3/21/2007

Male menopause? Mid-life crisis? Do men experience a "male change-of-life?"

Women experience menopause, the transition from the childbearing years to the post-child-bearing years when a major element of a woman's sense of identity is her fertility, her menstruation, her ability to give life and birth to new people; after it, she has to redefine her sense of self to accommodate the knowledge that she is no longer fertile.

It’s a fact of life.

Are men immune and not touched by the aging process? Put any "high opinions" of masculinity aside; there’s a certain truth to the joke that "women reach their sexual peak at the same time men are finding they have a favorite chair."

We’ve all heard about the "male mid-life crisis." It’s when a man of a certain age buys a sports car, changes his entire wardrobe and/or goes for the younger lover.

What IS the male mid-life crisis? Andropause.

Andropause is a medical phenomenon, similar to the female menopause, that can affect men between the ages of 40 and 55. Unlike women, men do not have a clear-cut signpost such as the cessation of menstruationto mark this transition. Both, however, are distinguished by a drop in hormone levels--estrogen in women, testosterone in men. The bodily changes occur very gradually in men and may be accompanied by changes in attitudes and moods, fatigue, a loss of energy, sex drive and physical agility.

Studies show that this decline in testosterone can put men at risk for other health problems such as heart disease and weak bones.

Unlike menopause, which generally occurs in women during their mid-forties to mid-fifties, men's "transition" may be much more gradual and expand over many decades. Attitude, psychological stress, alcohol, injuries or surgery, medications, obesity and infections can contribute to its onset.

Although with age, a decline in testosterone levels will occur in virtually all men, there is no way of predicting who will experience andropausal symptoms of sufficient severity to seek medical help. Neither is it predictable at what age symptoms will occur in a particular individual. Each man's symptoms may also be different.

Dr Malcolm Carruthers - who has worked with thousands of male patients in his London clinic - thinks that the male mid-life crisis is emotional in origin but if severe enough or long enough may have physical consequences, especially if alcohol or drugs are used to blunt the pain of the crisis. Typically, he says, the age group most prone to the crisis is around 40, mainly between 35 and 45, which is earlier than the andropause, which usually starts around the age of 50, say 45 to 55. 

So, around the age of 40, AND isn’t THAT a birthday? Commonly considered "over the hill." We realize that we are no longer "young" yet we aren’t really "old." We begin to take stock. What have I DONE with my life? AM I the man I WANT to be? Have I achieved what I thought I would? Have I achieved what I WANTED? WHERE do I stand now?

Dr Carruthers suggests that many mid-life crises go unnoticed and are passed off as the effects of a change of job, a change of house, or a change of spouse. Only occasionally does the drama turn into a full-blown crisis in which the man may feel he is stuck in a career which under- or over-extends him, producing the prospect of burn-out; or in a dead marriage or relationship which gives him the choice of divorce or separation and its consequent traumas, financial ruin, and starting over again. He also lists a number of factors that seem to predispose men to a traumatic mid-life crisis - in essence, these are things that destabilize him from childhood onwards: being born with a sensitive nature, distant or unloving parents, the loss of a parent, especially the father, loss or separation from a loved one or role model, and repeated failure or even repeated success in his career.

Sometimes the things that kept one going are simply not there: the friends move away, the children grow up, leave home and don't visit, the aged parents die, and your body can't keep up with the younger men in sport anymore. It is not surprising that escapist behavior might seem to be the solution: changing job, changing house, changing partner, changing lifestyle, getting the motorbike before it really is too late

Not all men are the same. Some men continue living through the first part of their life and into the second. Others go through a period of great turbulence but then find a new course and approach for the second passage of their lives.

Some of us may have experienced this emotional turbulence; some of us may experience it someday. Dr. Carruthers, in his book, "The mid-life crisis, even when it brings on depression, despair, anxiety or fear, is a time of great challenge, out of which come symbols of transformation. As we age, we human beings yearn for wholeness. We yearn for parts of ourselves that have been in the dark to find sunlight, and those that were sunburned to find shade. We yearn for the parts that have been underdeveloped to grow, and those that were overdeveloped to be pruned. We yearn for the parts that have been silent to speak, and those that were noisy to be still. We yearn for the parts that have been alone to find companionship, and those that have been overcrowded to find solitude. In short, we yearn to live our unlived lives."

Crossing over from one stage of life to another: the young man I was; the grown man I became. What I’ve done, have I done it? What I’ve felt, have I felt it? What I wanted to experience, have I experienced it? The love I sought, did I receive it? The love I wanted to give, did I give it?

The emotional and the physical, it’s facing growing older and WHAT that means. Not just to our own psyches but to our bodies.

It is the effect of an inadequate supply of male hormones in a man's body, an inadequacy which can develop for a variety of reasons as he gets older, and which produces a profound and widespread range of symptoms: it is a crisis of vitality just as much as virility, even though its most obvious sign is loss of both interest in sex and of erectile power; there is often loss of drive in professional or business life...also often fatigue, lethargy, exhaustion and depression, with a sense of hopelessness and helplessness; all too often men change their jobs or their lovers - anything to ease the malaise they feel - usually with little relief....physically, there is often stiffness and pain in the muscles and joints or symptoms of gout and a rapidly deteriorating level of fitness. There may also be signs of accelerated ageing of the heart and circulation.

"The andropause is the explanation of why the vitality and virility of millions of men has faded in middle age or later. It is the explanation of much misery, depression and unhappiness, loss of sexual performance, failing lives, failing health and failing relationships, and above all, it is the cause of impotence and loss of sexual function. But it would be a mistake to see this as merely a sexual issue. Consider the hormone testosterone. It permeates every aspect of the male body, every nerve, every muscle fiber, every brain cell. It is responsible for the development of the male body from the androgynous embryo, which will otherwise develop into the female form. If the testosterone receptors in the fetus are not working, or insensitive to the hormone, the development of the normal features of the male body will be incomplete or abnormal, or an intersex human will grow. If the hormone doesn't make its reappearance at the time of puberty, the male body will not develop secondary sexual characteristics such as a larger penis, beard and body hair, a deeper voice, and a male sexual drive. If the hormone doesn't flow around a boy's bloodstream adequately, his musculature will fail to develop as it should. Only the presence of testosterone in his blood will let him know of his maleness through spontaneous erections, either at night or during the day, and that classic male pre-occupation with sexy thoughts, feelings and images which interrupt a man's more practical thoughts in the way that we are so used to. Moreover, if testosterone doesn't act on a man's brain cells, he will lack drive and ambition, and take fewer risks.  Now, what do you think will happen if a man's testosterone levels start to fall at some point in his middle years? Will the areas of the body whose metabolism is so dependent on testosterone remain fully and effectively functional? It hardly seems likely, does it?"

We age. Remember when we were eighteen year-old boys; a subtle wind would cause an erection. "this virility may well have vanished, and spontaneous erections may be but a distant memory. He may still be able to get aroused in sexual situations, but his erection will take longer to get hard, and he will ejaculate more weakly, and he can't ejaculate as often as he once did."

Of course, MANY men will claim to be the exception; God forbid an erection is THE DEFINITION of masculinity or manhood. However, the amount of Viagra sales will prove the point.

In answer to the original question, "Do men experience a change-of-life," the answer is YES. It is partly emotional and partly biological. Is it something to fear or a cause of shame? NO.

We have no power over time and physiology. We WILL age; we WILL change. Fact of life.

What is most important is to accept the inevitable changes that will happen. Examine and understand one’s emotional feelings and reactions to these changes. Being a MAN about them; NOT focusing on one’s penis, erections or ejaculation, but accepting the change that life with inevitably bring to each of us.