When I first began research for my book on the “male change of life,” I wasn’t sure what I should call it. I assumed that what men went through was totally different than what women experienced. But the more I talked to men and women, the more it became clear that there were more similarities than differences. Andropause is the more technically correct term, but Male Menopause has come to be commonly used.
According to Mosby’s Medical Dictionary, 8th Edition, “Andropause is a change of life for males that may be expressed in terms of a career change, divorce, or reordering of life. It is associated with a decline in androgen levels that occurs in men during their late 40s or early 50s. Compare menopause.”
Ultimately I decided to call my book, Male Menopause even though the term is obviously technically inaccurate. The term “menopause,” introduced by French doctors in the 1870s, combines two Greek words—menses (“periods”) and pausis (“stop”). Men don’t have a period, so they don’t stop having one.
Based on my research I concluded that “Male Menopause (or Manopause for short) begins with hormonal, physiological, and chemical changes that occur in all men generally between the ages of forty and fifty-five. These changes affect all aspects of a man’s life. Male Menopause is, thus, a physical condition with psychological, interpersonal, social, and spiritual dimensions.”
Jonathan V. Wright, M.D. and Lane Lenard, Ph.D, 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 this country, it still does not exist, although incontrovertible scientific evidence to the contrary has finally begun a slow shift in attitude.”
Common Signs and Symptoms of Manopause
After working with more than 60,000 men and their partners who were experiencing the Manopause, I detailed the most common signs and symptoms including the following:
- Reduced libido or sex drive.
- Reduced potency or ability to obtain and maintain an erection.
- Fatigue or loss of vitality.
- Irritability and grumpiness.
- Aches, pains, and stiffness in joints.
- Depression that often manifests as anger or boredom.
- Night sweats or “hot flashes.”
- Dryness and thinning of the skin.
- Restlessness and longing to break free.
- Weight gain, especially around the waist.
Manopause, Low Testosterone, and Testosterone Replacement Therapy (TRT).
Hypogonadism is a clinical condition in which low levels of serum testosterone are found in association with specific signs and symptoms. When hypogonadism occurs in an older man, the condition is often called andropause or androgen deficiency of the aging male (ADAM).
Controversy remains regarding indications for testosterone supplementation in aging men due to lack of large-scale, long-term studies assessing the benefits and risks of testosterone-replacement therapy in men. Numerous studies indicate that TRT may produce a wide range of benefits for men with true hypogonadism that includes the following.
- Improvement in libido and sexual function.
- Increased bone density, muscle mass, body composition.
- Improved mood, cognition, quality of life.
- Prevention of cardiovascular disease.
Perhaps the most controversial area is the issue of risk, especially possible stimulation of prostate cancer by testosterone, even though no evidence to support this risk exists. Other possible risks include worsening symptoms of benign prostatic hypertrophy (enlarged prostate), liver toxicity, worsening of untreated sleep apnea or severe heart failure.
Despite this controversy, testosterone supplementation in the United States has increased substantially over the past several years.
Beware of Big Pharma Hype
Kendall Powell, writing in the Washington Post, cautions us about the direct-to-consumer advertising we are seeing that focuses on aging men. “In case you haven’t noticed, advertisements aimed at treating low levels of testosterone, or ‘low T,’ have displaced those erectile dysfunction commercials with side-by-side bathtubs. The ads ask: Are you suffering from any of the following — depression, low energy, weight gain, fatigue, low sex drive? Really, at midlife, who isn’t?”
These drugs, which require a prescription, treat hypogonadism, or low testosterone production. While doctors agree that testosterone therapy is beneficial in hypogonadal men, they are concerned about rejuvenation clinics and Internet sites that push testosterone — or supplements dubiously claimed to boost it — as a cure-all for aging symptoms.
More men than ever are asking their doctors about the newer testosterone products. A study published this month showed that between 2001 and 2011, testosterone prescriptions for men age 40 and older more than tripled, with the topical gels being the most popular form and men in their 40s the fastest-growing group of users. The report also found that more than a quarter of men prescribed testosterone had not had their levels of the hormone checked before they were given a prescription.
