The Male Version of Menopause

Like women, men go through changes as they age. Yet men's midlife changes are much different from women's.

Because the word "menopause" means "cessation of menstruation," it doesn't accurately describe what happens to men in midlife. Men who feel they're going through "male menopause" may actually be feeling the symptoms of aging. They may also be facing midlife psychological and spiritual issues.

In menopause, a woman's menstrual cycle stops permanently. At this stage, she can no longer become pregnant. Estrogen and other hormone levels drop sharply, causing various symptoms.

In contrast, testosterone declines slowly in men, and it can impact fertility, however some men still father children in their 70s.

The effects of aging on men
Aging can affect the male reproductive system. One condition that requires treatment is hypogonadism, or low testosterone levels. This is caused by a disease of the testicles or the pituitary gland. Signs and symptoms include:

• Tender or enlarged breasts
• Depression
• Fatigue
• Hot flashes
• Impotence
• Irritability and mood swings
• Loss of bone mass
• Loss of muscle or mass
• Concentration problems

If you have any of these symptoms, talk to your doctor. They could be caused by something other than low testosterone. For instance, another illness or the side effects of medication could be responsible.

Other changes
Men can have sexual and reproductive problems in midlife. Some examples are:

• Benign prostatic hypertrophy (BPH): This affects about half of all men. It can restrict urine flow and make ejaculation difficult. If urinating is uncomfortable or you get up several times during the night to go to the bathroom, see your doctor.
• Impotence: As they age, men can have problems getting and maintaining erections. These problems may be caused by conditions other than aging. Impotence can usually be treated.
• Decreased sex drive: Some middle-aged men become less interested in sex. Again, this may have nothing to do with aging. Chronic illness, medications or not having a partner are possible causes. Many men enjoy sex well into late life.

Midlife issues
Even middle-aged men in good health can feel stressed by new situations. You may suddenly need to care for aging parents. You may begin to question the value of the job you've held for years. You may start thinking about death, leading you to question what's truly important in your life.

These situations can have positive outcomes. Caring for older parents can renew relationships. Re-evaluating your life may lead you to work fewer hours or start a new career. You may decide personal fulfillment is more important to you than your present income. You may start finding joy in the moment instead of basing your happiness on what you achieve in the future. Try to face these issues openly and share your feelings with family and friends.

If you're a middle-aged man, learn how aging can affect your sex life. Be prepared for psychological issues, and get professional help if stress interferes with your daily life. Think of midlife not as the end of youth, but as the beginning of a deeper wisdom.

Related Articles Sexual Problems Impotence Hypogonadism Understanding BPH

External Sources Duthie EH, Katz PR, Michael ML, eds., Classification of sexual response and sexual dysfunction. In: Practice of Geriatrics. 4th ed. Philadelphia, PA: Saunders; 2007. National Cancer Institute. Fever, sweats, and hot flashes. Accessed February 7, 2007.

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