According to Dr. Google it’s a fact: the male menopause exists. In fact, there’d even be a male equivalent of PMS, called IMS. The only question is: is this correct? Men don’t have monthly menstrual cycles, do they? Also: women run out of egg cells at one point, but men continue to produce sperm cells throughout their lives. Plenty new fathers over the age of 65 around. Rod Steward was 66 when he had to change diapers again, Mick Jagger 73, and actor Anthony Quinn was even 81 years old. And those are youngsters compared to the Indian Nann Ram Jagi who broke his own record at the age of 96 when he became ‘oldest father in the world’ for the second time.

The story of the male menopause turns out to be a bit more nuanced

As is often the case in life, the story surrounding the male menopause turns out to be a bit more nuanced. What’s commonly referred to as ‘male menopause’ is called late-onset hypogonadism (LOH) or testosterone deficiency syndrome (TDS) in the medical world. That last term already points to the cause: testosterone deficiency. Normally, men don’t suffer from this easily. Their testosterone level drops too slowly for that: from about the age of 30 – when production is at its peak – by 1 to 1.5% annually. In women, estrogen production drops by up to 80% within a few years, an abrupt hormonal change that can cause quite a bit of turbulence (read: severe menopausal complaints).

Around 6% of men around the age of 60 have an acquired testosterone deficiency. However, some men have an increased risk of LOH. For example, overweight men. Body fat converts the male hormone testosterone into the female hormone oestrogen, which causes men to feminise and develop fat breasts. Having type 2 diabetes is also a risk. A 45-year-old man who has had diabetes for ten years has the same hormone levels as a healthy person aged 75. In men with the so-called metabolic syndrome – a combination of these risk factors – the chance of getting LOH is even 50%.

Testosterone deficiency can cause complaints that look suspiciously like female menopausal complaints. Think: depression, mood swings, sleep disorders, osteoporosis, decrease in muscle strength, hot flashes (!) and fatigue. These are all atypical and may also have a different cause. Typical LOH complaints are a reduced libido and erectile dysfunction.

Women can’t avoid menopause, no matter how fast they run

With the exception of the last complaint, there are indeed similarities. But there’s also an important difference. Women can’t avoid (peri)menopause, no matter how fast they run. In men, ‘the menopause’ or a too low testosterone level is often a sign of moderated health. Lifestyle changes (read: losing weight) do wonders. Otherwise, LOH is reversible through medication (testosterone in the form of gel or injections). That’s only possible if there is no longer a desire to have children. Medical testosterone makes a man infertile.

Conclusion: the male menopause doesn’t really exist. And the synonym ‘andropause’ seems a bit strange too, since ‘andro’ means man and ‘pause’ stands for stop, but the andropause does not end being a man. And none of this has anything to do with a midlife crisis. That’s the description for a psychological development that’s separate from the hormone system. A crisis that affects 20% percent of all persons no matter their gender. Although it seems to take twice as long in men as in women, Google says.

Irritable male syndrome, first diagnosed in sheep

By the way, the term IMS (irritable male syndrome) was coined by Dr. Gerald Lincoln of the Medical Research Council’s Human Reproductive Sciences Unit in Scotland. Lincoln first diagnosed the syndrome in sheep. He discovered that in the fall, when testosterone levels are low, rams become moody. Men aren’t sheep, but the same principle applies to them when their testosterone levels drop.

According to the American psychotherapist Jed Diamond – who wrote several books about IMS and male menopause – the symptoms of IMS are similar to those of PMS, such as mood swings, irritability and anger outbursts. However, scientists are rather skeptical about IMS. Just as they are about andropause. Male menopause or not, suffering from menopausal complaints or PMS is never fun, also not for those without a menstrual cycle.

Period! is an independent, online magazine about all aspects of menstruation. Period! is not intended as a substitute for medical advice. If you’re suffering from medical complaints, always visit your doctor or GP. Editorial articles can contain affiliate links. Sponsored collaborations can be found in the category Spotlight. Do you have any questions? Check our contact page.

Illustration: Shutterstock

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