Health & FitnessInformation ResourcesThe male menopause - not as daft as some may think The male menopause - not as daft as some may think
By Dan Fielder - 19/12/2007
Men have their own menopauses too. From Reggie Perrin to American Beauty, we're all familiar with the stereotype of the man who reaches 50 and buys a motorbike, trades his wife in for an embarrassingly younger model or chucks in his job to go off and travel the world.
Broadly speaking, the term "mid-life crisis" conjures up images of a dissatisfied man in middle age who suddenly goes through a series of sudden and violent changes of behaviour. But doctors and psychologists now believe that this controversial condition or syndrome affects many men in their 30s, 40s and 50s. Some believe it has a proper psychological or hormonal basis while others argue that the symptoms are just signs of a mid-life crisis and have other, logical, causes.
Those who believe the mid-life crisis is a genuine condition have identified a wide range of symptoms, including: irritability, loss of sex drive, erectile dysfunction (impotence), fatigue and depression, often characterised by unaccountable low moods, feelings of sadness and lethargy.
At least one study has suggested that those undergoing mid-life difficulties may be distinguished from other men affected by depression by their sense of urgency. Such men are driven to keep on being active, sometimes even more active than they were before the crisis. Other physical symptoms include: stiffness in the muscles and joints, night sweats, dry skin, hair loss, weight gain and a loss of ability to recover quickly from injuries. And a combination of these symptoms might understandably provoke a sense of crisis for a man.
The proportion of men who experience emotional difficulties during mid-life is unknown - especially as most men find it hard to talk about their feelings or physical problems, especially if they are related to sexuality. Classically, any man for whom work is his main source of personal identity, or who starts to feel or show his age, is a strong candidate for a mid-life crisis. And there is some evidence that the men most affected by a mid-life crisis are those who have given little thought to such inevitable upheavals as ageing and retirement.
While the Reggie Perrin stereotype can be comic, it isn't difficult to see that in real-life cases such drastic behaviour may be motivated by deeper issues that are all too serious. Many of us are aware of feelings of disillusionment and irritability setting in in middle age, attributable perhaps to a heightened sense of our own mortality and/or feelings of dissatisfaction at the way life has turned out. Very often such gloomy insights are brought on by a specific trigger - a redundancy, divorce or a milestone birthday.
In a society which puts a particularly high value on youth, men reaching mid-life may feel a loss of masculinity and confusion about their future role. Divorce, insecurity at work and the changing role of men add to the uncertainty many feel during this time of transition.
Changes in a man's sexual function that often come with getting older can be especially devastating. Suddenly, you can't do it three times a night any more, it's harder to get an erection ... is this the start of the slippery slope? Sleep may be another factor, as mid-life crises may be linked with a growing inability to sleep deeply. By the age of 45, according to one report, few men manage deep sleep at all, leading them to grow fatter and more unfit because they cease to generate growth hormone.
So what about other physical or hormonal causes - more like a woman's symptoms? Some doctors argue for the existence of a "male menopause" involving hormonal changes in the body, analogous to the female menopause. The very phrase "male menopause" is misleading, however, since menopause strictly refers to the cessation of menstruation. If there is a male equivalent, the experts have yet to agree on the name: the terms "andropause", "viropause" or "endopause" have all been put forward.
It's argued that the symptoms of the male menopause - the main one being a loss of libido - are caused in middle-aged men by the decreasing level (and effect) of testosterone, the hormone responsible for secondary sexual characteristics such as muscle strength and facial hair, as well as sexual drive and the production of other hormones, such as DHEA (dehydroepiandrosterone).
Testosterone levels gradually decrease from the late 20s, and, by the time a man reaches 80 they will be at pre-puberty levels. However, unlike oestrogen in women, there is no sudden, measurable drop in testosterone in men in middle age, and often the testosterone levels of men complaining of andropausal symptoms can still be measured as normal. What does appear to happen is that a carrier protein called sex hormone binding globulin (SHBG) increases in mid-life men. This increase is believed to undermine the body's ability to make use of its own testosterone. In addition, the cells in the body also tend to thicken with age, so they are less able to absorb testosterone.
Opponents of the male menopause theory don't deny that testosterone levels fall steadily with age or that SHBG levels may rise. What they do say, however, is that these changes aren't sufficient to produce any noticeable symptoms in the vast majority of men.
The journey from youth to middle age and on into old age may seem frightening and painful, but you can also see it as an opportunity to re-evaluate and perhaps change the direction of your life. Rather than believing that ageing is simply about having to give things up, try to think about what you'd like to start. Let's face it, when you reach 60, you could still be only two-thirds of the way through your life - which leaves a great deal of time to broaden your interests, travel, return to education, learn new work skills or take up new sports.
This article was written by Dan Fielder, a journalist who has written widely on health, psychology, workplace issues and humour. He is firm believer in the need for men to take greater care of themselves and his lifestyle is paved with good intentions. The article was taken from The Men's Health Forum website (www.menshealthforum.org.uk), Tel 020 7388 4449. For information on specific health problems, visit the link below.