Male Menopause: Understanding the Myth and Reality
I haven’t been feeling well. I’m feeling rundown, irritable, and my appetite is through the roof. My mood is drastically changing with each passing hour. It probably has something to do with my hormones.
While reading those sentences, you are likely imagining a woman who is experiencing issues with her normal menstrual cycle, or maybe you're envisioning an older woman who is encountering symptoms surrounding menopause. What you’re not picturing is an older male complaining about the unwanted effects of this hormones, but perhaps you should be.
Just like women, men are greatly affected by their hormones, and just like a woman, a man’s hormone levels will change over time, especially as they age. Because of these changes, some have started a movement to recognize and treat a condition called male menopause.
Menopause in Women
Before we can look at the male side of the equation, it is helpful to begin with a well-accepted fact – women experience menopause. For women, the journey towards menopause is easy to observe and track.
When a woman begins her first menstrual cycle, she enters a stage of development called premenopause. During this time, she will experience normal menstruation, which is regulated by normal peaks and valleys of hormones like estrogen and progesterone.
Premenopause continues for decades, and then in her late-40s or early 50s, the woman will shift into a period of perimenopause. Erratic changes in hormones mark this stage. These unpredictable fluctuations trigger a number of unwanted and uncomfortable symptoms of perimenopause including:
- Night sweats
- Sleeping problems
- Hot flashes
- Dry skin
- Mood changes with depression and irritability
- Lower sex drive
These symptoms of perimenopause can help someone identify the hormonal changes are happening within the body, but the clearest sign of perimenopause is inconsistent menstruation. The regular periods of premenopause will give way to periods that have inconsistent durations and intensities during perimenopause.
During perimenopause, periods may be:
- Shorter and less intense
- Longer and more intense
- Absent for several consecutive months
The transition to menopause and postmenopause occurs on the day of the final menstrual cycle. At this time, the hormone levels drop significantly and remain at this lower level.
There’s No Men in Menopause
It’s so important to know the basics of menopause in order to point out an important fact – none of that happens in men because:
- Men don’t menstruate
- Men don’t experience a time of radical ups and downs with their hormones
- Men don’t reach a point hormone levels drop sharply and stay consistently low
With all of these differences, calling anything men experience “male menopause” is a misnomer and slightly misleading. That is not the end of the story, though, as men do endure changes to their hormone levels and these changes can impact their physical, mental, and sexual health.
What Are the Signs of Male Menopause?
Whereas women experience a period of consistent cycling followed by years of irregular cycling followed by a profound drop and stabilization of hormones, men encounter a slow and steady hormone decline. Beginning around the age of 30, hormone levels decrease about one percent a year, every year.
The hormone affected by this recession is testosterone, the chemical associated with many stereotypical male characteristics like muscle mass and body hair. With lower and falling levels of testosterone, men may begin having physical changes like:
- Changes in sleep – some will have increased need for sleep, inability to sleep, or lower quality of sleep
- Increased body fat
- Reduced lean muscle
- Decreased sexual interest and performance
- Lower strength and stamina
- More fatigue and loss of energy
- Loss of body hair
- Enlarged or tender breasts
- Dropping bone density
One or two of these changes can significantly impact the physical standing of any man, but when you begin to have many symptoms, you could feel like a completely different person.
Unfortunately, the changes do not stop with your physical health. A man with decreasing testosterone levels will endure mental health symptoms as well like:
- Lower levels of self-esteem, self-worth, and confidence
- Less motivation
- Less interest in completing fun activities or spending time with people you enjoy
- Poorer concentration, attention, and memory
- Increased intensity, frequency, or duration of sadness, which may develop into depression
The mental health symptoms combined with the physical health symptoms have an ability to devastate any man’s overall well-being completely. From here, problems could compile and escalate, leading to any number of unwanted problems.
I knew menopause would come sooner or later and I've accepted the changes that come with it - this is my experience with coping with perimenopause.
