Yes, The Male Menopause DOES Exist

(News Today) - Earlier this year, a friend of mine called Sally hit a rough patch in her marriage. Her 50-year-old husband, Mike, with whom she had believed herself to be happy, repeatedly talked of feeling 'trapped'.

He habitually socialised with his male friends rather than his wife and two children, obsessively played his guitar in the shed and started behaving secretively - disappearing on weekends, coming home late from work - bristling with resentment to even sympathetic questioning.

Sally was even more astonished when, a few months into his bizarre behaviour, he suddenly left her, after more than 20 years together, and went back to live with his mother - telling Sally that he was 'no longer in love' with her and that he had 'always' been unhappy.

Unhappy, heartbroken and above all, bewildered, Sally started to search for answers as to what had gone wrong. She had thought that underneath the normal stresses and strains of married life, the two of them were fundamentally happy.

There was no 'other woman'; no rational explanation for his behaviour. Mike's sudden departure simply didn't make sense. Eventually, she decided that his behaviour was so uncharacteristic that perhaps it might have a medical explanation. She started researching 'middle-age depression' on the internet.

But nothing seemed to quite fit Mike's sudden transformation until eventually, in one of the online discussion forums, she hit on the words 'male menopause'. Further research found a website devoted to the topic, where every single element of his behaviour - from his mood swings to his bizarre denial of any happy past together - was laid out in bullet points as a symptom of the so-called 'andropause', or what some would call the male menopause.

The site suggested that there was much scientific evidence that the 'andropause' was a genuine physical and psychological condition that men could suffer in middle age - and which was analogous to the female menopause. It suggested that lower production of the male hormone, testosterone, in middle age could cause fatigue, weakness, depression and sexual dysfunction.

Sally was not sure whether to be reassured or disturbed, but the implication of the website was clear - what had happened to her husband was not just a 'mid-life crisis', but could be a genuine medical syndrome.

So, far from condemning him for his seemingly selfish and irrational mid-life crisis, she now faced the question: should she have sympathy for a possible hormone imbalance over which he had no more control than any woman going through the menopause?

Certainly, the topic has engaged doctors so much that, last month, a study into the condition was published in the New England Journal of Medicine. It confirmed that some men did suffer a drop in hormones in middle age - particularly testosterone - resulting in impotency and other sexual dysfunctions, and reported that some 20,000 men are currently receiving treatment for it.

However, and this is a big ' however', the research confirmed that the condition still only affected a small minority - only three per cent of men may ever experience the actual physical symptoms of lower testosterone.

And besides, even if Sally's husband was suffering from lower levels of testosterone, this report insisted that his other symptoms - sadness, tiredness, feelings of anxiousness - were not related to any hormone imbalance at all.

The temptation, then, is to dismiss the whole notion of the male menopause as a myth. Yet whatever the medical basis, I believe there are complex psychological factors that men confront in middle age that deserve to be taken far more seriously than they are at present.

Indeed, as a condition, it has been far better chronicled in literature than in medical science, most famously in Arthur Miller's masterpiece Death Of A Salesman, in which Willy Loman kills himself not because his family don't love him, but because his grand project as a man - to be a successful company man, to be 'well liked' - has come to nothing.

That same sentiment is echoed in Martin Amis's novel, The Information, which opens with the line: ' Cities at night, I feel, contain men who cry in their sleep and then say nothing.'

This sadness, this sudden crisis point in their lives, may not be the result of physical change, but I believe it is something real, tangible and often heartbreaking.

Dreams are fading, possibilities are closing down, their physical selves are often declining more dramatically than women, with loss of hair on the head and ugly, sprouting bristles elsewhere - the ears, the nose, the eyebrows.

Desk-bound, middle-aged spread takes hold, while women - their wives - are holding on to their sexuality longer than ever, sometimes partly as a result of HRT, sometimes as a result of the compensations of fashion and make-up.

Furthermore, the prospect of death is no longer a distant fantasy. A sense of growing mortality - and men on average still die several years earlier than women - can add to the general fear of encroaching old age.

Because of the clearly defined physical side to the female menopause, it is women who have customarily - and understandably - received attention and treatment for the distressing effects of this middle-aged malaise.

Many health authorities in this country have awareness campaigns to raise the profile of women suffering menopausal symptoms, and in America there is even a Menopause Awareness Day every September.

Men, on the other hand, rather than receiving sympathy have commonly been told to 'grow up'. But if my friend's husband is anything to go by, it's precisely the disappointment that they have found intrinsic to the idea of 'growing up' that leads to menopausal-type symptoms in the first place.

For what does 'growing up' mean to a man as his children start to peel off from school, his hair turns grey and his wife treats him as a comfortable part of the furniture? It means that the heroic project that most men, consciously or unconsciously, embark on after they first become adults, is coming to a close.

