Monday, October 7, 2013

Male Menopause or Grumpy Old Man?

Lorraine Baillie Bowie PhD, author-therapist-educator, writes about contemporary sex and relationship topics.

Has your once happy and agreeable husband turned into a cantankerous and testy old man? Do you stay awake at night trying to decide if you should accept his irritability and complaining as a normal part of aging, bang him with the frying pan, or haul him to the doctor for treatment? Let’s look at a few facts to help you in your decision.

Does Male Menopause Exist?

No matter what name you give it, age-related hormone changes in men do exist. Experts still debate over what to call it, but most doctors use the term testosterone or androgen deficiency. I find men respond best to the term low hormone rather than deficiency. Men are open to the term low—low oil, low on gas—which implies that something can be done to correct the situation.

Many lay people use the term male menopause because of its similarity to female menopause, but it is a quite different process for men, which is why the term has not gained medical acceptance. The condition, however, is definitely accepted by the medical community.

Difference in Male and Female Menopause

For women, ovulation ends and hormones drop rapidly resulting in obvious symptoms for most. Men, however, experience a gradual drop in hormone that could take years to show symptoms.

Testosterone tends to drop at about 1% a year after age 30 causing a man of 70 to expect as much as a 50% decline. Therefor a slowly increasing level of irritability and depression may not be as noticeable. Also, men do not have the fading menstrual cycle to alert them to a change. Hot flashes, a hallmark symptom in women, are not usual in men.


Look for symptoms that have slowly increased in frequency and intensity:

Psychological: irritability, depression, lack of confidence, poor concentration, poor memory
Physical: higher body fat, reduced muscle mass, decrease in bone density, decrease in body hair, swollen or tender breasts, low energy

Sleep disturbance: insomnia or sleeping too much. Note that a common sleep disturbance for a depressed individual is to fall asleep quickly, but awaken after a few hours. Also, sleep disturbance in older men may be difficult to assess due to prostate problems requiring frequent trip to the bathroom throughout the night.

Sexual changes: reduction in size of testicles, low desire, progressive erectile dysfunction. Note that men prefer to think of their erections as not being as firm as they once were rather than having erectile dysfunction. It’s the same as we women preferring to think about orgasms taking longer and being less intense rather than thinking we have orgasmic dysfunction.


Symptoms require a medical checkup to determine if low testosterone is the cause, or if another condition such as low thyroid, diabetes, depression or medication side effects could be at play.

  • Testosterone replacement, for many men, results in a lifting of depression and irritability, higher confidence, increased sexual desire and performance, and improvement in sleep. The benefits, however, decrease with advancing age. Testosterone replacement is controversial due to possibly increasing the risk of prostate cancer. Talk to your doctor about the risks and benefits.
  • Sexuality treatment presents a wide range of options from pills to implants to help with erections.
  • Depression and sleep problems can be treated with a nutritious diet and regular exercise. In some cases medication is an important part of the treatment.
  • Low muscle mass and bone density are treated with weight bearing exercise and, for some, medication for osteoporosis.

Do not buy into the grumpy old man syndrome. Explain the effects of low hormone to your fella and encourage him to seek treatment for his symptoms. Go to the doctor with him and let him know that you are there for him, just as he was, or will be, when you faced menopause.

In the old days, women’s medical needs associated with menopause were ignored and were even the fodder for jokes. As a young girl I remember my grandmother talking in a whisper about “the change.” Speak up about low male hormone and help him get the treatment he deserves.

You may also like to read:

Male Menopause: Myth or Reality
Manopause: When middle-aged men go through menopause

Lorraine Baillie Bowie PhD Blog: Totally Win At Love: Smart Talk About Sex and Relationships

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