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The ‘male menopause’ – what you need to know

East Midlands Ambulance Service is reportedly giving men up to a year of paid leave for “andropause related issues”, which some are calling the “male menopause”.

This move has angered some commentators who question whether there really is such a thing as the male menopause or “manopause”.

The andropause is not a condition that was recently invented. The medical establishment has been talking about it since the 1940s when it was known as the “male climacteric”. Symptoms of this condition include a lack of energy, weight gain (including “man boobs”), sexual difficulties, sleep problems, anxiety, irritability, depression and even hot flushes.

While many private clinics recognise and treat andropause, it is not recognised as a syndrome by the NHS, nor is it usually caused by a radical drop in “male hormones”, such as testosterone. Testosterone levels do naturally decline in men, but the average decrease is around 1% per year after the age of 30.

Less common – only seen in 6% of adult men under 80 – are chronically low levels of testosterone, also known as androgen deficiency. This may result from accidents affecting their testes, experiencing severe illness, or treatment for prostate cancer.

The natural drop in testosterone can be worsened by obesity, extreme stress and some medications or diseases, including drinking too much alcohol. So the andropause is probably more of a lifestyle symptom and therefore should be tackled as such.

The recent media spotlight on female menopause has highlighted just how badly women can be affected by midlife reduction in hormone levels. So much so that the UK government had to appoint a dedicated “menopause tsar” to deal with the resulting shortage of oestrogel, a popular form of HRT, as more and more women seek menopause treatment.

The East Midlands Ambulance Service is commendable in wanting to support men in making mid-life lifestyle changes, but calling it the “male menopause” undermines the magnitude of the physiological changes women experience as part of female menopause.

For men, lifestyle changes can have huge benefits. Taking care of heart health, exercise and healthy diets in midlife are known to be good for brain function and can help prevent dementia and heart disease later on.


For the full article by Professor Eef HogervorstDr Emma O'Donnell, and Dr Gemma Witcomb, visit the Conversation.

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