Replacement testosterone therapy in men 40 years and older who have low levels of natural hormone “is legitimate, when done legitimately,” says John Morley, an endocrinologist at St. Louis University School of Medicine. But, he contends, giving testosterone to men with normal levels of the hormone, especially over the long term, holds unknown risks.
Learn more about the manopause and take the manopause quiz.
Please join me on Twitter for an ongoing dialogue: @MenAliveNow
Thanks very much, Jed. I appreciate ALL your work. You are one of the few researchers and writers out there who are genuinely interested in understanding the challenges facing men.
Greg, Thanks much. As you know helping men, and the women who love them, is my passion in life. I’m glad my work touches you. Thanks for being on the team.
Starting testosterone replacement therapy was one of the best things I’ve ever done for my physical, mental and emotional health. It’s nice to feel like a man again!
J.W., thanks for the comments. Tell us more about your experience with testosterone replacement therapy if you’re willing.
Hey Jed,
I suffered from depression, anxiety, loss of self confidence, no interest in sex, crushing fatigue, zero motivation and complete apathy toward my life.
I’m still a work in progress, but all of the above issues have greatly improved (or been eliminated) since starting TRT and I am once again happy and optimistic about the future.
JW, Thanks much. Too many men have no idea about the benefits and risks for Testosterone Replacement Therapy, so glad you’re sharing your experiences.
Hi Jed! As a wife who has a husband of 25 years seemingly going thru a major mid-life crisis, I am reading everything I can about it and your info is so enlightening. Any suggestions on how to get my husband to get this info without him thinking it came from me? He has all of the classic signs sans affair; quit job 2 years ago, it has been found out a secret gambling problem, ran away from family which includes moving out, got a new job that he was then fired from, says any kind of therapy “doesn’t work and I’m not going”, wants a divorce but 8 months later hasn’t filed, has gained weight, is gaunt in the face, wakes up several times a night (so I am told by him), seems very sad. Won’t listen to me so how do we help him?
M.A.C,
As you are aware, there are a lot of men who are having these difficulties, but are resistant to getting help. They feel down, depressed, and stuck. But they feel that reaching out for help would be shameful and make things even worse. As a result I’ve found that the best way to help the men is to help the women help themselves and then teach them ways to reach out to the guys in a way that doesn’t threaten them. If you’d like more information on what I offer, drop me a note (be sure and answer my spamarrest challenge if its the first time you’ve emailed me. ) Jed@Menalive.com
Hi Jed, Thank you for all you do…
My husband exhibits at least 2/3rds of the symptoms of andropause. He is 53 yrs old. He has had his testosterone levels checked and they are within normal limits. What else, beside just getting older, can be checked? He has also developed a problem with “mountain sickness”, which started about 5 years ago.
As a physician/general surgeon who loves the workings of the human body, I have a powerful interest in what lies “upstream” of any phenomenon. Jed, I invite you to look at erectile dysfunction and andropause in this light: both are related to low testosterone levels. Look at the tragedy of Alan Turing whose 1954 suicide was connected to the effects of estrogen given him to control his homosexuality. Yes, homosexuality was a crime in Britain back then, and Turing, whose brilliant solving of the Nazi Enigma code machine helped us win WWII, felt its negative effect on his ability to use his mind-brain. Look at the incidence of breast cancer in America: it has risen from 8% in the 1960’s when I was a surgical resident to 12% today–a veritable epidemic today. Now look upstream for common cause. Don’t go far; it’s all around us in our air, our food, and our water. Yes, it’s the estrogen effect of… herbicides!… pesticides!… virtually all of them… and if you have a grassy lawn that you fertilize every spring, you’re breathing in that stuff, perpetrated by our chemical industry. I love humanity and I despise blind disregard for it, such as comes from the misapplication of knowledge that threatens us all. You and I, Jed, and your readers and clients all want to know that our lives do matter in the larger scheme of things. Keep up the good work.
Ken, Thanks for sharing this important information. People don’t know this history and its important for people to be aware. In my new book on Low T I’ll be addressing many of the issues you raise. Would enjoy talking to you about it.