We’ve all heard of menopause, probably in the form of callous jokes about hot flashes, mood swings, and / or being an aging woman in general. As a likeable adult man (especially with a female partner) who hopefully broke out of these outdated stereotypes, however, you ideally already know that educating yourself about the realities of menopause will be the responsibility of you. your partner and your relationship. But is menopause something you a man need to worry about personally?

While interest in testosterone replacement therapy has peaked in recent years, the conversation (and concerns) about what is sometimes referred to as “male menopause,” “andropause,” or, less formally, ” manopause ”. But is “male menopause” really a thing? The answer is both “No, not at all” and also “Well, sort of, maybe”. We (with the help of some experts in the medical field) can explain.

Do Men Go Through Menopause?

Technically speaking, no, men don’t go through menopause, largely because “menopause” – which literally means pause or the termination of the Mensexual cycle and therefore fertility – refers specifically to a sudden and rapid drop in hormone levels experienced only by women and / or people with ovaries and related reproductive organs.

(It is important to note that people born with this specific set of organs may not necessarily identify as female and may still experience menopause. For the purposes of this article, however, I will refer primarily to the cis man and woman, and the biological experiences that usually accompany each, that people of all gender identities can have.)

While the related term “andropause” attempts to create a more male-centric alternative by referring to androgens – a group of hormones (namely testosterone) that play a role in male traits and reproductive activity – experts like Dr Alexandre Tatem, a board certified urologist specializing in male reproductive medicine, still says the term represents something of a misnomer.

“It tries to be a direct corollary of what women go through during menopause,” Tatem told InsideHook. “Men are going through something very different.”

While a man will experience a gradual drop in testosterone levels as he ages, typically beginning in his 40s or 50s, this drop is much less sudden and dramatic (and often accompanied by significantly less intense symptoms) than it is. women endure during menopause.

“Male menopause, also known as ‘andropause’, is really a misconception,” says Dr Mohit Khera, MD, MBA, MPH, certified urologist and professor of urology at Baylor College of Medicine. “This assumes that testosterone levels decrease significantly as a result of aging.”

The reality, says Khera, is that “testosterone levels in men do not decrease significantly due to aging alone,” nor do women’s respective hormone levels as they reach middle age.

What hormonal changes can men expect as they age?

As usual, men have won the genetic lottery in that most can expect to experience gradual hormonal decline with age relatively free of dramatic symptoms.

“Men will lose about one percent of their testosterone production per year after about 30 years,” says Tatem, adding that it is generally “a very slow and constant decline in a normal, healthy man.” .

Yet just because most men can expect to experience gradual and relatively harmless hormonal decline with age doesn’t mean they have nothing to worry about. While men in general are generally spared the steep and symptomatic hormonal drop that women experience as part of their aging process, some men may still experience more disturbing drops in testosterone or develop other conditions with it. age that could contribute to lower hormone levels. .

“You can absolutely reach a point where you have a level of testosterone low enough to be pathological. It’s a problem called hypogonadism or testosterone deficiency, which is a medical condition that deserves treatment, ”explains Tatem.

Further, adds Khera, “Many men acquire health problems such as obesity, diabetes and metabolic syndrome as they age. These acquired conditions can cause serum testosterone levels to drop dramatically. So, it is true that as men get older they are more likely to have lower testosterone levels ”- although these lowered testosterone levels are not specifically due to aging alone.

Men with testosterone deficiency can experience symptoms such as fatigue, erectile dysfunction, low libido, increased fat deposits, decreased muscle mass, and depression, Khera explains.

According to Dr Zaher Merhi, MD, OBGYN and founder of the Rejuvenating Fertility Center in Westchester, New York, such symptoms sometimes associated with “male menopause” do not affect all men (like menopause symptoms do most women) and are often light. However, important symptoms can be the cause of a medical evaluation.

“It’s true that men will experience a natural drop in their testosterone levels as they age, but there is a difference between a natural drop and a problem that is neither normal nor healthy,” says Tatem. “It is not normal or healthy as a man to lose his erection, neither normal nor healthy to lose energy, lose libido, lose muscle mass, gain fat [without trying to or for no obvious reason]. These things are not normal; they are pathological.

When to seek treatment for low testosterone (and when not)

Although hormonal decline with age is not something that most men will experience the same way as women, actual cases of low testosterone should be treated and managed by a healthcare professional, in particular. Particularly because, as Khera notes, “low testosterone may be a marker of poor overall health in men,” associated with increased cardiovascular risk.

If men have the symptoms described above, says Tatem, “they should definitely have their testosterone checked by a trained professional who has their best interests at heart. And if they have low testosterone, then they should definitely get treatment.

According to Merhi, “conservative measures such as a healthy diet, exercise and stress relief may help” in mild cases, while men with more severe symptoms should consider having their testosterone tested by a doctor. healthcare professional who may recommend testosterone treatment.

Figuring out who counts as a trained professional and what kind of treatment is needed, however, is the tricky part. A growing number of for-profit clinics are trying to cash in on the testosterone trend by promoting testosterone supplements as something, Tatum says. all men need after a certain age.

“I love testosterone. I think it’s an amazing drug when used appropriately and judiciously, ”says Tatem, who notes that he has worked with testosterone prescribed to a wide variety of male patients. “But I think we are experiencing a change in society where there is increasing pressure on men from commercially supported clinics to push [testosterone therapy] on people who may not need it and may be creating problems.

Much of these issues, according to Tatem, stem from the fact that testosterone is (and is often used as), in fact, a performance enhancing drug. As with any medication, taking testosterone in excess or when it is not needed can be addictive. If you keep taking increasingly higher doses of testosterone in an attempt to satisfy this addiction, you run the risk of developing serious problems with high cholesterol and high blood pressure which can lead to kidney failure or kidney failure. cardiac disease.

To complicate matters further, there is some disagreement among medical professionals about what really constitutes low testosterone. “Because there is a debate,” explains Tatem, “it’s very easy to make an argument for giving testosterone to guys who don’t necessarily need it. This is great for clinics looking to capitalize on men’s fears about their declining masculinity, but not so much for men who seek legitimate medical care to address their concerns.

Yet none of this is to say that testosterone therapy is inherently bad and that no man should pursue it under any circumstance. If men have symptoms or are worried about low testone levels, “they should definitely go see a doctor and get tested,” says Tatem. The key is to seek care from the right sources.

“You should never go to a ‘clinic’ where you don’t know who the doctor is,” says Tatem. “Think twice and try seeking care from someone who specializes in men’s health, who is trained in this area and who you know is a professional who cares about doing this. it takes, and not so much to get you to sign up for a monthly subscription service.