethargic, and aggressive. In humans, it describes that pattern of mood swings, irritability, fatigue, and low libido tied to hormonal dips. While not an official diagnosis, IMS resonates because so many men recognise themselves in it. It’s not you being weak or just stressed, it’s your body’s biology nudging your behaviour.
What Can You Do About It?
The first step is awareness. If you’re feeling off for weeks or months, it’s worth getting checked. “Treatment begins with the right diagnosis. A specialist will typically evaluate symptoms, lifestyle, and confirm with lab tests,” says Dr Chandy.
But here’s a thing, lifestyle changes can move the needle a lot. Strength training is one of the most powerful natural testosterone boosters. "Regular exercise, weight management, adequate sleep, stress reduction, and a balanced diet can significantly improve hormone balance,” suggests Dr Chandy. Adequate sleep may be the most underrated therapy to fix the imbalance. Eating enough protein, healthy fats, and key nutrients like vitamin D and zinc matters. Look for options rich in antioxidants and good fats, such as colourful vegetables, nuts, seeds, spices and herbs that are generally used for cooking. Fatty fish, olive oil, leafy greens, eggs, onion, and broccoli are also great options. Cutting back on alcohol, handling stress, and getting leaner all help, too. “Treating thyroid disease, diabetes, or obesity often restores balance naturally. Therapy and counselling may help manage irritability, depression, or stress related to hormonal shifts,” explains Dr Chandy.
For men with clinically low testosterone, “Testosterone replacement therapy (TRT) may be considered under medical supervision,” says Dr Chandy. Studies show it can restore muscle, energy, mood, and libido, but it’s not for everyone. There are potential risks, so it has to be a carefully considered, monitored decision.
Hormonal imbalance can be restored. However, the biggest challenge is not overcoming physical or medical issues but societal stigma. Unfortunately, the dialogue around the topic has been scarce and the internet is an overwhelming spot of information, rather misinformation. Recognising the signs early, making lifestyle shifts, and seeking medical help, if needed, can help you feel like yourself again which is strong, steady, and present in your life.
