There are three early signs to look for. The first is loss of short term memory, and....I can't remember the other two.
Seriously, in addition to memory loss, we look for physical changes including expansion of the belt line and sleep disturbances, emotional changes including irritability, anxiety, and depression, and sexual changes, which are often the most critical and difficult for a man to talk about including lowering of sexual desire, erection problems, or difficulties with ejaculation.
Example: I first met Rob when he was 42 shortly after he had divorced his first wife and married a woman 10 years younger than he. He was looking forward to starting a new life, with a new wife and a new job, in a new area. After twelve years of marriage, the dream was becoming a nightmare. He said he was 35 pounds overweight and feeling "fat and old." He felt his career was stalled and he didn't feel any fire for what he might want to do in the future. He alternated between passive withdrawal and angry outbursts. He had difficulty sleeping and would get up four our five times a night to urinate. His sex life had greatly diminished and what remained, seemed more often, done out of habit than passion. He admitted he was having erection problems and told me, with terror in his voice, that for the first time in his life, it seemed that he was finding reasons not to have sex, even when his wife was interested. There was constant conflict at home with his wife and children. It seemed, he said, like his wife was critical of everything he did and he felt more like one of the unruly kids than a husband and father.
We all know men like Rob. So what's going on? Typical midlife crisis or is there more to it than that?
Certainly this is a time where adolescents are going through their own growing pains, parents are dying, job horizons are narrowing, friends are having their first heart attacks, and the past floods by with reminders of opportunities not grasped and dreams left unfulfilled.
But something more basic is happening. As Theresa Crenshaw, M.D. say, "Men experience a 'lite' version of menopause--physically, that is--called viropause. Their hormones and neuropeptides diminish, albeit less abruptly. Their bodies sag and change shape. Characteristic medical conditions like enlarged prostate develop. Sexual functioning is often compromised by hormonal imbalance, disease, medications, mind, or mood. Their stamina and temperament alter as well. Emotionally, like their female counterparts, men can have repercussions from viropause of catastrophic magnitude--including severe depression and suicide. Yet often they are less well equipped to deal with these extremes than women."
We are indebted to women who were really the first ones to take male menopause seriously. While men were insisting it didn't exist, women, many who had studied female menopause for years, were doing some of the earliest research.
We can't talk about Male Menopause without talking about the Penis and the Prostate, sensitive areas for most men. We know that one often shrinks as we age, while the other grows larger.
As we know, the structures of the male urinary system and of the male sexual system are intermingled. The prostate gland is at the center of both systems. The gland is about the size of a walnut and sits beneath the bladder.
The Big Three Prostate Problems
Author John Irving describes the kind of problems many men experience as they get older.
"Odd and painful peeing is not new to me. Seven times in the last five years, I have suffered this unnamable disorder...Urinating is often a challenge, the sensation always new and surprising. Also, it's time consuming going through your day in anticipation of the next time you'll have to pee. Sex, typically, is unmentionable. Orgasm is truly climactic. Coming is a slow experience like the long, astonishing journey of a rough and oversized ball bearing. In the past I had given up the act altogether. Which drives me to drink, which makes the pee burn: an unfriendly circle. And always the non-specific diagnosis."(1)
We now know that the prostate gland is the most frequently diseased organ of the human body. (2) All men are susceptible to contracting the three major diseases of the prostate:
(1) Prostatitis
(2) Benign prostatic hyperplasia (BPH), also called enlarged prostate
(3) Prostate cancer
According to Bradley R. Hennenfent, M.D., one of the leading authorities on prostate problems, "A man's odds of getting one of these three diseases approaches 100%."(3) Yet we are just now beginning to understand what these diseases are, how they relate to each other, and why so many men develop them as they get older.
Treatment and prevention.
After age 50, most men begin to develop an enlarged prostate, a condition called benign prostatic hypertrophy (BPH). As the gland enlarges, it squeezes the urethra, often causing increased urinary frequency, a weaker flow, and difficulty getting started. The current medical treatment of choice, a drug called finasteride (Proscar) has significant drawbacks. According to Dr. Weil, "It's expensive, sometimes causes impotence, can take up to a year to have an effect, and works for only 30 percent of patients."
