Male menopause Dr Rob Hicks In middle age many men seem to go through something that's been labelled the mid-life crisis. More recently this cluster of distressing physical and emotional symptoms has been likened to the female menopause - but does the male menopause exist?

In this article

Does it exist? How are men affected?

Other causes Treatment

Strictly speaking men can't have a menopause as such

Strictly speaking men can't have a menopause as such, since the definition of the menopause is the time at which periods cease. However, it's argued that they can go through a male equivalent, called the andropause, that's accompanied by symptoms similar to those experienced by women.

It's claimed that the andropause is hormone-related, just like the female menopause. However, the female menopause is triggered by a dramatic fall in the levels of female hormones, whereas the levels of the male hormone testosterone fall far more gradually over many years. Many 70-year-old men have similar testosterone levels to those of a 20-year-old.

Symptoms of andropause

• poor sex drive
• tiredness and fatigue
• change in body shape
• reduced muscle mass
• irritability
• sweating
• flushing
• generalised aches and pains
• low mood

Common complaints as men reach middle age are poor sex drive, tiredness and fatigue, acknowledgement of ageing, hair loss and changes in body shape as they become less muscular and more rounded.

Other symptoms include irritability, sweating, flushing, generalised aches and pains, and low mood, sometimes depression.

Looking at these symptoms, it's easy to see why a comparison is made with the female menopause. Women may experience any or all of these symptoms.

Many doctors acknowledge that a genuine change for men occurs, but believe it has a psychological basis rather than a hormonal one. The realisation that they've left youth behind is reinforced by the signs of wrinkles, receding hairline and fat.

Reasons for similar symptoms

• anaemia
• thyroid gland dysfunction
• depression
• marital disharmony
• job dissatisfaction
• financial problems
• alcohol misuse

Many men may have progressed as far as they ever will in their careers and this may be hard to accept. As their children grow up and leave home, many will question whether they now have a role to play.

Marital disharmony, job dissatisfaction, financial problems or alcohol misuse are some of the other reasons that may be behind the way a man is feeling.

If it's accepted that physical changes are a normal part of the ageing process, then this allows the emotional symptoms to support a psychological basis for the male change of life.

It's important not to forget that, as with women, other physical illness can be responsible for the same group of symptoms and should be investigated. Anaemia, thyroid gland dysfunction, or depression may be underlying causes.

Any treatment should, of course, be appropriate to the underlying cause of the symptoms.

If the cause is believed to be the andropause, then it's still under discussion as to whether testosterone as hormone replacement therapy (HRT) should be offered. This is available in the form of skin patches, injections or tablets, and many men treated claim to notice an improvement in their symptoms. However, it hasn't been shown that this is because of the HRT or because of a placebo benefit.

Male HRT shouldn't be taken lightly

Male HRT shouldn't be taken lightly though. It's been linked with development of prostate cancer and any treatment needs to be closely monitored.

This article was last medically reviewed by Dr Rob Hicks in April 2007.
First published in October 1997.