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MiddlesexMD

Male Menopause: Stand by Your Man

by Dr. Barb DePree MD


Admit it, ladies. When it comes to menopause, we’ve sucked up all the oxygen in the room. We’ve cornered the market on attention, research, and therapies. So when men exhibit hormonal symptoms, such as decreased libido, confusion, irritability, fatigue, and insomnia, we chalk it up to a “midlife crisis,” wait for the red convertible, and hope it doesn’t include the 20-something girlfriend.

Many men experience male menopause (or andropause), and all men lose hormones as they age, albeit more gradually than women but with similar effects. Men’s testosterone levels decrease by about one percent per year after age 30. By age 70, testosterone levels are about half what they were at their peak. Even in younger men—in their 40s, 50s, and 60s—the effects of low testosterone can result in mood swings and problems with libido and with maintaining an erection. For most men, this is a severe blow to self-esteem, and it often becomes the pink elephant in the bedroom—denied and overlooked only with very selective vision.

During this life passage, our support is a critical factor in how well our men weather it. “Without an understanding partner, these problems may result in a powerful combination of anxieties and doubts, which can lead to total impotence and sexual frustration,” wrote Drs. Caroline and Andrew Dott on their website. And if our man is having problems with libido and mood swings, guess what? Our sex life just went south as well.

The reality of male menopause and how best to treat it is still frontier territory—a lot is unknown and a lot of discussion is ongoing. Hormone replacement therapy for men, while promising, is still in need of long-term research. However, for men without underlying emotional or physical problems, testosterone therapy may help reverse the more distressing symptoms of andropause.

As with women, however, the first task is to eliminate any underlying physical or emotional condition that could contribute to loss of libido, impotence, and the symptoms of male menopause. Whatever a man’s testosterone level, if he is obese, if he drinks or smokes or is inactive, his sexual performance will be affected. Smoking and drinking can actually damage, sometimes irreversibly, the nerves and blood vessels in the penis. Certain medications can also affect sexual performance.

The good news is that sexual performance is strongly linked to good overall health for both men and women. Men who are active and who exercise regularly report greater sexual satisfaction than inactive men. So in the course of helping your partner through this phase, you may both gain a healthier lifestyle.

During this challenging time of change and adjustment, it’s important to be aware that your partner could be experiencing many of the same hormonal changes that you are and that your understanding and support is critical. Consider:

  • Educating yourself. Broaching the subject of the physical and emotional changes you’re noticing in your mate is a very touchy subject. Read books like Surviving Male Menopause: A Guide for Women and for Men by Jed Diamond.
  • Breaking the silence gently. Encourage your partner to talk to a doctor or counselor, but expect resistance. It will take time for him to process and acknowledge the very uncomfortable changes he’s experiencing. Denying that there is a problem doesn’t make it go away.
  • Changing the family diet. If you haven’t already, now is the time to adopt the healthful eating habits that will serve both you and your partner well during these transitional years and beyond: low fat, lots of fresh fruits and vegetables, whole grains… you’ve heard it all before.
  • Modeling healthy habits. You can’t steamroll your partner into self-improvement, but if you set the example by working out regularly and not smoking and drinking, maybe your partner will decide to join in. If nothing else, at least you’ll feel better.

3 comments


  • The most important thing for me was to understand that my wife’s drop in libido around menopause was not personal. That’s not something that you can simply tell someone like me and have it sink in with a simple sentence or two, no matter how accurate it is. I had to read lots in this blog, and read many similar things in years past, to really get that. Because before this, I thought that one’s libido was as permanent and reliable as the ability to move and walk, feel anger and happiness, and appreciate ice cream. When one does not experience a decline in libido oneself, and has never experience NOT having a high libido as an adult, it’s very hard to understand that it can so easily vaporize and that it is so dependent on a few hormones.

    Gary on

  • Gary here again, checking your website for updates. I appreciate your effort to support men who experience a decline in libido, mood, etc. I just wish there was more support for men like myself in my late 60’s who have experienced essentially no decline in libido, are full of energy, have no health issues, aches or pains of any kind. I read patronizing advice that I’m more interested in “less genitally focused sex”, are more interested in “just cuddling”, am more into it for the “companionship” and that I might want sex only once a week. Excuse me, I’m not dead yet! LOL Please recognize that perhaps the biggest problem for middle age and older is the increased disparity in how partners age. My wife and I were evenly matched in our early years, and now it feels like I’m back in high school with no girlfriend, and my wife is a great companion, but her sexual energy completely disappeared around 15 years ago with her change.

    Gary on

  • Interesting to read, and it suggests I should consider myself fortunate? Andropause? I personally have no idea what you’re talking about — never experienced any of those symptoms. I’m in my late 60’s and still as interested in sex as ever — daily would be fine with me. Lots of energy, almost always in a good mood.

    My wife is in her early 60’s and has a lot of energy too. But no sex drive at all, unfortunately (therapy and remedies haven’t helped much in that department).

    Gary on

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