Men also undergo their own version of menopause.
Does you man have any of the following symptoms?
- Feeling grumpy, miserable and lacking confidence
- Trouble sleeping
- Lethargy. A loss of excitement about life and career
- Weight gain, loss of strength and muscle tone, aching joints
- Memory loss
- Diminished libido
A blood test and full medical and symptom history will reveal whether a man has reduced hormone levels.
The three sex hormones men need are:
DHEA: Dehydroepiandrosterone, a hormonal precursor produced by the adrenal glands and made into testosterone.
TESTOSTERONE: The main male hormone, although women require low levels too (essential for muscles, bones and libido).
PROGESTERONE: A predominantly female hormone that men need at low levels; it prevents excess testosterone.
Treatment usually involves testosterone (by cream or gel), DHEA (in capsules) or progesterone. After treatment ‘men sleep better, get back their zest for life and their wives get back the men they fell in love with.’ Dr Gluck warns that treatment may not be suitable for men with a history of prostate cancer.
Here is a naration from a man who suffered from male menopause.
When I turned 40 I briefly flirted with the idea of treating myself to a vintage Ford Mustang. Thankfully, dignity got the better of me and I continued trundling around in my sensible, mid-range, mid-price middle-age-appropriate hatchback.
Now I’m nearing 50, my mid-life crisis (if indeed that’s what it is) has become less about recapturing lost youth and more about dealing with crippling existential anxiety. And when I’m not fretting about my place in the universe, I’ll be raging at the injustice of it all.
Life continues around me and yet I feel strangely locked out; not so much looking through a glass darkly as staring at a steel wall. My mind and body no longer feel connected. Emotionally I’m all over the place; railing against the world one minute, sobbing uncontrollably the next. My body remains in a constant state of achy fatigue.
Although I suffered from mild depression in my early 30s this felt different, more profound. Why, on the eve of my 50th birthday, had I become so irascible, so impatient, so unpredictable and distant around people I cared for? What was this woozy sense of unreality hanging over me and why did I feel so fuzzy and exhausted all the time?
I have a comfortable, interesting life, friends and a wonderful woman who loves me, so why did I find it so hard to focus on the positive? I slept fitfully and most mornings would awake with a sense of foreboding — unable to lift my head from the pillow, let alone leap at the challenges of the day. And when I finally made it through the front door and out into the waiting world, that sense of disconnection rendered me helpless. What was happening to me?
Of course, many Inspire readers will recognise these symptoms, but it was only during lunch with a close female friend, now in her 50s, that the subject of the menopause — or manopause — came up.
For the past six months, Jayne had been suffering from hot flushes, mood swings, irritability, over-emotional outbursts, insomnia and feelings of exhaustion and despair.
After hiding under the duvet for weeks on end, she finally plucked up the courage to seek help and was about to begin a course of HRT. Apart from the hot flushes, her symptoms sounded remarkably similar to mine.
‘Perhaps you’re going through the andropause,’ she suggested with a wry smile.
‘The male menopause,’ she said, rolling her eyes.
Jayne proceeded to tell me about her boyfriend who was also suffering from menopausal symptoms.
‘His mood swings were becoming intolerable and he found it hard to concentrate on anything,’ she said. ‘To top it all, he lost interest in me physically, so I made him have a blood test and it turned out his testosterone levels were way down.
‘He’s now on supplements and the transformation has been remarkable.’
Jayne explained that like women’s menopause, the andropause is linked to a drop in hormones. After 30, most men experience a 10 per cent drop in their testosterone levels every decade. Unlike women, they probably have no idea it’s happening.
But if middle-aged men really do experience a similar kind of hormonal imbalance to women, why aren’t we more aware of it? Like me, none of my male friends had even heard of the andropause. Most were familiar with the menopause and some could even list a few of the symptoms, but they had no idea that men might be prone to something similar. The mainstream medical profession appears divided. My GP scoffed when I asked him whether the andropause might explain my erratic behaviour.
Although testosterone levels fall as men age, the NHS argues that the decline is steady — less than 2 per cent a year — and that this change is unlikely to be noticeable.
They suggest that menopausal symptoms in men are more likely a result of lifestyle factors or psychological problems. But I have a pretty good life, I don’t smoke or drink too much and as far as I know I have no major psychological issues. So I was surprised when my GP recommended antidepressants without much in the way of consultation.
I’d been prescribed Prozac and Valium during my earlier brush with depression, but had struggled with the deadening effect of the drugs. Better to feel something than nothing has always been my philosophy.
I wasn’t willing to take that risk again so I decided to get my hormone levels tested by one of the leading authorities on the subject.
Dr Marion Gluck is a world pioneer in ‘bio-identical’ hormones to rebalance the body’s endocrine system. She’s the go-to specialist for menopausal women in the know, but has recently seen a steady trickle of men too, which she finds gratifying.
‘The only time I tend to see men in my surgery is when their wives or girlfriends have dragged them here,’ she says, wrapping a tourniquet round my arm in preparation for a blood test. ‘Men find it much harder to admit when something is wrong.’
Marion believes GPs are too quick to dismiss the manopause. She tells me that hormones regulate virtually every function in the body, so it’s important to recognise their significance to physical and mental wellbeing.
When my blood test results are in they reveal my testosterone and thyroid levels are low. Marion isn’t surprised. The exhaustion I’ve been feeling, along with my inability to concentrate, are classic symptoms of a thyroid deficiency. My irritability and mood swings are a sure sign my testosterone levels are on the wane.
Marion is keen to point out my symptoms may not be exclusively down to hormone deficiency; there are probably a number of factors at play, so it’s important these are taken into consideration when diagnosing signs of depression. This, according to Marion, is where the NHS is failing patients. ‘Instead of blithely prescribing anti-depressants to anyone who complains about feeling low, doctors should take a more holistic approach, by asking why patients feel depressed.
‘The diagnosis should be built around contributing factors including hormone levels, lifestyle choices and mental wellbeing.’
For this reason she tends not to rely too heavily on blood test results. ‘I prefer to treat individual symptoms, not statistics on pieces of paper,’ she says. ‘Besides, there is no such thing as “normal” when it comes to hormone levels. What’s normal for a 48-year-old man may not be normal for a man in his 70s.’
Marion describes her diagnostic approach as like building a jigsaw, fitting each piece of the puzzle together until a bigger picture emerges. ‘Before prescribing any treatment I really need to understand the person I’m helping.’
The good news is that none of my symptoms appears to be unusual for a man of my age and Marion is confident that with some carefully planned hormone treatment, I will soon be feeling my old self again.
The middle years can be particularly tough for men as we take stock of our lives and wonder what might have been. It’s when those anxieties impinge on our ability to function that we should start to be more like women and seek help.
It’s liberating to know my symptoms may be down to a simple chemical imbalance.