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Breaking the silence: male menopause and why no-one wants to talk about it

By Jed Diamond


My search to understand male menopause began in the early 1990s, and was both personal and professional. I was nearing the age of 50, and my wife was telling me something was wrong. “You’re hormonal,” she told me, “It’s like you’re going through menopause or something.” At first, I laughed at the idea: like most people, I didn’t believe men went through a ‘change of life’ phase that was similar to what women experienced as they approached menopause.

Gail Sheehy, author of ‘Passages and menopause: the silent passage’, wrote in 1993: “If menopause is the silent passage, ‘male menopause’ is the unspeakable passage. It is fraught with secrecy, shame, and denial. It is much more fundamental than the ending of the fertile period of a woman’s life, because it strikes at the core of what it is to be a man.”

So then, what is male menopause, and why is the topic so taboo? As a clinician and writer who works with men and their families, I’ve conducted clinical research with men and women throughout the world to try and find out.


Why are we afraid to talk about it?

Men seem to have a much more difficult time talking about ‘the change’ than do women. This is not unexpected, since women are generally more tuned into their bodies and their hormonal rhythms than men are. In fact, when a female colleague of mine learned I was planning to write a book on male menopause, she said: “It’s about time you guys finally figured out you were hormonal, as well.”

Males are often raised to define their masculinity as ‘that which is not female’. As a result, more men have a difficult time understanding, talking about, and accepting the reality of entering this new stage of life. But, gradually the silence is beginning to lift, and both men and women are recognising that both groups experience the hormonal changes tied to the natural process of ageing.

We know, of course, that both males and females begin to go through puberty when certain hormones are released from a part of the brain called the ‘hypothalamus’. It shouldn’t surprise us then to learn that we all experience symptoms at mid-life, when our hormone levels begin to drop significantly. An increasing number of men can relate to Dave Frishberg’s thoughts on the matter, a fifty-two-year-old songwriter who said: “Gee, I hope there’s such a thing as male menopause… because if there isn’t, ‘what was that?’”


Symptoms of male menopause

Although ‘andropause’ is the more correct term for this stage in male life, ‘male menopause’ is more commonly used. Those who have researched the changes that occur in men, and men at midlife recognise that both men and women experience many of the same symptoms, including the following:

  • Decreased potency (inability to obtain and maintain an erection)
  • Reduced libido (sexual desire)
  • Increased irritability and anger
  • Fatigue and loss of energy
  • Aches, pains, and stiffness
  • Depression with symptoms that differ from those seen in women
  • Night sweats or ‘hot flashes’
  • Weight gain


Male menopause: a multi-dimensional change of life

There seem to be two groups who are speaking about male menopause. One group suggest that since men’s hormones decline slowly, and men can still reproduce later in life, that male menopause simply doesn’t exist. The other group believes that male menopause does exist, but is the result of a loss of testosterone as we age. They believe that treating ‘low-T’ with testosterone replacement is all that is necessary.

Research findings now show that male menopause is a multi-dimensional change of life. It can be described this way:

“Male menopause begins with hormonal, physiological, and chemical changes that occur in all men generally between the ages of forty and fifty-five, though it can occur as early as thirty-five, or as late as sixty-five. These changes affect all aspects of a man’s life. Male menopause is, thus, a physical condition with psychological, interpersonal, sexual, social, and spiritual dimensions.”

The scientific basis for andropause, or male menopause is becoming more widely accepted. Marc Blackman, M.D. formerly chief of endocrinology and metabolism at Johns Hopkins Medical Center said: “The male menopause is a real phenomenon, and it does similar things to men as menopause does to women, although less commonly, and to a lesser extent.”


Treatment options

The first step in seeking treatment is to get an accurate diagnosis. If there is any indication that a man is experiencing symptoms of male menopause, you can follow up with additional blood tests to rule out other causes, as well as assess testosterone and other hormone levels.

Treatments that may be used include the following:

1. Changes of diet

2. Increased exercise

3. Counselling to address issues of sexuality, intimacy, and emotional support

4. Help with irritability, anger, and depression

5. Exploring issues of career, and what is perceived as a ‘life’s calling’

6. Dealing with increasing stress levels

7. Hormone balance and enhancement

Although it is important to work with men via all seven of these approaches, many clinicians find that diet and exercise are particularly crucial. Even healthy diets can be missing key nutrients that are necessary for health and well-being. A sedentary lifestyle increases hormonal disruptions, and can contribute to your experience of any menopausal symptoms.


Going forward

There’s still a great deal we are learning about male menopause. Jonathan V. Wright, MD, and Lane Lenard, PhD, authors of ‘Maximize your vitality and potency’, say, “Although the idea has been around in one form or another for thousands of years, until very recently the existence of a hormonally-driven male menopause compared to that experienced by women was widely denied by the forces that rule mainstream medicine.”

Although there is much greater awareness now about the changes that men go through as they age, there is still a great deal of confusion and misinformation. Too many still believe that hormonal changes are a ‘woman’s problem’. Those who recognize the hormonal basis of male menopause still fail to understand that hormones are just one part of the problem: things like nutrition and exercise are equally as important.

Jed Diamond

From Jed Diamond

Jed Diamond, Ph.D., L.C.S.W., is Founder and Director of MenAlive, a health program that helps men, and the people who love them, to live well throughout their lives. He has over 40 years’ experience in the field of male-gender medicine, and integrative mental health.


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