Why Men and Menopause Don't Mix


When we were writing The Menopause Book a few years ago, we were often amused by how people reacted to our topic. To women of a certain age, we were rock stars. They had so many questions about the changes in their bodies and were grateful for answers based on science rather than quackery. Men were not so enthralled. In fact, we used to joke that simply uttering "menopause" was the fastest way to get rid of a boring guy at a cocktail party.

Since then, the M word seems to have come out of the closet. Symptoms have been dissected on talk shows, magazine cover stories, and even a long-running hit musical. Talking about your hot flashes at the office is not the taboo it used to be (although we still wouldn't recommend it—TMI). And, most important, there has been an explosion of research about the effects of menopause that has been covered extensively in the mainstream media.

Maybe that helps explain why, suddenly, it seems like men want in on the menopause action. A recent slew of headlines about so-called male menopause gives the impression that men go through a parallel transition at midlife and deserve just as much sympathy as women do. How ironic that a phase of life many women would like to skip seems to have generated a kind of Venus envy. But the fact is, guys, menopause is ours. You can't have it.

Technically, male menopause is an oxymoron. That's because it's physically impossible for men to experience menopause. No man that we know of has ever been visited by what our grandmothers used to refer to as Aunt Flo: a monthly menstrual period. The technical definition of menopause is no visits from Aunt Flo for 12 months. But if you don't have monthly periods, there's nothing to stop. Hence, no male menopause.

You'd think that would be the end of the argument, but facts have nothing to do with this. Instead, there seems to be a determined effort by men to deny the effects of aging. They're not getting older; they have a condition.

In fact, a small percentage of men may actually have a condition that explains some symptoms, but it's not menopause. The correct name is "late-onset hypogonadism" and identifying it was the subject of a recent article in The New England Journal of Medicine that inspired many of the latest "male menopause" headlines. European researchers surveyed 3,369 men between the ages of 40 and 79 and found that a very small number of them suffered from a drop in testosterone levels and three symptoms that appeared to affect their sexual health: erectile dysfunction, reduced sex drive, and fewer morning erections.

A few caveats here. First of all, the study found that only 2 percent of men appeared to be suffering from this. Compare that with 100 percent of women who go through menopause. Frankly, there's no comparison. Also, all of these difficulties relate to sexual health. Granted, that is important, but real menopause affects every part of a woman's body, not just her G spot. Even the lead scientist in this study, Dr. Frederick C. W. Wu of the University of Manchester in England, concedes that there is a risk of overestimating the number of men who suffer from this condition. The data about symptoms came from interviews with patients, not clinical observations by doctors, so it might not be completely accurate. And many of the men also suffered from other medical problems, particularly obesity, that may have hurt their sexual health.

We're not trying to be anti-male here. In fact, we're trying to be helpful. Men who may be thinking of taking testosterone as a remedy would do well to recall the experience of millions of women who routinely received hormones for menopause until a massive federal study called the Women's Health Initiative indicated that this therapy increased the risk of breast cancer and stroke. There are still many unanswered questions about the safety of testosterone therapy (for a summary, click here). Until there's more research, it would be wise to be wary.

But back to the larger issue. Menopause is ours. We have earned it by enduring decades of menstrual periods, mood swings, and all the other inconveniences that come with being a woman. It wasn't always fun, but it was our life. For most women, menopause isn't just an end to all that; it's also a moment of psychological and emotional reckoning. When your periods stop, you know something has changed irrevocably in your body. You may exercise and watch your weight and use sunscreen every day to keep looking as young as possible. But inside, your body is definitely aging. Women can't be in denial about that the way men can.

As we have become more comfortable talking about these changes, women have begun to share valuable information and are talking more openly with their doctors about what they are experiencing. These are all good, positive developments.

As for men, start your own conversation. There's beer in the fridge. You can get it yourself.