Some men develop depression, loss of sex drive, impotence and other physical and emotional symptoms when they reach their late 40s to early 50s.
Other symptoms fairly common in men this age are:
- hot flushes
- mood swings
- loss of muscle mass and fat redistribution
- tiredness
- dry and thin skin
- increased sweating
- poor concentration and irritability
- loss of enthusiasm
These symptoms can interfere with everyday life and happiness, so it's important to try to work out the underlying cause, and what can be done to resolve these problems.
Is there such a thing as a 'male menopause'?
The 'male menopause' (sometimes called the 'andropause') is an unhelpful term used by the mainstream media to explain the above symptoms.
This label is confusing because it suggests that the symptoms are the result of a natural drop in the hormone testosterone in middle age, similar to the female menopause. This is not true. Although testosterone levels fall as men age, the decline is steady – about 1–2% a year from around the age of 40.
Testosterone deficiency can sometimes be responsible for symptoms when the testes are not functioning properly (see the section on hypogonadism below), but in many cases the symptoms are nothing to do with hormones.
Personal or lifestyle issues
Lifestyle factors or psychological problems can often be responsible for many of the symptoms described above.
For example, impotence, loss of libido and mood swings are often the result of stress, depression or anxiety. These psychological problems are typically brought on by work or relationship issues, divorce, money problems or ageing parents. Drinking too much alcohol and losing sleep only makes these problems worse.
A 'midlife crisis' can sometimes be responsible. This can happen when men think they've reached life's halfway stage. Anxieties over what they’ve accomplished so far, either in their job or personal life, can cause a period of depression. In men, this usually happens between the ages of 35 and 50 and can last for up to 10 years. Learn more about the male midlife crisis.
Poor diet, lack of exercise and smoking can also contribute to symptoms.
Hypogonadism and diabetes
When lifestyle or psychological problems do not seem to be responsible, there may be an underlying medical cause.
Many men with type 2 diabetes will have a condition known as hypogonadism, where the testes produce few or no hormones. Hypogonadism is diagnosed when there are:
- symptoms such as loss of libido, loss of morning erection, impotence, weight gain around the middle, decrease in muscle mass, fatigue, hot flushes, decreased motivation and self-confidence, and
- evidence of low morning testosterone levels
The testosterone deficiency experienced in hypogonadism is abnormal and often has an identifiable cause, such as Klinefelter's syndrome (a rare genetic condition where a man is born with an extra female chromosome). In other words, it is not just a normal age-related change.
What to do
If you are experiencing any of the above symptoms, see your GP. They will ask about your work and personal life, to see if your symptoms may be caused by a mental health issue such as stress or anxiety.
If stress or anxiety are affecting you, you may benefit from medication or a talking therapy such as cognitive behavioural therapy. Exercise and relaxation can also help. Read about stress management, treating anxiety and treating depression.
Your GP may also order a blood test to measure your levels of testosterone. If the results suggest that you have hypogonadism, you may be referred to an endocrinologist (specialist in hormone problems). If the specialist confirms this diagnosis, you will be offered testosterone treatment to correct the hormone deficiency, which should relieve your symptoms.
Read more about hypogonadism.
