Is male menopause a thing?
Most of us are somewhat familiar with the concept of menopause. It’s essentially a transitional period women go through – usually at some point between the ages of 40 and 58 – as their reproductive cycle stops. Most of its symptoms are also well-known: mood swings, hot flushes, night sweats, and much more.
What is not so well-known, however, is that men also go through a transitionary phase that has some similarities. Often referred to as male menopause or “andropause”, it tends to occur around the same broad age range, and usually also brings with it a host of less-than-desirable symptoms.
These transitionary periods are mainly hormone related, and while this is true for both genders, this article will focus on what men often go through and what sort of control they might be able to get over the situation through both therapies and lifestyle choices.
Our bodies, our selves
Andropause is a term used to describe a number of age-related changes that occur in men as a result of a drop in hormone levels. And of the body’s many hormones, it is those depleting testosterone levels that tend to have the greatest effect on us.
Gradually dropping off starting at around age 30, and much more noticeably after 40, testosterone stores can reach extremely low levels in males, and when they do, a number of noticeable and highly unpleasant changes can occur in the body. These may include poor mood, poor concentration, poor sleep, low energy levels, reduced bone growth, reduced muscle mass, higher water retention, hair loss, and on and on.
Of these, perhaps the most impactful are the mood and cognitive concerns. Among many men there is indeed a rather striking change that occurs, where life is suddenly a darker or simply “less fun” place. Depression diagnoses are therefore not an uncommon result of the onset of andropause.
Effects of the gradual dropping off of testosterone can include poor mood, poor concentration, poor sleep, low energy levels and reduced muscle mass
The science behind it all is rather straightforward: When testosterone stores are not sufficient, our bodies are unable to carryout out functions vital to our health and wellbeing. For example, the reason we see a drop in muscle mass is because testosterone is a pivotal part of the muscle-building process, as it binds to muscle cells, amplifies the development of new protein strands and aids the release of human growth hormone (HGH). With less testosterone to bind them together, muscles begin to shrink. Many of my male clients who work out even one to two hours a day four to five times a week see little results due to low testosterone – a much different picture than when they were in their twenties, and one that can be highly frustrating.
As for weight gain, testosterone plays a leading role in the process of metabolism. The situation is exacerbated by the fact that body fat contains enzymes which convert testosterone into estrogen – depleting levels even further. Therefore, the less testosterone you make, the more fat you accumulate, which decreases testosterone, which leads to more accumulated fat – and you are stuck in a vicious circle.
As for the serious concern of mental health and wellbeing, there are different potential reasons for a disturbance here. Some suggest, for example, that the common uncomfortable symptoms of andropause, such as irritability, fatigue, and low libido, cause a person’s mood to suffer, leading to mental health and wellness issues such as depression. Yet another holds that testosterone plays an important role in the production of serotonin (which helps regulate many functions in our body), and the less testosterone we have in our bodies, the less serotonin we can produce – which can, among other things, affect our mental wellbeing.
Whatever the root cause, there is a definite correlation between depression and low testosterone. A 2004 study by Dr. Molly M. Shores of the University of Washington found that men with low testosterone were four times more likely to be diagnosed with clinical depression than those within the normal range.
What you need to do
So to be crystal clear, when we look at why men suffer andropause, it’s down to hormones. And the reality is that hormones – or rather hormone depletion and hormone imbalance that occur as we age – can actually do a lot more than just trigger andropause.
As we have seen, our hormones impact almost every aspect of our make-up, from the way we look to our moods and personality. But on top of this, hormones are vital for ensuring our bodies continue to grow and develop properly; therefore, when levels are out of kilter, we may in fact find ourselves at risk for a number of serious health conditions.
Indeed, diseases such as Alzheimer’s, cardiovascular, diabetes, cancer – and many more – have been shown to have links to hormone imbalance (and with diabetes in particular I’ll mention that it is almost impossible to reverse the disease in middle-aged men without putting them on testosterone therapy).
That being said, while low or imbalanced hormone levels can have more serious implications over the long-term, the main impact of low hormones is usually limited to physicial and mental discomfort and conditions that we tend to associate with “aging”.
So if you should find yourself in such a position, do not shrug off the symptoms. Start off by contacting a physician who specialises in the issues. Because believe it or not, the fix can actually be quite a quick one. Treatments such as bioidentical hormone therapy (never synthetic), and lifestyle advice (diet in particular, but also sleep and stress management and much more) followed with the right level of discipline, can in most cases help those symptoms disappear.
How we should view aging
The 20-year-old who is eating poorly, not exercising, working too hard, smoking, drinking too much, not getting proper sleep, etc., is likely going to feel a lot worse than the 70-year-old who is taking care of his body. So when we think about the hardships of aging, do keep it all in perspective.
And that perspective has everything to do with treating your body well. It’s rule number one, and if you are not doing this, then all the medicines and treatments in the world are not going to do too much to make you feel better.
So while we should not fear aging – but rather accept it and even embrace it – we should do as much as possible to avoid suffering. To do this, we must keep in mind that nature will most likely support you well throughout the aging process if you are doing your part and living a healthy lifestyle. That’s always going to be about 80% of it.
As for the rest, that is where medical science steps in – and as a proponent of bioidentical hormone replacement therapy (BHRT) – I will leave you with the results of a 2015 study from the International Journal of Endocrinology: The research demonstrated the safety and effectiveness of testosterone replacement in men, observing more than 80,000 males taking testosterone for over 15 years. The conclusions highlighted how testosterone therapy was shown to have very good results in lowering obesity, diabetes, heart disease, erectile dysfunction, prostate cancer, and more – and all with an excellent safety profile.
So there we have it: Four parts healthy lifestyle, one part the marvel of medical science, and you have the best possible recipe for managing the aging process.
The opinions in the column are by Dr Graham Simpson, the Chief Medical Officer and Founder of Intelligent Health, a preventive medical centre located in Jumeirah, Dubai, and are not necessarily those held by Esquire or Hearst International.