Male Menopause: Myth or Reality?

My search to understand male menopause began in the early 1990s and was both personal and professional. Personally, 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. But professionally many of my male clients were experiencing a loss of sexual desire, erectile dysfunctions, irritability and anger, and other symptoms that I was learning were related to the “change of life.”

Gail Sheehy, author of Passages and Menopause: The Silent Passage, wrote in a 1993 article in Vanity Fair magazine, “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.”

History of Research on the Male Change of Life
The concept of male menopause is not a new phenomenon. In 1944, Drs. Carl G. Heller and Gordon B. Myers wrote a paper, “The male climacteric: its symptoms, diagnosis and treatment,” in the prestigious Journal of the American Medical Association. The symptoms which the authors attributed to the male climacteric were exactly those that have been described in more recent literature as symptoms of andropause or male menopause: Loss of libido and potency, nervousness, depression, impaired memory, the inability to concentrate, fatigue, insomnia, hot flushes, and sweating. Heller and Myers found that their study subjects had below normal levels of testosterone and that symptoms improved dramatically when patients were given replacement doses of testosterone.

By the time I began my research in the early 1990s, I found very little work had been done in the United States. The Heller and Myers study had not been followed up in the U.S., but it had been in other parts of the world, including England, Australia, Denmark, and Russia. My book Male Menopause was published in 1997 and was followed by Surviving Male Menopause: A Guide for Women and Men in 2000.

Symptoms of Male Menopause
Although “andropause” is the more correct term for the male change of life, “male menopause” is more commonly used. I decided to use male menopause as the title of my book because I found there were more similarities than differences in the symptoms that men and women experienced. In my research I found the most common symptoms of male menopause were reduced libido, reduced potency or ability to obtain and maintain an erection, fatigue, irritability, aches, pains, and stiffness, depression manifesting as anger or boredom, night sweats, dry and thinning skin, feelings of restlessness, and weight gain, especially around the waist.

Male Menopause: Myth or Reality?
Some clinicians don’t believe that male menopause is real. They point out that in women, ovulation ends and hormone production plummets during a relatively short period of time. In men, hormone production and testosterone bioavailability decline more gradually. For women, this signals the end of their reproductive potential. For men, they can continue having children later in life.

But there are an increasing number of health-care professionals who think that the male change of life is every bit as real and important as it is for women. One of the first was Rosetta Reitz, an American feminist and Jazz historian, who wrote Menopause: A Positive Approach in 1977. Reitz points out that the term “menopause” applies to the ending of a woman’s monthly menstrual cycles, but it is really much more than that. “Menopause has come to mean a combination of elements a woman experiences at the same time her menstrual flow stops.”

She goes on to say that “we can apply the term to men, too, even if they don’t menstruate. For it is more the combination of life’s circumstances that occur around the age of fifty, sometimes beginning as early as forty for some, that creates the condition labeled menopause.”

Mosby’s Medical Dictionary says male menopause is “a change of life for males that may be expressed in terms of career change, divorce, or reordering of life. It is associated with a decline in androgen levels that occur in men during their late forties or early fifties.” Marc R. Blackman, M.D., former chief of endocrinology and metabolism at Johns Hopkins Medical Center, says, “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 beginning treatment is to get an accurate diagnosis. I start by having clients take my Male Menopause Quiz. If there are indications that a man is experiencing symptoms of male menopause, we can follow up with additional blood tests to rule out other causes and assess testosterone and other hormone levels.

Some clinicians believe that the problem is mainly due to low testosterone and believe the best treatment is testosterone replacement therapy. I believe male menopause is more than simply an age-related loss of testosterone. Male menopause begins with hormonal, physiologic, and chemical changes that occur in all men and occurs in men around 40 to 55 years old, although it can occur as early as 35 or as late as 60. These physical changes affect a man’s life in psychological, interpersonal, social, and spiritual dimensions. Treatment approaches that I use include the following:

  1. Changes of diet.
  2. Increased exercise.
  3. Counseling to address issues of sexuality, intimacy, emotional support.
  4. Help with irritability, anger, and depression.
  5. Exploring issues of career and calling.
  6. Deepened practices of spirituality and passion in the second half of life.
  7. Hormone balance and enhancement.

Conclusion and Focus for the Future
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 analogous to that experienced by women was widely denied by the forces that rule mainstream medicine. Officially in his country, it still does not exist, although incontrovertible scientific evidence to the contrary has finally begun a slow shift in attitude.”

We will learn a great deal more in the coming months and years. For more information on our ongoing research you can visit me at www.MenAlive.com.

© Copyright 2012 GoodTherapy.org. All rights reserved. Permission to publish granted by Jed Diamond, PhD, LCSW, therapist in Willits, California

The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by GoodTherapy.org. Questions or concerns about the preceding article can be directed to the author or posted as a comment below.

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  • Lorna

    September 13th, 2012 at 1:19 PM

    OK I realize that there are probably some men who think that they are going through the change right along with their wives. But this can’t be happening across the board the way that it is for women. For women menopause Is a done deal, it’s going to happen whether you like it or not. It sounds like in the case of men there are simply a bunch of lifestyle changes that they can make to help them avoid the worst of the symptoms, if they ever experience it at all. So I tell you what- come up with the best answer possible for women going through this and THEN move on the the men. They have dominated health care studies for too long.

