Is the male menopause a real thing?

Is the male menopause a real thing?

Female menopause certainly is real: for all women the ovaries stop producing hormones in middle life . The drop in hormone levels from youth to middle age is dramatic and universal. In that context, the term male menopause is very misleading.

There is no sudden drop in testosterone levels in middle age. Rather testosterone levels ( the male hormone, produced in the testicles) falls very gradually, by about 1% a year from age 30 or so onwards. And because this decline is very steady and very slow it is unlikely to cause any symptoms at all.

But it remains the case that some men, in middle age, experience mood swings, irritability, reduced muscle mass and exercise tolerance, fat redistribution ( fat belly, man boobs) , loss of drive and enthusiasm, difficulty sleeping and tiredness, poor concentration and memory, erectile dysfunction and loss of sex drive. And its tempting to want to blame the “male menopause” for all of the above and expect a pill or an injection to fix it.

The majority of men experiencing these symptoms have normal testosterone levels. Middle life can be a stressful time : anxiety, depression, too much alcohol, bereavements and smoking are all more likely causes of most of these symptoms.

Of course it is possible to have a low testosterone level and this can develop in later life in men who are obese or who have type 2 diabetes when it is more correctly called ” late onset hypogonadism”. This is a specific medical condition, not a normal part of ageing and NOT to be regarded as a male menopause. In this condition blood test for testosterone levels would show low levels and testosterone supplements may be prescribed, under the guidance of a consultant endocrinologist or urologist.

Your doctor will be pleased to discuss your symptoms and may measure your serum testosterone levels. If low, you should expect to see a specialist. But please be clear : almost all women benefit from hormone replacement therapy because their hormone levels fall dramatically in middle life. Almost all men do not benefit from testosterone replacement therapy because their hormone levels do not.

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