Male Menopause: Really?

It would seem that women are not alone in experiencing troublesome symptoms when they reach a certain age. If you are noticing conditions akin to those suffered by females during the change of life, you are one of many men to suspect the existence of a male equivalent of the menopause. But what does medical science have to say?

Definition of Male Menopause

Men don’t have the same hormonal process as women when they reach a certain age. They usually experience a gradual decline in testosterone levels, around 2% a year from between the age of 40 to 50. For a healthy man, the production of sperm can continue into his eighties and beyond. For a woman, her ovulation pattern suddenly ceases, fertility is over and oestrogen levels drop radically. All women will experience menopause but only some men will have menopausal-type issues. For this reason, the term male menopause, or andropause as it is also known, is scientifically controversial, but nevertheless the mid-life symptoms experienced by some men are very similar to those experienced by women during menopause

Male Menopause Signs and Symptoms

Doctors are reporting that men at their mid-life stage sometimes present with symptoms of extreme fatigue, muscle weakness, loss of body hair, night sweats and depression. Some men notice a loss of muscle mass with a resultant lack of ability to exercise and there may also be a shift in where body fat is stored. This means a man may acquire a larger belly or develop fat around the chest area, a condition known as gynaecomastia (man boobs). Sexual problems such as low libido and erectile dysfunction are also very commonly reported problems amongst this age group.

According to the NHS, some men in their late 40s to early 50s develop emotional as well as physical symptoms and these can include mood swings, irritability, and a general lack of zeal. This is a time when problems with concentration may arise, sometimes causing short-term memory lapses. Depression may be a symptom of mid-life crisis, possibly triggered by the perception that the most vital and virile years are past.

A mid-life crisis is often noticeable by a radical change in behaviour. Sometimes this manifests itself in social withdrawal, neglect of personal care, weight loss or gain, sudden insomnia and uncharacteristic moodiness and anger. It is around these middle years when some men realise that their strength is beginning to diminish, and they find it hard to come to terms with signs of ageing. This can lead, in some cases, to a bid for proof of masculinity.

The Question of Hot Flushes or Sweats

There are various reasons why we sweat, but for men to experience sudden onset sweating or flushes around mid-life may poses certain questions and may be one of the reasons that many men feel that they are experiencing symptoms akin to the menopause. Looking first at the most usual causes for excessive sweating, here are some of the physical and emotional triggers:

Gastroesophageal reflux disease (GERD)

It has been found that night sweats are often linked to the problem of a faulty muscle that normally tightens to seal the oesophagus and prevent undigested food and stomach acid from rising into your throat and causing the unpleasant burning pain known as heartburn. It probably earned this title because it can also cause chest pain (which is not heart related). GERD makes swallowing difficult and can also present as the symptoms of asthma. Apart from the other unpleasant sensations, it also makes sleeping difficult.

Hyperhidrosis

In certain circumstances the nerves that control your sweat-gland function misfire and trigger perspiration when it is not needed for the usual reasons such as when you are too hot, anxious or have had a particularly spicy meal. Medical science has not yet managed to discover why this happens, but it has been established that it may be a symptom of another medical issue or the result of taking certain pharmaceutical medication. If you have hyperhidrosis disorder you will notice that you sweat profusely both at night and during the day. You may perspire from just certain parts of your body or all over. If this problem affects your sleep or causes distress, there are prescription medications that can control it.

Stress and Anxiety

Waves of heat, accompanied by perspiration, are symptoms of stress and anxiety. They can strike at any time, both day or night, and usually accompany distressing thoughts. They can also occur randomly because you are in a constant state of heightened anxiety. Don’t feel that because you have no visible sign of this condition you shouldn’t seek help. Without treatment, stress and anxiety can have a very negative impact on your life and your ability to take pleasure in anything you may wish to do. It’s very important to get help. Therapy for anxiety is extremely effective in helping you to overcome the triggers, the symptoms and to regain your peace of mind.

