Male menopause
Publicity about the treatment of impotence with the medication Viagra (sildenafil) and similar medications such as Cialis (tadalafil) and Levitra (vardenafil) has raised people’s interest in the topic of the male menopause. This term is often used about men between 45 and 55 years of age. As they approach this stage of their lives, many men worry about what they might expect. ‘Is there such a thing as the male menopause?’ is a common question.
Strictly speaking, and when compared with the changes that happen at the time of the female menopause, there is no such thing as a male menopause. In women the menopause is a sign of rapid reduction in female hormone production. This can produce a variety of symptoms, both physical and psychological. The most obvious physical symptom is the cessation of menstrual periods.
With increasing years the production of male hormones also declines. But the decline is generally regarded as being very gradual, usually less than one per cent a year. Many men have become fathers in their seventies and beyond. However, recent research is bringing some of these issues into question and there is currently much debate and controversy about treatment with male sex hormones.
What happens when we age?
Without doubt, ageing does bring a reduction of some of the things often regarded as typically male, such as physical strength, and libido (sex drive). Appearance also changes. Weight gain (middle-aged spread), hair loss and skin changes are all part of normal ageing.
As well as these physical changes many psychological problems can contribute to the so-called male menopause. In middle life most men have to come to terms with the fact that they will not achieve all the ambitions of their youth. These might relate to success in their careers. They may miss out on an expected promotion and see a younger person overtake them. Dreams of financial success might be vanishing and sporting abilities declining.
Some men become anxious that they are no longer attractive to their spouse or other members of the opposite sex.
All these things can produce a form of depression and lead to strange behaviour. Starting a relationship with an attractive, much younger woman, or embarking on a highly risky business venture are extreme examples of the sort of things that can happen.
Men with these problems need a lot of support from family and friends. They need help to accept a new stage in their lives and to be frequently reminded of what they have achieved, rather than what they haven’t.
Testosterone deficiency
Many older men will have testosterone levels similar to those of men in their 30s. Only about one in 200 men under 60 and one in 10 men over 60 have abnormally low testosterone levels. Fatigue, muscle weakness and loss of sex drive can indicate low testosterone, but these symptoms can be also caused by other conditions. Your doctor can check your testosterone level if you have these symptoms.
Even if your testosterone level is low, the cause may be another condition such as depression or obesity. If so, treating the underlying condition may return testosterone levels to normal.
Testosterone therapy does help men with severe testosterone deficiency, but the evidence isn’t clear regarding whether it helps other men. Bear in mind that testosterone therapy does have potential risks, including enlargement of the prostate, growth of prostate cancer or breast cancer that is already present, breathing problems during sleep, acne and infertility.
Last Reviewed: 18 May 2007
