Feeling the dreaded signs of perimenopause, are you? Yeah, us to. Getting older is not for wimps, that’s for sure. As we age, we can no longer run as fast, jump as high, or dance all night long the way we used to do. Well, believe it or not, it’s not just us menopausal women who are facing physical changes. Men are, too. Oh yes. Male Menopause is a thing.
It’s called Manopause in our world, although the real name for it is Andropause, and it can take men, and the women who live with them, by surprise. Here’s everything you need to know about male menopause, this little-talked-about reality of male existence.
What is Male Menopause Anyway?
Just like women experience menopause, men over 40 may experience andropause—sometimes called male menopause. During andropause, a man’s testosterone levels start to fall at about 1 per cent per year.
Think your guy just has beer gut? Nope. In aging men, progressive testosterone deficiency (also known as androgen deficiency) leads to a syndrome called hypogonadism, which causes muscles to become flabby and decrease in size, leaving men with that dreaded middle-age paunch. It can also lead to a host of other unwanted physical changes: osteoporosis, decreased libido, erectile dysfunction, difficulty sleeping, mood changes, and even hot flashes. Some call this the “grumpy old man syndrome.”
Sound like anyone you know?
What to Do About Male Menopause
Just like women can get hormone replacement therapy during or after menopause, men experiencing symptoms of andropause can undergo testosterone replacement therapy (TRT). TRT is not as simple as taking a pill—taking testosterone orally is extremely toxic to the liver. Instead, men can get testosterone injections or apply topical gels to their lower abdomen, upper arm, armpit, or shoulder. As the gel dries, the testosterone is absorbed through the skin.
The long-term effects of TRT are a little hazy. Men with low testosterone levels often have cardiovascular and prostate problems as well. Long-term TRT use can increase the production of red blood cells, causing the blood to thicken—this may increase the potential for a stroke or heart attack, especially in smokers. It can also cause significant changes in men’s cholesterol levels, which can directly affect cardiovascular health. Unfortunately, TRT lowers the good cholesterol widely recognized for its role in protecting against coronary artery disease. The upside of this is that TRT also lowers the bad cholesterol responsible for blocking arteries.
Another consideration is that, while TRT does not cause prostate cancer, it can make existing prostate cancer grow rapidly. If a man in your life is receiving TRT, his doctor should be meticulously monitoring his prostate health with regular exams and screenings.
Before receiving TRT, men experiencing symptoms of andropause should see a urologist and look into having their testosterone level tested. The results of TRT for symptomatic men are remarkable and can improve many of the physical effects associated with the toughest part of life—getting old.
Sometimes health or financial constraints mean that TRT isn’t an option. My advice for those men is to modify their diet, maintain a healthy exercise routine, and accept the reality of aging—a reality that sometime brings with it a little paunch. Like older women, older men can be sensitive about no longer being able to maintain that youthful body, but staying healthy and positive—and having sex—can work wonders on body image.
How Menopause and Andropause Can Impact Your Sex Life
Women typically have less interest in sex after menopause, due largely to the decrease in estrogen. As estrogen levels fall, it becomes increasingly difficult for the vagina to lubricate itself. Topical estrogen and a variety of lubricants can be used effectively and safely, but for the most part, postmenopausal women have less interest in sex than do men experiencing andropause.
For this reason, as a male health specialist, I advise my patients not to turn their backs on a lifelong partner for a younger, more responsive lover. Unfortunately, as we all know, cheating happens. But I always say that sacrificing the friendship, intimacy, and bond of a long-term relationship is never worth the quick fix.
Instead, I emphasize that sex is not only safe for older couples, it is also good for them, maintaining overall physical strength and cardiovascular health and keeping them invigorated. The changes of aging are natural and should be looked at as an opportunity for a couple to expand their sexual repertoire. As long as both partners are caring and compassionate with each other, especially in the bedroom, and talk candidly with each other about the changes they’re going through, couples can maintain a healthy, playful sex life for a lifetime.
Dudley Seth Danoff, MD, FACS, is president and founder of the Cedars-Sinai Medical Center Tower Urology Group in Los Angeles, a Diplomate of the American Board of Urology, a Fellow of the American College of Surgeons, and the author The Ultimate Guide to Male Sexual Health.