Side Effects of Medication

Various drugs can cause night sweats. These include antidepressants, steroids, such as cortisone and prednisone, antipsychotic medication, and hormone therapy drugs. If your sweating coincides with taking a new medication you may be able to switch to a different one.

Sleep Apnoea

Men with this condition may find that, among other symptoms, they have night sweats. Apnoea is when the soft tissue in your throat blocks the airways during sleep. You will wake many times during the night with feelings of choking and this means you miss out on restorative deep sleep. It should always be reported, and a specialist can help you to manage it. Losing weight and reducing alcohol consumption will help greatly.

Hormonal Disorders

Certain conditions involving the hormones can trigger night sweats and these include:

1. Hyperthyroidism – the thyroid is a small gland at the front of your neck. It makes tetraiodothyronine (T4) and triiodothyronine (T3) – both are hormones that control your use of energy. When the thyroid makes too much T3 and T4 the condition is known as hyperthyroidism. One of the symptoms is excessive sweating but treatment can alleviate the condition.
2. Pheochromocytoma – a condition that causes non-cancerous tumours to grow within the central nervous system, particularly affecting the adrenal glands and this causes excessive sweating because the adrenal glands then put the body into a stress-response state.
3. Low testosterone – there are a variety of causes of low testosterone levels. Some of these are injury, medications, substance misuse, and certain health conditions. As well as night sweats, low testosterone may give other symptoms such as erectile dysfunction, muscle weakness, lowered libido, decreased bone mass, mood changes, focussing and memory issues. A blood test can verify low testosterone and it can be treated with hormone replacement therapy.

Causes of Mid-Life Problems

The question is, are symptoms due to falling testosterone levels or a result of other age-related issues? It’s normal for levels of testosterone to reduce with ageing but in the case of certain health conditions, such as diabetes, testosterone levels may begin to decline sooner. Doctors report that testosterone replacement can often bring some relief to men experiencing symptoms.

A condition called late-onset hypogonadism may be the cause of problems associated with low testosterone and this, as its name suggests, sometimes occurs as men reach more senior years.

Signs of mid-life crisis may not always have a physical cause. The prospect of getting older can bring feelings of depression. It can also lead some to examine their lives and possibly regret lost opportunities. All men don’t experience these turbulent emotions and for many the middle years are a positive time to reflect on experience gained, and to move forward with the benefit of acquired wisdom. It is believed that those who are most likely to struggle with emotional upheaval are those who have experienced traumas such as redundancy, rejection, divorce, and bereavement.

It is a time when changes are naturally occurring. Elderly parents may be needing extra care, children may have reached the stage when they are leaving home for university and the physical side of a long-standing relationship may have lost some of its sparkle. Issues such as financial worries, work-related stress or divorce are often the culprits when physical symptoms arise. One of the most common conditions experienced by men as they reach mid-life is erectile dysfunction and this can be caused by anxiety, stress, and depression. There are other causes of ED, however, such as changes in the way blood vessels behave due to the circulatory system.

The fact is though that those symptoms that seem to denote a mid-life crisis can interfere with a man’s general sense of well-being and impinge on everyday life and happiness. It is therefore very important to establish the cause and find the best way to manage and correct it.

Diagnosis of Male Menopause

To make a diagnosis a medical practitioner will need firstly to understand the symptoms and then a physical examination may be necessary. Various blood tests will be carried out to be sure there are no other undiagnosed medical conditions causing the symptoms. One of these blood tests will be to check testosterone levels.

Medical Treatment for Male Menopause

In the same way that hormone replacement therapy (HRT) for women with extreme menopausal symptoms may be prescribed, it is possible to have hormone therapy for low testosterone levels. This may help with issues such as low libido, feelings of unusual and extreme fatigue, excessive sweating, and depression. Read more in our blog Low Libido in Men.