Fortunately, there is a better alternative. According to Andrew Weil, M.D., "European studies have shown that extract of saw palmetto--made from the berries of a plant native to the American Southeast--reduces the size of the prostate in only four to six weeks. And it's effective 90 percent of the time!"(4) I have followed Dr. Weil's advice and it has helped reduce the number of times I wake up at night to urinate.
Michael B. Schachter, M.D., author of The Natural Way to a Healthy Prostate, agrees that saw palmetto is very beneficial and suggests additional supplements that research has shown to be helpful in treating and preventing prostate problems.(5) "The single most important nutrient for a healthy prostate is zinc," says Dr. Schachter. "The normal prostate contains up to ten times more zinc than any other organ of the body. Zinc deficiency, which is common among Americans, may cause prostate enlargement."(6)
Dr. Weil recommends a number of simple things we can do to prevent prostate problems from ever occurring, including the following:
* Drink lots of water (your urine should be light in color).
* Have an active sex life, but practice moderation. (You will have to determine the frequency of ejaculation that is best for you.)
* Eat plenty of soy foods. The phytoestrogens found in soy may block the negative effects of testosterone on the prostate.
* Reduce the amount of saturated fat in your diet. According to a study done at Stanford Medical School, men who eat more than 30 grams a day of saturated fat (mostly from meat and dairy) have twice the risk of prostate cancer as do men who eat only 11 grams of saturated fat a day.
* Eat meals rich in tomatoes. A recent study conducted by the Harvard School of Public Health shows a 20 percent reduction in prostate cancer risk in men who eat tomatoes or tomato sauce four times a week and a 50 percent reduction in those who eat ten servings a week.(7)
THE PENIS
The number of males between 40 and 70 is projected by the Census Bureau to grow to 54 million by 2010. Findings from the Massachusetts Male Aging Study, the largest study on male sexuality since the Kinsey Report, found that 52% of the men between 40 and 70 experienced some degree of impotence, and that problems increased with age.
Depression, and in the extreme case, suicide often follow when men don't understand what is going on with them, feel they are losing their manhood, and give up hope. 80% of the suicides in the U.S. are male.
Most all are preventable, and all can be treated. Most of the problems have a physical basis, unlike our earlier belief that it was "all in a man's head."
Penis--Impotence, %. Bike riding, low testosterone, DHEA
Another example. New treatments, Concerns of Test.
getting hormones at the gas station.
Cock-sure: The Wisdom of the Mid-life Penis
Three things typically happen to men, beginning at mid-life:
- It takes longer for a man to have an erection
- The penis requires more direct stimulation
- The penis is simply not as hard as it was in a man's younger days.
What does that tell us about our natural inclinations for sex, love, and intimacy? Men at mid-life come to value love and intimacy more.
Interestingly, research shows that men have more estrogen in brain than menopausal women
In my book I predict that hormone replacement therapy may become as common for men as it is for women now. Men will derive many of the same benefits, such as a slowing of the loss of bone mass and better protection for their hearts.
I don't agree with those who want to stay forever young. We don't need a few good boys, we need men. On the other hand, I don't agree with those who say menopause is natural, and that no one should take hormone replacement. The thickening of the lenses as we age is natural, but no one would argue that we shouldn't wear glasses.
Before take hormones, see what the wisdom of your body is saying. I talk about this more in my chapter on the Wisdom of the Penis.
There are also other good "treatments": Exercise, like bike riding. A low fat diet. Going to a doctor. Getting other support for health issues. Active involvement in a men's group. Natural herbs like yohimbe and saw palmetto.
Sex changes in the second half of life, for both men and women. What is the meaning of soft penis? In my book I talk about two polarities of New Sex: Dynamic and Magnetic
She experiences Post Menopausal Zest
He experiences: Post Menopausal Rest. A turning inward, a "coming home." This involves more than just healing for individual men. It involves the Wisdom of the Elder. It is a return to the Land Where Old Men are Respected. Respected for what they have to offer. As I describe in my book, in other cultures post-menopausal men are valued as Peace Makers, Spirit Guides and Mentors of Youth.
