Male Menopause: Is It for Real?

You may have heard of the male mid-life crisis, but how about male menopause? We’ve all seen the TV commercials depicting ruggedly handsome men talking about their “low T”, or low testosterone. A decreased interest in sex seems to be the main drive behind seeking treatment. However, in addition to a low libido, it’s becoming more common for men to report some of the same symptoms that women experience in perimenopause and menopause. For men, symptoms such as fatigue, weakness and depression make the condition very real.

But do men really go through what is referred to for women as a well-defined menopause? Arun Mathur, MD, a ProMedica Physician specializing in family medicine, says there is currently a debate over that question. “Some physicians prefer to refer to this problem as androgen or testosterone decline in the aging male. These hormones control the development and maintenance of masculine characteristics. While men do experience a decline in the production of these hormones, the decline is a much slower process in men than when hormone production ends for women. Subtle changes in men may occur as early as age 30 and more dramatically after the age of 70 in some men.”

Other symptoms of testosterone decline in men include a decrease in genital and testicular size, enlarged nipples (gynaecomastia), increase in body fat, and a decrease in muscle size and strength. “Difficulty remembering things and an inability to concentrate are common,” Mathur says. “Moodiness may occur, and a decreased motivation and self-confidence may be evident. Anxiety and nervousness may develop.”

To make the diagnosis of male menopause, a physician will perform a physical exam, ask about symptoms and probably most importantly, order tests to rule out medical problems that may be contributing to the condition. Blood tests will be performed, including measuring the testosterone level.

“If testosterone levels are low, replacement therapy may help relieve symptoms for some individuals,” Mathur says. “But just as with hormone replacement therapy in women, testosterone replacement therapy has potential side effects. Replacing testosterone may worsen prostate cancer, for example. These side effects should be thoroughly discussed with your physician before beginning any replacement regimen.”

A change in lifestyle may also be recommended. Eating healthier and exercising routinely can improve symptoms such as depression. Medications, such as antidepressants, can also help. And while many men mistakenly believe that their loss of interest in sex is simply due to getting older, Dr. Mathur says that’s a misconception. “A gradual decline in testosterone can’t explain a sudden, near-total lack of interest in sex. Erectile dysfunction may be an indication of other health problems. On the contrary, some medical problems that have traditionally been attributed to diabetes, high blood pressure and coronary artery disease, are now being found to be caused by low testosterone.”