Male Menopause: What is it?

"Dear Abby:

"I am a 50-year-old man who has been married for 22 years. My wife and I have two wonderful teenage children. About six months ago, my wife's niece (I'll call her Rene), whom I had never met, came from another country to live with us so she could go to college in the United States. She is in her early 20s."

As I read Abigail Van Buren's "Dear Abby" column in my local newspaper, I shook my head and thought, "Here's another family headed for trouble." The man's letter continued:

"For the first few months, everything was fine. Now I find myself thinking about Rene all the time. I think I'm in love with her. I travel quite a bit because of my job, and every time I come home, it's torture. I have to act as if nothing is going on in my mind. No one knows the way I feel. If I tell my wife, she'll be crushed, and it will be the end of our marriage. If I tell Rene -- who has done nothing wrong and loves my wife like a mother -- she may want to return to her country without finishing her studies.

"I have always tried to do the right thing. I never thought that at this age, I'd be feeling this way. I don't want to ruin anyone's life, including my own. What should I do? --Desperate in Delaware"

Based on my own research that culminated in the publication of my book, "Male Menopause" (Sourcebooks, 1997), I sent a response to "Dear Abby." I was pleasantly surprised that my letter ran under a headline for her column that appeared in newspapers all over the country: SYMPTOMS OF MALE MENOPAUSE ARE REAL.I have been a psychotherapist for 40 years and have seen too many men destroy their own lives -- and the lives of those they love -- because they didn't understand the inevitable changes that go on in a man's body, mind and spirit at midlife. I've found that my understanding of these issues has been greatly expanded since recognizing that men go through a form of "male menopause," generally between the ages of 40 and 55. Marc Blackman, M.D., chief of endocrinology and metabolism at Johns Hopkins Bayview Medical Center, says, "The male menopause is a real phenomenon, and it does similar things to men as menopause does to women, although less commonly and to a lesser extent."

I believe that thousands of families could be saved from splitting apart if men and women learned about the newest research findings on this crucial time of life:

• More than 25 million men in the United States are now going through male menopause.

   

• Fifty-two percent of men between 40 and 70 suffer from some degree of erectile dysfunction.

   

• Men, like women, experience complex hormonal rhythms that affect their mood, their physical well-being and their sexuality.

   

• Emotional symptoms include irritability, worry, indecisiveness and depression.

   

• Physical symptoms include fatigue, weight gain, short-term memory loss and sleep disturbances.

   

• Sexual symptoms include reduced libido, fear of sexual failure, and increased desire to prove that he can still perform by seeking a younger partner.

   

• Male menopause is like puberty the second time around, where a man must face issues of identity, sexuality, dependence and independence.

   

• When a man is going through male menopause, he often finds it very difficult to be an effective parent.

A Woman's Concern
I receive hundreds of letters a week from women who are confused about what is happening to the man of the house. Here's a typical story:

"I believe my husband is experiencing male menopause. My husband attended a training course away from home for five weeks. He asked me to visit during the third week, which I did. It was like a romantic getaway for both of us. But when he returned two weeks later, something had changed.

"I knew something was wrong when I met him at the airport. He was very moody, said nothing was wrong, and wouldn't talk. When we made love, he found it difficult to obtain an erection and seemed angry when I tried to talk with him. Since then, he's become more and more withdrawn and uncommunicative. He insists that there isn't another woman involved and seemed surprised that I would even bring it up.

"What really hurts is how he treats our daughter. They have always been very close, like best pals. Lately he is critical of everything she does. He snaps at her, then apologizes, and later does it all over again. She and I both feel that we have to walk on eggshells. Clearly something is very wrong. Our daughter is beginning to spend more time away from home. I'm sure it's because she is so hurt by her father's sudden change of behavior. What's going on? What can I do?"

A Man Gains Insight
Jake wrote me to tell me how he had come to understand that male menopause was at the center of the stress he was experiencing with his family:

"I'm 45 years old and have been married to my wife for 23 years. We have four children who range in age from 9 to 19. Until recently, I was the kind of dad I had always wanted to be -- involved with their lives, caring, concerned. But something changed when I hit 40. Not since I was a child did I feel such a deep-seated anger and sadness. I would yell at the kids, which I never used to do. Late at night I'd lay in bed with my wife and cry my eyes out. I couldn't believe it was me. I'm a grown man, a truck driver, for heaven's sake, throwing a tantrum like a 4-year-old or bawling like a baby.