  • ted

    September 13th, 2012 at 2:30 PM

    its not for nothing that so many men in the age group that you have told about start to experience changes within themselves.although it may be gradual compared to women (because there is no event that ceases like in women),I do think male menopause does exist.I have experienced all this since the past few years(I’m 64 now) and my friends have experienced something similar too.

  • Kyleigh

    September 13th, 2012 at 3:57 PM

    I have always heard my mom talk about menopausal symptoms but never my dad! I think he would rather die than talk about having hot flashes or a low libido, and quite honestly I would too!

  • kyle

    September 13th, 2012 at 11:04 PM

    not easy for a man to admit to something like this.there is that male ego that is often spoken about…and I think that is the only reason why male menopause is a subject that has rarely been ventured into…if men and women both undergo sexual maturity then they must also have similar systems when it comes to decreased sexual drive isnt it?!

    and I am sad to see how this quiet from men from so long is now costing us because this phenomenon is understood so little and those that do struggle with this have no real avenue or guide to follow!

  • ellen

    September 14th, 2012 at 12:43 PM

    having seen changes in my husband starting in his late forties,I can definitely vouch for the fact that male menopause does exist.i think the only reason why it is explored and spoken so little about is because menopause was always associated with women and their menstrual cycle and hence that kept the men out.their changes were taken as more having to do with age,which is not the most accurate thing.

    this needs more studying and well we may have findings that will in turn help men during their male menopause and could enrich them just as the understanding of menopause has helped women.

  • Joeseph

    September 15th, 2012 at 3:43 AM

    Women have wanted to make this “their issue” for a very long time, and that’s fine. But there does need to be more research into whether this is a possibility for men too. To do this you have to find a provider who is at least open to the idea that this could be a possibility for a man without being critical of his chief complaints. This type of physician may not necessarily be the easiest to find on your area, but if you think that this is something that is going on with you then it is certainly worth a try to find a doctor who might have some valuable insight. Male menopause is bound to be one of those touchy subjects that not everyone is going to want to talk about, but if there are enough men that this is affecting to warrant a study, then maybe that in itself is enough evidence to show that this is something that at least deserves further research.

  • Kennedy

    September 16th, 2012 at 12:55 PM

    Im forty three and although I have not experienced any of these symptoms yet this does scare me a bit.But why is it male menopause or andropause? The symptoms seems clear enough to be classified as something that comes with age. It need not be something different from the aging process, does it? Or am I missing something here?

  • Jed Diamond

    Jed Diamond

    September 16th, 2012 at 4:18 PM

    All good comments and thanks for the feedback on the article. A few things I’d add. There is more to this an simply aging since it begins with men around 40 and is over by 65. It definitely has to do with a combination of hormonal, physiological, psychological, sexual, social, relational, and spiritual changes. A new book has recently been released, Manopause: Your Guide to Surviving His Changing Life. Written by two women, it offers the latest findings and will be valuable to men as well. Check it out at: themanopauseman.com. I also invite you to come visit me. Thanks for your continued interest in this
    important work that impacts us all.

  • Dawn

    September 17th, 2012 at 11:02 AM

    I seriously have a hard time believing that this is something that really happens to men. I mean I can see how ageing definitely affects the ways that certain parts of our bodies work but to suggest that men can go through menopause in the same way that many women do is just insane. I think that many women are going to view this as just another way of men wanting to get the upper hand while men will not want to acknowledge that these things are happening to them!

  • Jed Diamond

    Jed Diamond

    September 17th, 2012 at 4:27 PM

    Dawn,

    I know I had a difficult time accepting that I was going through a hormonally driven change of life that had similarities to what women went through. But doing large-scale interviews and reading many studies from all over the world, I concluded that it was true. The good news is that there is a lot women and men can do to prevent problems and improve their health and well-being.

  • Alice

    October 4th, 2012 at 6:15 AM

    I am just surprised about this certain study on men’s menopause. It sounded strange because it’s been women who were known for this adulthood stage and it’s been also clinically proven that w omen suffer much than women. I guess you always have a choice whether you would settle to feel the pain and uncomfortable phase that a menopause person is going through or choose to have a treatment by which effectively gives you relieve and avoid undesirable effect of menopause and let me just remind you that they are plenty of choices regarding the medication now in the market which is according to your desire and choice.

  • Alice

    October 4th, 2012 at 8:43 AM

    I find it hilarious but then just realized that it was basically based on facts. It’s definitely a part of every individuals life regardless of gender. But, we always have a choice and it’s up to us whether we will gonna live with it.

  • Jed Diamond

    Jed Diamond

    October 5th, 2012 at 4:08 AM

    One way I think of this stage of life which we can call male menopause, andropause, or, manopause, is that its like puberty, the second time around. Think about puberty. We all go through it whether we are male or female. Some of us have more difficulty than others. There is a significant hormonal component. In puberty, the hormones are increasing, while in manopause they are decreasing. But there are also other issues of independence, identity, love, and power.

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