Is ‘man-opause’ real? How men experience midlife hormone change

Common symptoms associated with midlife hormone changes may not be the strict experience of women. We find out if ‘man-opause’ is real and what it looks like.

Poor concentration, low mood, lack of libido and motivation?

Aching bones, fatigue and excessive sweating? Sound familiar?

These physical and emotional afflictions may be synonymous with the female menopause, yet men of a certain age can experience similar mid-life symptoms.

GP and How to Be Well author Dr Karen Coates says men experience a similar downturn in hormones in their mid- to late-40s as women do.

“It’s all about testosterone, the hormone which drives libido and energy,” Dr Coates says.

“Women have a small amount of testosterone, but ours is balanced with estrogen and progesterone to help us function.

“Men, on the other hand, rely almost completely on testosterone for their drive, energy and mood.”

This depletion is often referred to as andropause.

Why male hormones drop

A man’s testosterone levels peak in his mid-20s, and decline around 1-2 per cent every year, although some men’s levels may fall faster than others.

It’s when they hit their mid-40s, or “mid-life”, that trouble can start, especially if their lifestyle and health is out of balance.

Head of endocrinology at Austin Health Professor Mathis Grossmann says there is no male menopause, but “literature suggests there’s a modest drop in testosterone when men age” and this amount can vary among men.

Most of the age-related decline in testosterone is not due to ageing itself but rather to the accumulation of age-related chronic disease, especially obesity, Prof Grossmann says.

“Obesity causes testosterone levels to drop by 30 per cent or more,” Prof Grossmann says.

“Other illnesses, such as diabetes (especially if poorly controlled), heart failure or renal failure, all contribute to age-related decline in testosterone levels.”

What midlife male hormone change looks like

Rather than “male menopause”, a change in behaviour, motivation and physical symptoms may be an indication that men need to pay attention to their overall emotional, physical and mental health, Dr Coates says.

“It’s ‘grumpy old man’ syndrome,” she says.

“While women experience rage and irritability during peri- and menopause, men experience grumpiness and may feel miserable.”

How to manage male hormone changes

Prof Grossmann says the best way to stay healthy as you age is to engage in a healthy lifestyle and keep a healthy weight.

“Your doctor can help you to achieve these changes,” he says.

Testosterone treatment is only recommended for men with pituitary or testicular disease.

Prof Grossmann says weight loss is the key for men with age-related reductions in testosterone.

“Weight loss, while difficult to achieve, is the treatment of choice, because this will increase and, in many cases, normalise your testosterone level and improve general health and quality of life,” he says.

Dr Coates also recommends some lifestyle changes to improve testosterone levels.

“Look at your sleep patterns and aim for at least seven hours a night.

“Find ways to manage your stress.

“And take regular time out to rest and recharge,” she says.

She also advises men cut down on their alcohol intake.

“Excessive alcohol (in men) will push hormones into the estrogen pathways, so they’ll start growing ‘man boobs’,” she says.

”It’s a sign, and not a good one, that estrogen is taking over.”

She also recommends increasing the amount of daily movement — particularly with weights — to increase muscle mass, and walking for its physical and mental benefits.

Symptoms of declining testosterone

  • Change in sexual function
  • Reduced ability to obtain or maintain an erection
  • Declining or lack of interest in sex
  • Feeling sad or depressed
  • Mood swings
  • Irritability
  • Difficulty concentrating
  • Memory failure
  • Lack of motivation
  • Reduced self-confidence
  • Physical changes
  • Decreased bone density
  • Reduced strength and ability to work out for long periods of time
  • Lethargy and fatigue
  • Aches, pains and stiff joints
  • Excessive sweating

Written by Charmaine Yabsley.

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