"I never knew that depression in men often expresses itself in anger. That was certainly the case with me. I was often irritated and grouchy and sometimes would have angry outbursts over the least little thing. I would tend to blame it on my wife or the kids. I know they began to withdraw and lose respect for me, which made me feel even worse.

"One of the most difficult aspects of this time of life is the uncertainty. I question everything. I have faith in nothing. Even though I hate the way I feel, I can't seem to do anything constructive. I seem to be on a downward slide and I am destroying my family. There are times I think of killing myself. At least I wouldn't be hurting those I love the most.

"I can thank my wife for helping me break out of this destructive cycle. She lovingly but firmly encouraged me to talk to a counselor. I resisted for a long time, but finally went to see someone. It was the most important decision of my life. My family is recovering from my 'midlife crazies.' I'm beginning to be a loving husband again, and my kids tell me that they are glad they have their father back."

12 Tips for Dealing With Male Menopause in the Family
1. Recognize that when one member of the family is having problems,
it affects all the others in the family as well.

2. Like puberty, menopause is an inevitable life passage. Be alert to the most common signs of male menopause, including the following:

• Loss of sexual desire for marital partner
• Problems with erections
• Irritability and anger
• Fatigue and low energy
• Marital and family conflict

3. Be aware that men and women often go through the "change of life" at the same time. A great deal of mutual understanding is needed to support each others' process.

4. Recognize that parents often go through menopause while their children are going through adolescence. Since these stages of life are similar, conflicts can arise if not understood. For instance, a father can get angry at his daughter's emerging sexuality because he is uncomfortable with his own sexual changes.

5. Realize that male menopause generally arises slowly over a number of years. Symptoms may be difficult to recognize and interpret.

6. Be aware that for some men, the symptoms can arise very quickly. "It seemed like one minute he was the normal, loving guy I have always known. The next minute, he was moody, angry and withdrawn," one woman told me.

7. Appreciate the fact that male menopause is often precipitated by changes within and without, including:

• Disability or death of parents, friends or colleagues
• Children leaving home
• Job changes or fears of job loss
• Slowing down or loss of physical abilities
• Sexual dysfunction and worries about virility
• Concerns about future goals and directions
• Financial worries

 

8. Accept that most men will initially deny that they have a problem. Since male identity is shifting, even contemplating such a change can be terrifying to a man.

9. Understand that there are a number of steps to accepting and dealing with male menopause. Here's how a man's thinking usually progresses:

• Step 1: There is no problem here.

   

• Step 2: If there is a problem here, it must be you who has it. You need help.

   

• Step 3: If there's some problem with me, it is minor. I just need to relax more.

   

• Step 4: Even if the problem may be more serious, I can handle it myself.

   

• Step 5: Even if I need help, there's no one who would understand.

   

• Step 6: If someone understands that I need help, I just want him to give me a quick fix (like changing the fluids in my car) and get me back on the road.

   

• Step 7: I guess I'm more complex than my car and I may need support with hormonal, physical, emotional, interpersonal, sexual, social, economic and spiritual aspects of my life.

 

10. Accept the fact that most medical professionals don't understand or accept the concept of male menopause. Research on male menopause is still about 30 years behind research on menopause in women.

11. Realize that the predominantly male medical establishment is caught in its own denial. Surveys have shown a significantly higher acceptance of the concept of a male menopause among female physicians than among their male counterparts.

12. Rejoice in the fact the male menopause can be treated through a variety of modalities including:

• Hormone replacement therapies
• Exercise and diet
• Herbs and medications
• Stress reduction, relaxation and body-centered therapies
• Cognitive and psychotherapeutic support
• Couples and family therapy

Jed Diamond is the author of seven books, including the best seller "Male Menopause" (Sourcebooks, 1997), which has now been translated into 16 foreign languages, and The Irritable Male Syndrome (Rodale, 2004). He has lent his expertise to such programs as "The View" and "Good Morning America." See his Web site at menalive.com for more valuable information on living long and well.