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Men who pause should worry less to do better

Male menopause does exist but it has more to do with the mind than declining hormones. And it’s rarer than thought. Data shows that far more men believe hormonal deficiency is turning them into wusses, when all that’s probably affecting them is performance anxiety, writes Sanchita Sharma.

india Updated: Jun 19, 2010 20:43 IST
Sanchita Sharma

Male menopause does exist but it has more to do with the mind than declining hormones. And it’s rarer than thought. Data shows that far more men believe hormonal deficiency is turning them into wusses, when all that’s probably affecting them is performance anxiety.

While all women stop menstruating (good thing) and have mood swings (bad, bad thing) when levels of the hormones — estrogen and progesterone — drop after the age of 45, only 2 per cent men experience a fall in testosterone production.

When it comes to menopause, men have it better than women. And, as a woman, it does not bother me. Except in societies where women are treated worse than chattel and the family’s cattle, it’s well established that men lead in illness and lag in health. Women live longer, with men more likely to inherit genetic diseases and hurt their health with substance abuse than women. Even when ill, men are less likely to visit doctors and when they do, are more likely minimise symptoms and disregard medical advice.

Back on menopause, the changes in women are biological with signs that are in your face. Women have to deal with hot flashes and night sweats, vaginal dryness, mood swings, trouble focusing, increased facial hair and change in period patterns (periods can become erratic, shorter or longer, lighter or heavier). Technically, the diagnosis of female menopause comes one year of their having had their last period, but the symptoms can begin several years earlier.

Men, on the other hand, have little to worry about except worry itself.

In men, age-related fall in testosterone levels is far less dramatic, with the hormone levels falling by only 1 to 2 per cent a year from the age of 40 onwards.

Along with low testosterone levels, doctors need three symptoms — decreased frequency of morning erection, decreased frequency of sexual thoughts (or sex drive) and erectile dysfunction — to establish a diagnosis of late-onset hypogonadism, the medical name for male menopause.

Other symptoms include loss of energy, sadness and tiredness. What’s more, a study of 3,369 men between 40-79 years across Europe showed that only 2 per cent of middle-aged men fit this criterion of male menopause. The study, reported in the New England Journal of Medicine, found that those who said they had symptoms of weakness, depression and sexual problems were obese and had poor overall health, both factors that increased risk of diseases such as diabetes and heart disease.

What’s clearly implied is that obese and ill men are more likely to have lower libido and be depressed than healthy men. And they are equally likely to look for a quick-fix to treat their tiredness, impotence or dwindling sex drive in the form of testosterone therapy. The researchers concluded that testosterone therapy was over-prescribed: it increased 400 per cent in the US since 1999.

Earlier this month, an editorial in the journal Drug and Therapeutics Bulletin said the same thing: that many men reporting menopausal symptoms had normal hormone levels. It warned that giving synthetic testosterone the male counterpart for hormone-replacement therapy for women to relieve symptoms could increase the risk of prostate cancer..

Boring as this may sound, what works every time is eating healthy and adopting an active lifestyle. (Incidentally, the NEJM study also listed difficulty walking, running and bending as menopause symptoms). A healthier lifestyle will not only lower weight but also improve mood and lower anxiety and depression.

The only way to fight male menopause — real or imagined — is to get up and running, literally.