If It's Not "Male Menopause," Then What Is It Called?
This condition, the continuous loss of testosterone over the years, is known by several names:
- Male menopause
- Low testosterone/low-T
- Hypogonadism/late-onset hypogonadism
- Androgen deficiency in the aging male – ADAM
- Partial androgen deficiency in the aging male – PADAM
One name that seems very popular is andropause. Andropause is a term used when referring to this loose group of symptoms which result from the loss of testosterone in aging men.
Although this might seem like a new concept, there has been a reference to this collection of symptoms in medical journals as early as 1946.
Is Male Menopause Real or Fake?
It is already established that the vast majority of men begin a slow loss of testosterone starting in their 30s, but there continues to be some debate on the subject.
You may hear or ask yourself questions like:
- Is andropause real?
- Why am I just hearing about it now?
- If it is happening to everyone, is it even a medical condition?
The final question is very interesting and deserves some discussion. If all men experience a loss of testosterone, why diagnose this as a medical condition or a medical disorder?
Isn’t that the same as diagnosing other universally experienced conditions like growing older or getting hungry? Should we just diagnosis every normal part of human life and take endless medications to “cure” the issue?
Although men routinely suffer from andropause, it can be quite devastating for some. Not only can it impact their physical and mental health and functioning, but the condition can also affect their longevity.
Lower than expected levels of testosterone in older men is associated with an increased risk of death. So, even though all men lose testosterone, some men suffer greater consequences.
Male Menopause Diagnosis
If male menopause/andropause is a recognized condition, it requires medical intervention to treat. But first, it must be properly diagnosed.
An andropause diagnosis involves a conversation with your doctor about the symptoms you are experiencing and a quick physical examination. During the exam, your doctor will assess your body hair, breasts, penis, and scrotum to notice signs of the condition.
The doctor will also work to rule out other conditions that may cause similar symptoms. Other issues that may be confused with andropause include:
- Organ failure
- Past steroid use
- Cancer treatment
- Medical side effects
Your doctor will also encourage blood tests before making a diagnosis. Since levels of testosterone fluctuate during the day, your doctor will recommend you receive at least two blood tests to be completed early in the morning, when testosterone levels are their highest.
If all signs point to low testosterone without another known cause, you will receive the diagnosis.
Just as women may use hormone replacement therapy (HRT) to manage their decreased levels of estrogen and progesterone, men may be prescribed HRT with testosterone. HRT for men is available in many different forms and formulations like:
The best option for you will depend on numerous factors, so be sure to talk over your options with your doctor. Be sure to inquire about the risks and side effects of each medication to make the best decision for your needs and wants.
Medication options won’t be right for every guy, and not every guy will need a medication to treat their declining testosterone.
There is no way to boost your testosterone production naturally, but fortunately, there are other steps you can take to temporarily prevent, slow, and compensate for the inevitable decline of the hormone in your body including:
- Target the real problem. With some many conditions affecting your health and well-being, you must be certain low testosterone is actually the cause. Be honest and clear about your symptoms and concerns – no matter how embarrassing – to identify the real problem.
- Stay healthy. By adjusting your diet and upping your physical activity, you can improve your strength, stamina, energy, and muscle mass, which are just the aspects andropause robs from you. These changes will take a lot of hard work and consistency, but they will lead to great outcomes that will stay with you. Long-term changes provide long-term results.
- Avoid the herbals. Herbal supplements and remedies might make a lot of fantastic promises like returning your testosterone production to levels you haven’t had since your 20s. Watch out for these outlandish claims. There is no research to show that any supplement works to improve your condition long-term. In fact, some herbs, like DHEA, might actually cause more problems by triggering a higher risk of prostate cancer.
- Seek out support. As we know, declining testosterone impacts your mental health as well as your physical health. Because of this, be sure to include additional supports and mood-boosting activities into your routine. Meeting with a mental health professional can help you recognize your symptoms and offer helpful strategies to stabilize your mood and motivation.