Hormone replacement therapy carries various side effects, including a greater risk of heart disease and a higher risk of worsening of possible prostate cancer. Before prescribing, your doctor should discuss with you other ways in which you might help your symptoms such as making certain lifestyle changes before the decision is made to go down the hormone treatment route.

Self-Help with Lifestyle Changes

There are many things you can do to help yourself during this unsettling time. The main changes you can make are:

• Diet
  • Ensure your diet is healthy by cutting out processed and fast foods, sugar, including such things as sweet desserts, fizzy drinks, pastries, cakes, biscuits and refined flour products such as white bread, confectionary, pizza, and white pasta. These can be replaced with the wholemeal version of such things as bread, pasta, and rice. Introduce more fruit and vegetables into your diet and ensure the protein you eat is not too fatty. Try to eat oily fish such as salmon, trout, mackerel, sardine at least twice a week.
  • Drink plenty of water and keep alcohol to a moderate level. Too much beer, wine or spirits may give you an initial lift but will let you down heavily both in terms of feelings of fatigue and low mood. Alcohol is ultimately a depressant.
• Achieve a Healthy Weight
  • Carrying too much weight will make you feel worse and put extra pressure on internal organs as well as joints. It also impacts on getting a good night’s sleep so if you need to shed a few pounds (or stones) this is a priority. It’s a good idea to have your thyroid checked to be sure your weight gain is not caused by an under-active thyroid. A natural supplement that is scientifically proven to safely help lower body weight in those with a high BMI is Tongkat Ali, read more under the Natural Supplements section.
  • Being underweight is not healthy either, and you may need to concentrate on eating more lean protein along with complex carbohydrates such as wholemeal bread, cereals, pasta, and rice. Have a simple blood test to establish that your thyroid is not over-active.
• Physical Activity
  • You may be feeling exhausted and not in the frame of mind that makes you want to tackle anything too strenuous but managing to do a little exercise each day will greatly help. Even if it’s only a short walk, an hour’s gardening, a steady swim, or a cycle ride, you will be doing yourself a great deal of good and helping to get things back on track. Exercise has a good effect on your feel-good senses. It releases endorphins and that makes you happier. If you are not feeling up to getting out and about, yoga stretches, and isometric exercises will help greatly with keeping your joints supple and your muscles toned.

• Sleep
  • Sleep deprivation is one of the things that contribute to the symptoms you may have. If you are experiencing anxiety, depression, night sweating, feelings of low confidence or self-image, you may find sleep is elusive. Developing a sleep-time routine where you go to bed at roughly the same time each night helps your body clock to automatically begin to prepare you for sleep. Choose a lightweight duvet and sheets that help you keep cool, a mattress that supports you properly and pillows that are comfortable for your neck. Consider keeping a fan by your bed in case you are struggling with excess sweating.
  • If you find that your mind refuses to let go at bedtime, try one of the meditation apps available or sleep sounds such as rainforest, thunderstorm, or waves on the shore soundtracks. Anything that helps you drift off into a peaceful sleep is worth a try. An alcoholic night cap might help you to fall asleep, but unfortunately it will also cause you to wake in the early hours feeling dehydrated.
  • Many men as they reach mid-life onwards experience the need to get up several times in the night to pee, this is very disruptive to sleep and if you find this becoming an issue it’s advisable to have your prostate gland checked in case it may be enlarged. Medication is available to help shrink an enlarged prostate, and this will help you to have less disturbed nights, as well as allowing your doctor to keep a check on the general health of your prostate.
  • A 12 week study concluded that a daily intake of 320mg of Saw Palmetto extract could improve issues such as urinary frequency, urinary incontinence and the need to urinate throughout the night. Read more about our Saw Palmetto Complex capsules.

