But everyone ages, and men experience symptoms beyond needing reading glasses and realizing they can’t bench press what they could at 30. Some doctors believe that men go through an aging process similar to menopause, but not as abrupt. It hasn’t been studied as much as menopause in females has, though that is changing. It’s hard to know what men should expect as they hit midlife. But more research is being done, and here’s what we know.
Is Male Menopause a Thing?
Some medical professionals say that there is a male version of “menopause,” and call it “andropause.” Other terms for this phenomenon include “testosterone deficiency syndrome,” “androgen deficiency,” and “late-onset male hypogonadism.”
Other medical professionals don’t really think it’s a corresponding process to what women go through. That’s because with men, the decline in the production of testosterone is gradual, and not all men notice symptoms associated with this decline. And any symptoms could be related to the simple process of getting older.
Physical changes that men can expect as they get older include decreased bone density, a decline in physical strength and endurance, and pain and stiffness in joints. Some men experience a decrease in density of body hair and an increase in fat around the abdomen. These could be related to the decline in testosterone.
What Symptoms Do Men Experience as They Hit Middle Age?
The most common symptoms men experience as they reach middle age are lesser ability to achieve or maintain an erection, less interest in sex, and fewer spontaneous sleep erections. Other midlife symptoms men commonly experience include
- Different sleep patterns
- Increased body fat and decreased muscle bulk
- Lack of energy
- Emotional changes, including lower motivation and trouble concentrating
It is known that testosterone levels gradually decline about 1% per year after age 30, but a blood test is the only way to diagnose low testosterone levels or lower bioavailability of testosterone. Further complicating matters is that some men have lower than normal testosterone without experiencing symptoms.
Male Menopause, or Midlife Crisis?
Men and women often face emotional challenges as they reach midlife, finding that perhaps their efforts at success were not very fulfilling, and that old age is fast approaching. We’ve all seen (and perhaps ridiculed) the middle-aged man who suddenly acquires a sports car or a much younger companion. It’s all too easy to chalk up midlife changes to emotions.
Then again, before there was a lot of medical research about menopause, much of what women experience was chalked up to things like “empty nest syndrome.” It’s entirely possible that as research into male midlife changes intensifies, it too will be taken much more seriously from a medical perspective.
Whatever age a man or woman is, however, emotional changes that persist more than a couple of weeks, or that interfere with day-to-day life should be reported to a medical professional, because there are numerous physical causes for emotional symptoms, from hormonal changes to thyroid problems, to brain chemistry imbalance. Many of these problems can be successfully treated medically.
If a man is experiencing lower libido or energy, or isn’t performing in the gym as well as he used to, is testosterone always the answer? No, not always. In fact, the definition of “low testosterone” is open to some discussion. On average, when testosterone levels fall below 300 nanograms per deciliter (ng/dL), they’re considered low. However, this isn’t necessarily a one-size-fits-all proposition, according to Dr. Joel Finkelstein of Massachusetts General Hospital in Boston.
The truth is, taking testosterone when it’s not needed is pointless, according to sexual health therapist Matty Silver. So before exploring the testosterone supplementation option, a man who thinks his testosterone levels are dropping should find out for sure by seeing a physician and having testosterone levels tested. The good news is, many age-related changes can be effectively addressed with lifestyle changes.
Effect of Lifestyle on Midlife Changes
Many symptoms of aging are worsened by lifestyle habits like smoking, consuming too much alcohol, avoiding exercise, and gaining too much weight. These habits not only make people look and feel older, they increase the risk for heart disease, diabetes, high cholesterol, and clinical depression. Furthermore, some health conditions can affect testosterone levels, like sleep apnea. When such a condition is diagnosed and treated, testosterone levels may return to normal. A healthy diet and regular physical activity (preferably five or more days per week) can go a long way toward preserving strength, muscle mass, and energy, and these lifestyle factors promote better sleep and a more positive mood.
New Research on Men and Estrogen
The latest research on so-called male menopause involves something you might not expect: estrogen. Last September, the New England Journal of Medicine reported on a study that better defines hormonal shifts men experience as they get older. The study, which included 400 healthy men age 20 to 50 found that estrogen is important in men for keeping fat levels down, and that both estrogen and testosterone are involved in sexual desire.
When men in the study had lower levels of estrogen, they accumulated more body fat, and the converse was true too: when men had higher estrogen levels, they had less body fat. When it came to sexual functioning, researchers found that a combination of estrogen and testosterone was more effective than testosterone alone.
Researcher Dr. Abraham Morgentaler, associate clinical professor of urology at Harvard Medical School explained that estrogen actually comes from testosterone in men, so when men’s testosterone levels drop, estrogen levels drop too, affecting sex drive, muscle mass, and body fat. The good news is, when men are deficient in both estrogen and testosterone, testosterone supplementation can replace both, since in men estrogen is made from testosterone.
But Dr. Finkelstein of Mass General says that this study doesn’t definitively answer the question of whether testosterone supplementation is a good thing. He points out the old conventional wisdom that women in menopause should take estrogen and progesterone, an idea that was debunked after a large clinical trial found that estrogen and progesterone replacement increased risks of heart attack, stroke, blood clots, and breast cancer. There has not yet been enough research on male menopause to determine whether testosterone supplementation should be widespread.
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