Male Menopause – Reality Problems and Measures

Little is known about the male menopause, or “male climacteric”, other than it doesn’t exist in the same form as a woman’s: hormonally speaking it may not exist at all.

Is There a Male Menopause?

Do all men experience a menopause or “climacteric”? If there is such a thing, what are the symptoms? Drawing a parallel from the menopausal symptoms in women, should men be the beneficiaries of hormone replacement therapy (HRT)? Once this question is advanced, others follow.

What would happen to the male climacteric if HRT were widely used? What would the success rate be? What are the harmful effects? There are very few answers to any of these questions because so little research has been done in this area, though this is sure to change in the near future as more people take an interest in male symptoms.

The male menopause hasn’t the same drama as a woman’s. It is more gradual, gentle and in a way more insidious than a woman’s; nor does it occur during exactly the same years. It is much better thought of as a male climacteric, which envelops all the changes going on in the body and mind as the male genital system begins to wane.

Fear of Failure

There is no doubt that “fear of failure” plays a very important part in the ageing man’s withdrawal from sexual activities.

Once a man has noticed that his potency is declining, or he experiences one occasion when he is unable to achieve sexual satisfaction through impotence, he may withdraw voluntarily from any kind of sexual activity. This is mainly because most men are unable to face the ego-shattering experience of repeated episodes of sexual inadequacy. Most men are unable to accept the fact that a lessening of sexual drive and a lowering of sexual performance are parts of the normal ageing process, and they make all sorts of excuses and will blame many different kinds of external factors rather than face the truth that their bodies are maturing.

Researchers Masters and Johnson hypothesized in 1970 that a man who finds his potency declining may be showing signs of lowered levels of androgens that may amount to a deficiency. They went on to say that until studies had shown that there was a general requirement by the body for androgen (testosterone) replacement therapy during the male climacteric, cases had to be treated on an individual basis.

There are endocrinologists in many parts of the world who make a special study of the male climacteric, employing hormone replacement therapy for their male patients. The whole area, however, still awaits clear definition and guidelines. Until then HRT for men will remain a highly specialized field not generally practised. In this respect women are better off than men. It may be because women are honest and courageous enough to declare that their bodies are deficient, whereas men, particularly in the sensitive area of sexual activities, have yet to come to terms with their bodily changes.

Work/Family Tensions

Most men between the ages of 40 and 60 are going through the most competitive stages of their careers. The tensions of work are not eased by the financial necessity to look after a growing family with many needs and activities. On the one hand, men are striving for personal eminence, and on the other they are preoccupied with the security of the “family”. A man in this situation often finds that he spends more time following his professional career than with his family. This leaves a smaller amount of time for loving relationships with his partner, and the stress may lead to gradual lessening in sexual activity.

Both mental and physical fatigue have an ever- increasing influence on sexual activity. An active sex life in the middle years means being in good condition, for if a job requires a great deal of physical effort, a man may simply not be fit enough to have stamina left over at the end of a day to enjoy an active sex life. Sometimes, if a man is not fit, a weekend of recreation is more exhausting than the demands of his job, particularly in the age group of 50 and over. Again, this leaves very little energy for sexual activity.

If a man is exposed to unaccustomed or excessive physical activity he may feel a loss of sexual responsiveness for a day or so, which will add to his feeling of despondency.

Sexuality in Older Men

Masters and Johnson, a pioneering research team in human sexuality, made a detailed study of the psychological and physiological factors that might contribute to a decline in a man’s sexual prowess as he grows older. From their studies it became obvious that there are factors that affect a man’s sexual responsiveness:

• monotony, described as being the result of repetitious sexual relationships
• preoccupation with career and economic pursuits
• mental or physical fatigue
• overindulgence in food and drink
• any physical or mental infirmities in either of the partners
• tear that his performance does not come up to scratch may be greater than at any other time in his life, especially during a time of stressful career decisions.

Monotony is quoted most often and most constantly as the factor that leads to a loss of interest in sex and sexual performance. The end result of this may be one of dutiful indulgence and the need for sexual release. This sometimes arises from a failure of the sexual part of a relationship to grow throughout the marriage. Overfamiliarity with a partner is often blamed; the female partner may no longer be stimulating to her man. She herself may be engrossed in looking after children, or busy with her career. Furthermore, women generally do age more during their 40s and 50s in terms of physical appearance than men. Without attention to her appearance, a woman may become older-looking than her partner.

Sexual Problems

As men grow older they eat and drink more, which has a tendency to repress their sex drives. Also, if men feel satisfied from good food this lowers their capacity to achieve in other areas. Overindulgence in alcohol has a particularly negative effect on potency. Impotence developing in a hitherto potent man often makes him drink excessive alcohol and otherwise behave in a way that has not been in his nature.

Most men approaching middle age become concerned about performance. One of the ways of handling any concern is to withdraw from having to perform. This leads to total avoidance of sex within the marriage. If a man is also drinking heavily it only makes matters worse. A problem may arise within the marriage.

A man may find that he is impotent with his wife but with another partner, who cannot measure present sexual performance against past, he is perfectly normal.

At any age, physical or mental infirmity can lower or even eliminate sexual drive. After the age of 40 physical or emotional difficulties have a much greater effect, and above the age of 60 a tremendously negative influence. Being physically disabled in the short or long term lowers sexual responsiveness in either sex, but if the illness is acute, such as pneumonia, loss of libido is usually transient and accepted by both partners. With more long¬standing disabilities, such as arthritis, interest in sex may decline slowly until it becomes non-existent. Conditions such as long¬standing diabetes can lead to impotence in men for medical reasons and such problems need to be discussed with a partner.