Though I began looking for the lost men when I was born, I've been working with drug abuse treatment for last 30 years. Six years ago I realized that our periodic wars on drugs are really wars on young men. Out of our fear, we lock them up where they are brutalized and raped. Its estimated that 1000 men are raped in our prisons every hour.
We blame the youth for the lack of leadership in the culture. What's needed is not more prisons (the major growth industry in California), but a return of the elders.
Its also time we stopped blaming women for the breakup of the American family. Its time we stopped forcing them to be mothers and fathers, stopped demanding that they carry their own weight as well as carrying the load for us men.
Male Menopause is a call for the return of the men, not as conquering heroes, who wish to put women back in their place, but as humble elders who are strong enough to be equal partners to women and who are ready to take responsibility for their own health, their own life, and are ready to give something back to women, children, and the society.
In my book I talk about 4 organizations: The Sterling Institute of Relationship, The New Warriors, The Promise Keepers, and the Million Man March. All share a common commitment to take responsibility for the destructiveness men have unleashed on the their wives, children, communities and themselves, to heal the wounds they've created, and join together to create a world where children can grow up without fear.
Here's the experience of one woman:
"When I heard they were getting together, I wondered, What the hell are they going to talk about?" said writer Iyanla Vanzant as she watched the gathering of men from her home fifteen miles from the Capitol.
"I saw my father out there on that mall, although he has been dead for eleven years," Vanzant says. "I saw my former husband out there. He too has been on the other side for quite some time. My brother was there. My son was there. In fact, all the men in my life I have ever told, 'Do something! Just do something!' were out there, whether or not they were present. I saw them making an effort, taking a step to do something for themselves. It made me proud. It made me humble. It scared me to death!"
And what did they talk about? Iyanla Vanzant had waited a long time to know, but she would have to wait a little longer. "I cooked for them and waited for them to come home--my mate, my son-in-law and his cousins and their friends, my longtime childhood friends and their friends and their children. I waited for my four-year-old grandson to come home and share his experiences. I was excited."
What she heard when they finally did return surprised her and gave her profound hope. "It never crossed my mind that they would talk about what they have done and no longer want to do," she said obviously deeply touched.
"I never imagined they would explore the topics of fatherhood, husbandhood, manhood, and selfhood. My mama never told me that men talked like that. I never heard my daddy talk about anything like that. Surely it was unimaginable that one million Black men would come together to talk about righting themselves, getting closer to God, or being better men for the sake of the women and children."
But talk they did, and the talk translated into action for many. Men were on the move and women could begin to let go of the male burden they had carried for so long. For some the experience was wonderful and also disorienting. "The gathering of a million Black men helped me realize how long I have been the man in my life," says Vanzant, echoing a theme I have heard from hundreds of women. "I have been doing all the things I wanted a man to do for me and with me. While doing is not an activity exclusively reserved for men, women have been doing their part and the man's part for so long, we leave little room for them to show up in our lives."
For women who have had to do it all, the return of the prodigal father does not always feel like a blessing. "That I had been asked to stay home and not do was frightening," Vanzant recalls. "It created conflict in my brain. My personal affirmation, 'Can't no man tell me what to do!' pounded in my mind. How dare they! was my next thought. But then I remembered the language. Atone."
Something different was going on with these men than had occurred in recent memory. "Atonement is not the language used when malice or deception is intended," Vanzant reasoned. "They could have called it a day of strength or a day of pride. They did not. Atonement is a spiritual concept indicating a conscious intent to seek redemption...Many Black women have had their hearts broken or abused and their egos damaged by Black men. Many of us have not forgiven them for it. In many instances, our egos are not ready to forgive."
It will take a long time to heal the wounds, but many are beginning. The poet Rumi says, "Out beyond ideas of wrong doing and right doing, there is a place. I'll meet you there."
Thank you.
