“Male Menopause”: Is there such a thing?

Nov 17, 2019 Dr Zulfikar Bux, Features / Columnists

Assistant Professor of Emergency Medicine
As men reach their 40s and 50s, they experience changes in their body and symptoms that could be devastating at times. These changes are sometimes termed “male menopause”. But is there such a condition as “male menopause”?
Today we will get down to the bottom of this term and explains what really happens when men approach this period in their lives.

WHAT ARE THE SYMPTOMS THAT STIMULATES THE USE OF THIS TERM?
The following symptoms have led to the suggestion that men undergo menopause when the reach their 40s and 50s:
• Depression
• loss of sex drive
• erectile dysfunction
• mood swings and irritability
• loss of muscle mass and reduced ability to exercise
• fat redistribution, such as developing a large belly or “man boobs”
• a general lack of enthusiasm or energy
• difficulty sleeping or increased tiredness
• poor concentration and short-term memory
These symptoms can interfere with everyday life and happiness, so it’s important to find the underlying cause and work out what can be done to resolve it.

IS THERE SUCH A THING AS A ‘MALE MENOPAUSE’?
The “male menopause” is an unhelpful term sometimes used in the media. This label is misleading because it suggests the symptoms are the result of a sudden drop in testosterone in middle age, similar to what occurs in the female menopause. This is not true. Although testosterone levels fall as men age, the decline is steady at less than 2% a year from around the age of 30 to 40, and this is unlikely to cause any problems in itself. A testosterone deficiency that develops later in life, also known as late-onset hypogonadism, can sometimes be responsible for these symptoms, but in many cases the symptoms are nothing to do with hormones.

PERSONAL OR LIFESTYLE ISSUES
Lifestyle factors or psychological problems are often responsible for many of these symptoms. For example, erectile dysfunction, loss of libido and mood swings may be the result of stress, depression, anxiety or the misuse of alcohol or illicit drugs.
There are also physical causes of erectile dysfunction, such as changes in the blood vessels, which may happen alongside any psychological cause. Psychological problems are typically brought on by work or relationship issues, divorce or financial problems. A “midlife crisis” can also be responsible. This can happen when men think they have reached life’s halfway stage. Anxieties over what they have accomplished so far, either in their job or personal life, can lead to a period of depression.
Other possible lifestyle/psychological causes of the “male menopause” include:
• lack of sleep
• a poor diet
• lack of exercise
• drinking too much alcohol
• smoking
• low self-esteem

LATE-ONSET HYPOGONADISM
In some cases, where lifestyle or psychological problems do not seem to be responsible, the symptoms of the “male menopause” may be the result of hypogonadism, where the testes produce few or no hormones. Hypogonadism is sometimes present from birth, which can cause symptoms like delayed puberty and small testes.
Hypogonadism can also occasionally develop later in life, particularly in men who are obese or have type 2 diabetes. This is known as late-onset hypogonadism and can cause the “male menopause” symptoms. But this is an uncommon and specific medical condition that’s not a normal part of ageing. A diagnosis of late-onset hypogonadism can usually be made based on your symptoms and the results of blood tests used to measure your testosterone levels.

WHAT SHOULD YOU DO?
If you’re experiencing any of these symptoms, see your doctor. They’ll ask about your work and personal life to see if your symptoms may be caused by a mental health issue, such as stress or anxiety. If stress or anxiety are affecting you, you may benefit from medication or a talking therapy, such as cognitive behavioral therapy (CBT).
Your Doctor may also order a blood test to measure your testosterone levels. If the results suggest you have a testosterone deficiency, you may have to start testosterone replacement to correct the hormone deficiency, which should relieve your symptoms.
Most of the time, these “male menopausal” symptoms are related to lifestyle or psychological factors. Exercising, seeking help and avoiding triggers will help to alleviate these symptoms most of the time and will free you of being labeled as going through “male menopause”.

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