What happens to men in middle age? While the Bible described life expectancy as “three score years and ten” and half of 70 years would have meant middle age starts at 35, modern life expectancy for men is longer. Middle age can be more accurately said to start at between 40 and 45.

So why around that age do men tend to stray, buy a red sports car, get restless at work, and throw a fit when addressed by an attractive young assistant as “sir” for the first time? I suppose this leads to the question as to whether there is a male menopause. More accurately, are there equivalent hormonal changes, and are men also subject to the psycho-socio-cultural effects of aging?

Frankly, there is just no male menopause if loss of fertility and hormones is what defines it. The term male menopause is also manifestly ridiculous. Men do not menstruate so how could they stop menstruating? For want of a better descriptive term of this phase in life, another word is coming into popular use – andropause.

Something does seem to happen to men traversing andropause. How can we explain it?

AGE-RELATED HORMONE CHANGES IN MEN

The testis is just not an ovary. While the ovary is endowed at birth with all the eggs it will ever have, and essentially runs out by menopause, the testis is like the Energizer bunny and just keeps going and going. That is why old men can still be fertile. I am sure that one day we may find a reason behind all this, but for now we can only speculate.

So while the ovary runs out of eggs and produces less and less hormones through menopause, the testis goes on producing its sperms and hormones into much older age. The production of testosterone, the key male hormone, does peak at around age 50, but a subsequent gradual reduction takes place over the subsequent 30 to 40 years. Some men do exhibit an earlier and more rapid decline in testosterone levels than others. Sperm counts will also decline in older age, but remain capable of fertilizing an egg. Obviously, there is little comparison with the abrupt changes that occur in women.

ARE THERE GENUINE SYMPTOMS RELATED TO ANDROPAUSE?

If there are, no one has really been able to prove they exist. As men age they do complain of reduced libido or sexual potency, increased fatigue, a decreasing ability to concentrate and be productive, sleep disturbances, anxiety, and depression. Some men even report hot flashes, sweating, and rapid heart beats (palpitations).

None of these symptoms can be related to any of the hormonal changes. Most likely they are effects of aging itself, certainly those related to sex, memory, and sleep. All these symptoms just slowly get worse with age. Watching athletes’ age would seem to confirm this.

Is andropause then only a phenomenon occurring in men’s minds? I will try and answer that next time.

Until then, remember that life is not a dress rehearsal.

Wulf Utian MD PhD DSc

Author; CHANGE YOUR MENOPAUSE – Why one size does not fit all. http://www.amazon.com/Change-Your-Menopause-size-does/dp/0982845723/