The psychological menopause is a final attempt to kick against the impending failure of that project. This sense of the expiry of some particular idea of oneself is not purely a product of male middle age - both men and women have to come to terms with changes that are inevitably visited on every life.

But the male crisis is different from 'the change' experienced by women going through the loss of their fertility. It is a crisis of identity, of the idea of the 'heroic individual' which men are taught to buy into from the first time they buy an adventure comic as a schoolboy.

By the time they have reached middle age they have realised they are no longer going to be Superman but bumbling Clark Kent.

'I sometimes think that while women are conditioned to see life as a domestic saga, men expect it to be an epic,' Sally told me ruefully. 'It is not enough for them to be loved by their family and to see that as a success. They need to be the hero of their own lives.'

I recognise my friend's description of her husband in my own interior landscape. Like Mike, I know that I am loved by my wife and family and that I love them fully in return. And yet at the age of 54 I cannot, however hard I try, see that as fully amounting to 'success'.

It is wonderful, it is life-affirming, it is meaningful - but it is not the same as success, which is a special category that has to do with ambition, affirmation by peers, acclaim and recognition.

I had my own male menopause some years ago, when I realised the initial burst of impetus that propelled my literary career - starting with two acclaimed, award-winning books and going on to several novels which commanded large advances - was settling down into something that was producing nothing more than an average middle-class wage.

Most authors experience a hiatus at some time, and even a middleclass income is pretty respectable for most novelists, but the fact was my career had flattened out and was no longer on a rising curve. Furthermore, this change was happening when I was hitting 50 and my fourth child was being born.

Supporting a family for the rest of my life suddenly seemed an intolerable burden. I would be a wage slave until I was 70, eking out an existence, writing articles if necessary for the Fish and Chip Gazette and appealing to a smaller and smaller rump of novel readers who would pirate my books online anyway, leaving me penniless.

It was ridiculous, really - I had achieved more than I had ever hoped as a writer, every book had been shortlisted for some prize or other, and one's stock as writer is always rising and falling anyway.

But the feelings of failure were real. This idea of 'success' that is lodged in the minds of many men is an elusive, lofty and often destructive creature. The idea of my success as a person was, however, somehow tied up with always moving on to greater and greater professional heights.

It didn't occur to me that I was suffering any physical effects of the male menopause, and since I suffer periodic depression anyway, I would be hard pushed to tell the difference.

My wife was supportive, but I couldn't help but imagine that, since when we met I was a rising literary lion, she would now see me as a mewing, moulting pussycat. And the faint sheen of having a vaguely well known husband would quickly pale if the bills weren't getting paid.

In short, I thought I was becoming surplus to requirements. For me the symptoms passed - a fact perhaps not unconnected with a sudden recovery in my professional fortunes with new book contracts being offered, a number of screenwriting projects being commissioned and film options being taken out on several of my novels.

But Mike remained in the doldrums. 'I was starting to feel I didn't amount to very much. I was getting less ...' he struggled for the right word ... ' relevant. I had a feeling of low status in my household. I felt worthless. It was a "life in the old dog" thing, I suppose. My last chance.'

It was not purely a personal sense of life slipping by for Mike, but it was 'the end of an era' for all of his generation. He was watching the people he grew up watching on TV - the pop singers, the movie stars, the politicians - all looking old and tired. It was as if he was part of a wave that had crested and was beginning to crash into the sand, leaving no trace.

Perhaps there is nothing to be done about the male menopause. After all, we all age and decline. Doubtless many women would simply tell men to 'get over it' and get on with their lives.

But part of the frustration for a lot of men who suffer this state of mind is that no one really takes them seriously. They may fulminate, they may rage, they may bicker, they may get grumpy or withdraw altogether, but perhaps the truth is that men are still not allowed to have 'female' emotions - feelings of loss, of sadness, of grief even.

Perhaps men behave like children - retreating into themselves or exploding into drastic, often self-destructive action - not because they need to grow up, but because they are treated as children, as inventors of trivial complaints about imaginary woes.

Mike certainly felt that way. He cracked because he felt he was seen as an irrelevance. 'I felt taken for granted by everyone,' he complains.

Whatever you think of men and their malaises, whether those complaints are real or trumped-up, even whether they are dismissed by medics, those close to menopausal men ignore their distress at their own peril.

For when male mid-life crisis strikes, common sense, reason and even self interest count for nothing. Perhaps we're self pitying and self indulgent, perhaps we're in genuine pain and, more likely, like Willy Loman, we're both.

But writing it off as self-pity is bit like treating a severed artery with a testosterone patch.

Source : kompas

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