Natural Supplements to Ease Male Menopause Symptoms

Ashwagandha

Also called Withania Somnifera, this herb has been used in Indian medicine for many centuries. It is known to be an adaptogen which means that that it can support the body in dealing with anxiety and stress. It has been found to be beneficial in helping with sexual health issues, particularly boosting testosterone levels and sperm production. This may be due to its ability to reduce cortisol levels in the case of anyone suffering with stress. High levels of cortisol can impact negatively on sperm production.

Ashwagandha has the highest number of positive clinical trial results to date, including a 2015 randomised controlled trial to establish its use in increasing exercise performance strength, supporting fat loss as well as boosting testosterone levels. The trial results were conclusively positive, and research has verified ashwagandha to be helpful in increasing testosterone levels, improving sexual function and body composition.

Our award-winning Ashwagandha capsules are made using the highest bioavailable extracts from the roots of the plant sourced from India. The extraction process of our product is achieved without using alcohol or chemical solvents.

Tribulus Terrestris

Tribulus is a plant that has stood the test of time in traditional natural medicine. Clinical research has been conducted to investigate its potential in improving sexual function. Results of a large randomised, double-blind, placebo-controlled clinical trial, were published in 2017 by Maturitas, (the international journal of mid-life and beyond), highlighting findings that Tribulus enhances sexual function, being particularly effective in cases of erectile dysfunction. It was also found to have positive libido boosting properties.

Our highly acclaimed T-Boost Complex capsules contain a high percentage of Tribulus terrestris.

Tongkat Ali

Botanical name, Eurycoma Longifolia, commonly known in its native Malaysia and Southeast Asia as Tonkat ali. The roots of the plant have been used in ancient medicine to help boost sexual desire and alleviate impotence. It was also found to help with the easing of depression, high blood pressure and chronic fatigue so this plant provides a great deal of support to those struggling with mid-life issues.

In more recent times, Tongkat ali is sometimes referred to as Malaysian ginseng, and in its native Malaya is nicknamed ‘home-grown Viagra’. The Malaysian government has spent a great deal of effort in attempting to license it for its health benefits via government organisations such as the Forest Research Institute of Malaysia. The plant’s roots contain substances which have been shown to improve sex drive, reduce fatigue and improve well-being.

A 12-week trial of Tongkat ali involving men between 30-55 years, showed a significant improvement in terms of physical function along with increased libido. Abdominal fat mass was also reduced in participants with a high BMI. Amongst men with a low testosterone level whose average age was 51 years, one month of daily supplementation with Tongkat ali extract showed a marked improvement in testosterone levels.

Our Tongkat Ali capsules are produced from the roots of mature Indonesian Eurycoma Longifolia. T-Boost Complex also contains Tongkat ali as part of a blend of other potent extracts.

At What Point Should You Seek Professional Help?

Reaching your middle years needn’t necessarily bring about negative changes that need help either medically or emotionally. Some men escape the turmoil experienced by many. But for those who do find themselves in crisis, it is important to know that you don’t have to cope alone. Much can be done to support you in managing physical symptoms as well as low mood, anxiety, and depression and it is vitally important to your well-being that you reach out for professional help.

Talk to your doctor if:

• Emotional distress is affecting your need to eat or sleep.
• Your stress levels are causing you to feel uncharacteristically angry and aggressive.
• Anxiety is frequently making you short tempered with your partner or children and threatening your relationships.
• Lack of concentration is impinging on your ability to function well at work.
• You find you have lost interest in the things you usually enjoy such as sport, hobbies, and social life.

You may be contemplating a major change to deal with your feelings of unhappiness. Before doing anything serious such as ending a relationship or marriage, ditching your job, and seeking an entirely new career or relocating, it may be a good idea to speak with a mental health professional to give yourself the chance to resolve inner turmoil before making any irreversible decisions.

What you are feeling may stem from a medical condition and a doctor can establish whether this is the case before referring you for some therapy for emotional problems.

Should you wish to discuss any aspect of using natural supplements, or would find advice helpful, please feel free to contact us on 01297 553932.