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What Middle-Aged Men Say about Male Menopause
(05/04/2004) by Beverly Whipple, Ph.D., R.N., F.A.A.N.
Copyright 2001
No excerpts of this article may be reprinted without permission
While scientists disagree about male menopause, the ultimate experts on the subject---middle-aged men themselves---express few doubts that it exists.
Physically, a man may notice a gradual decease in muscle mass and strength. There may be a slight loss of bone mass. Common psychological symptoms are lethargy, depression, irritability, mood swings and loss of a sense of well-being.
He may also notice the first faltering of potency, or a slackening of sexual desire. And unless a man is in a good relationship with a knowing partner, the shock of these changes may bring on a powerful psychological crisis, which can frighten a man into impotence, or erectile dysfunction, as it is now called.
Many men wonder "Is it just me?" But they won't talk about it with their wives or other men.
The term menopause may actually be a misnomer when applied to men. Their reproductive glands do not all shut down the way women's ovaries do. What happens is more gradual than female menopause, and not universal.
Women's estrogen levels decline suddenly, while men lose only 0.5% of testosterone annually, beginning at age 40, rarely dipping below healthy levels. This also has nothing to do with fertility. A healthy proportion of men can sire children well into older age.
So biology doesn't seem to explain male menopause. Unlike women, men don't usually have hot flashes (although rare cases, caused by a sudden drop in testosterone, have been documents). But men do have some symptoms.
Many men are dealing with their bad habits catching up with them. Smoking, a lack of exercise and fatty foods may bring on sexual problems and muscle loss. Aging makes men feel vulnerable. They realize life is finite, and they don't know how to cope. Coming to terms with mortality is not just a his-or-hers issue, it's a couple's concern.
There is a heightened awareness that the clock is ticking. And the biggest midlife health problems for men---impotence, depression and muscle loss---inevitably have an impact on women as well as men.
Now do these symptoms exist because of male menopause or does the idea of a midlife crisis encourage men to get busy and have one, before the window of opportunity closes? The midlife years often involve the onset of illness such as diabetes, heart disease, colon and prostate cancer. Even the healthiest middle-aged man is physically compromised, and if thinning hair and weakening eyesight weren't enough to contend with, these conditions may be accompanied by depression.
The physical problems may cause the depression, or the depression can cause some of the physical symptoms, among them diminished sex drive. Stress can also inhibit testosterone release.
Middle-aged men are seeing younger men who are more energetic. When they look in the mirror, the look more like their fathers every day. Their parents are getting ill or dying, and their kids are leaving home. Every day, they fear they are going to become older, fatter, balder, weaker and less important in the world.
When middle-aged men have affairs, they are not really looking for new partners, they are looking for reassurance of their potency, for someone who will make them feel wonderful. They don't expect to get trapped and upend their lives.
There are many, many myths about this time of life. In fact, the idea that middle age is bad or boring or both, has caused the members of the graying Baby Boom generation not to use the term. Middle age has a horrible connotation, and the facts to not support this.
Data show that middle age is the very best time in life. The best year is fifty. You don't have to deal with the aches and pains of old age or the anxieties of youth. Is anyone going to love me? Will I ever get my career off the ground? Rates of general distress are low. You’re healthy. You're productive. You have enough money to do some of the things you'd like to do. You've come to terms with your relationships, and the chance of divorce is low. Midlife is the it you've been working toward.
HIS AND HERS MIDLIFE AND MENOPAUSE
Age of onset
Males: 40-70, mostly about 50
Females: 40-55, mostly about 50
Causes
Males: smoking, fatty foods, a lack of exercise, a realization of mortality
Females: A sharp, sudden drop in the hormone estrogen
Major symptoms
Males: decreased sexual performance and desire, loss of muscle and bone mass, depression, fatigue
Females: Hot flashes, vaginal dryness, mood swings, insomnia, depression, bone loss
Treatment
Males: Smoking cessation, low fat, high calcium diet, aerobic and weight bearing exercise; counseling; medication to relieve impotence
Females: Hormone replacement therapy, vaginal lubricants; aerobic and weight-bearing exercise; low fat, high calcium diet
Copyright Beverly Whipple, Ph.D., 2001
All rights reserved.
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