Ah, middle-age the self-doubt, the existential angst, the sudden awareness of just how short life is. Work, marriage, kids. Its not easy. And then comes the lack of enthusiasm, the tiredness, the brain fog and the irritability. But these are not necessarily de facto products of having made it to a certain age.
Rather they aresymptoms and you can throw in hot flushes, insomnia, mood swings and a general disinterest in sex of a still controversial idea: that, like women, men experience menopause.
This is not a definitive biological, hormonal event as it is for women the sometimes decade-long spell of similar symptoms, leading to a lack of menstruation for a year, followed by officially entering ones post-child-birthing phase of life. It likely doesnt have quite the same negative impact on well-being, on relationships and work.
Certainly not everyone in medical circles thinks its even a real thing, and scientific study of the manopause more officially, the andropause is lacking. And yet many men, and increasingly, clinicians too, concede that something sometimes happens when you hit your mid-40s or early 50s. You go off the boil.
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The male menopause just isnt as well recognized as the female menopause, explains Dr. Clive Morrison of Londons Centre for Mens Health. This is in part because the latter is a natural, well-documented event for every woman, but its a less distinct, drawn-out process for most men, and it doesnt affect all men either. In part its because were not really sure why it happens to men. And in part also because of culture, which still broadly has a temperance attitude to sex. The male menopause is confused with the stigma around loss of libido, even though thats only one possible symptom. But this is more about your mojo. Its about your quality of life.
It doesnt help, of course, that a lot of the many possible symptoms of andropause are products of aging too: like it or not you can start to lose muscle typically about 3-5 percent of your muscle mass every 10 years after the age of 30. You might put on weight too, or rather your body fat is redistributed, so you get a bit of a belly. This all makes correct diagnosis of the andropause tricky a situation only made worse because, as Morrison stresses, each of us has our own threshold levels for each symptom, such that a man may display all of the psychological signs and some but by no means all of the physical or bio-chemical ones.
And psychological factors may be indicative of something else depression, maybe, not the andropause. Inevitably this all makes deciding on the right course of action tricky too.
There are simple things that we know do help that, in fact, help towards better health generally. Move more at a minimum just taking good, regular, long walks. Train gently but regularly with weights. Eat a low-carb, high protein diet. Get a good eight hours sleep every night. Address the stress in your life rather than normalizing it.
But others those who may be tempted to supply a quick fix, much as HRT or Hormone Replacement Therapy has (not uncontroversially) become for menopausal women also suggest that the andropause is likewise a hormonal issue in men. Its all, they say, about a loss of testosterone, as for womenabout estrogen.
Indeed, far from the misconception of testosterone as being all about sex, its decline is also linked to muscle atrophy, reduced bone density and a susceptibility to depression; and theres an inverse correlation with obesity and mortality from heart failure the less of it you have, the more prone you are to both issues. This is why some experts dub the male menopause Testosterone Deficiency Syndrome. And why often testosterone replacement therapy is pushed.
Anecdotally, that certainly works for some men. But dont rush into this. For one, while the rapid shutdown in estrogen production has been attributed to symptoms of the female menopause, men typically see only a 2% testosterone decline per year over their thirties. Its argued that this is unlikely to have noticeable consequences.
Then there are the practical issues: regular testosterone injections this is how its typically delivered into the bloodstream dont come cheap. Prices vary but were often talking at least a few hundreds dollars per month and, obviously, those who recommend this treatment also profit from it too. Nor can you just have these as boosters to get back on track: since injecting testosterone also typically causes your natural testosterone production to gradually close down, once you start, youre committed for life. Its a crutch, not a cure.
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This doesnt help when a drop in testosterone can be hard to measure conclusively healthy testosterone levels may disguise a decline from even higher ones. Current understanding also has it that subtle shifts in testosterone levels are more part of a broader package of metabolic changes in various key hormone levels prolactin, gonadotropin, DHEA and others youve likely never heard of with consequences similar to those experienced by menopausal women.
Its all very complex, sighs Morrison. Its often partners who first notice the problems the moodiness, the low libido. But then that gets misinterpreted and the man is sent off for marriage guidance when that kind of intervention isnt whats needed at all. Its the male menopause.
But understanding that, understanding the part played by testosterone which a lot of general practitioners still think of as some kind of snake oil is only recent. Thats just over the last 10 to 20 years, which unfortunately is not very long in medicine.
In other words, were still some way from grasping quite what the andropause is, what to do about it and, in some quarters, whether theres anything to do anything about. All of which is little consolation for those men who are suffering from a nasty potpourri of physical and psychological ailments that just when careers are peaking, just when theyre maybe wrangling both children and elderly parents, when retirement seems a lifetime away and time to look after themselves is almost zero comes along and really screws with their day.
But dont let that put you off. If youre not feeling right, and something inside leaves you unconvinced if its all just the normal pressures of a certain time of life, see a doctor. The manopause may sound like a joke, but it doesnt feel like it.
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