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June 14, 2010 • 17 mins

Doctors have identified a condition called andropause that affects middle-aged men's moods and hormone levels. It's sometimes referred to as "male menopause," but is that really an accurate description? Molly and Cristen investigate in this episode.

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Speaker 1 (00:00):
Brought to you by the reinvented two thousand twelve Camray.
It's ready. Are you welcome to stuff Mom Never told you?
From housetop works dot com. Hello, and welcome to the podcast.
I'm Kristen and this is Molly Molly. Have you ever

(00:21):
heard or used, perhaps those really lame jokes about guys
who are maybe grumpy in being cranky one day saying, Oh,
don't mind him, he's just on this period. No, I've
never said that. That's good. I just called them sad
bunnies today. That's way better than the male period joke.

(00:44):
But the reason why I bring up what is perhaps,
you know, one of the way most gender jokes I
can think about off the top of my head, is
because you and I found out that, um, while you know,
men obviously don't have periods like women do, there's a
chance that men might go through menopause, right, And the

(01:07):
reason you brought up the period thing is just the
controversy around whether this condition exists kind of relates to
whether we try and make men and women equal in
this regard. You know, it happens in the same time
of life as women go through menopause. There are a
lot of the same symptoms. So now they've given this
new term to you know, the cranky, grouchy middle aged
men of male menopause, and it's been you know, you'll

(01:29):
find all these articles doesn't exist, doesn't not exist, And
that's what we're going to dive into today. Yes, can
males really go through menopause? And you might hear um.
Male menopause also refer to by a more clinical term
called andropause Andrew the root for male um and it

(01:50):
generally involves the same symptoms or some of the same
symptoms as a menopause in women, which can include hot
flashes and a drop in beto, moodiness, fatigue, weight gained, depression,
decreased muscle mass, and bone loss. My goodness, don't we
have lots to look forward to, Molly. Well, at least

(02:10):
we don't have to face the threat of a lack
of morning erections, because that's also a risk for men
going through menopause. But we do have vaginal dryness. So
tip for test it's not a contest, Christie. I'm just
giving out another symptom of signs your testosterone is love
because that is what's at the root of this idea.
Of male benopause. After the age of thirty five, man's

(02:32):
testosterone levels drop about one percent each year, and those
who claim that male menopause is a real thing claimed
that men's levels of this hormone gets so low that
it causes these symptoms of menopause. Now, just in case
you're wondering, in a forty year old man, the average
amount of testosterone in his blood is five hundred nanograms

(02:54):
for des a leader of blood. Now, if you can
envision exactly what that looks like, then bully for you,
because I can't. But just to give you an idea
of what's too low. Um, anything below three hundred nanograms
is you're you're trending into that that low test testosterone territory. Now,
the reason that I think this this diagnosis is pretty

(03:15):
controversial is that, as I said, it happens naturally in men.
As you ate, your testosterone drops, And the question is
whether it can drop so much that that that's what
causes these symptoms. And here's where we get into the
argument of what's correlation and what's causation. Um, But real quick,
let's talk about reasons that testosterone does drop as you age.
Are two reasons it can drop really low. One is

(03:37):
dysfunction and the testicles they just stopped producing as much
as they should. And one is dysfunction and the hypothalamus
where the pituitary gland is yes, and that has to
do with the testosterone secretion. Correct. Now, while we might
think of testosterone as something that you know, fuels a
man's well and women we also um our bodies also

(03:58):
create testosterone, but for men we might think of it
as something that motivates um, you know, moods, certain moods
and sex drive as well. But testosterone does a lot
more um to regulate different functions in the body. It's
final to a man's potency and sex drive, obviously, but
it's also important for maintaining muscle strength, healthy bones, positive mood,

(04:21):
and high energy. Now here's where we get back to
the correlation causation thing, Kristen, Because, as you said, let's
take low energy. For example, you come home, you've got
no energy. You probably don't exercise, You probably just grab
whatever is right there to eat for dinner. You don't
take the time to fix yourself something nice. As a result,
you're gonna gain some weight, and that in turn has

(04:42):
been linked to diabetes, cardiovascular disease, even death. So a
lot of researchers you're trying to figure out if treating
this low testosterone is the is the key to solving
these larger problems. But again, correlation versus causation, just diabetes
show upon a man because he's got low test astone
or was the r pre disposed to diabetes and also

(05:03):
happens to have low testosterone. Right, And if we're talking
about um sex drive for instance, which is one of
the main reasons I think why men seek out clinical
help for this in the first place. Um, you know,
if you're you're talking about men gaining weight, people who
are overweight, that's been linked to a lowered sex drive
as well. So they're all these all these factors, like
you said, that could be contributing to these negative symptoms.

(05:27):
So it's very hard to get a diagnosis of this condition.
Though it's estimated that twenty five million men in the
United States suffer from the condition. But you know, Christie,
when I was reading these articles, it was very confusing
because you'd be reading about a guy that they decided
had uh andropause or male menopause, and you'd read about
how he didn't want to have sex with his wife,
and he didn't want to move off the couch. Was moody.
He was moody and grumpy. And at first I was

(05:49):
just like, if this is what male menopause is, like,
I bet a lot of men are just getting on
biagra and they're or they're just getting on antidepressant and
they're not treating this whole picture. But it sounds like,
you know, it takes a while for this whole picture
of this condition to emerge because the symptoms happen so gradually.
Well it's interesting too because an article and Discovery Health

(06:11):
to your point, mentions that while a lot of men
who have these these symptoms will end up on indidepressants,
and it points out that if men have other symptoms
of male menopause is specifically a lack of libido, then
the end of depressant is only going to aggravate um,
aggravate that and actually make this uh possible Andrew pause

(06:35):
even worse. And it's I bet it's so hard to
go into a doctor to talk about this because I'm
guessing I'm I don't know if study has been done
on this, but I'm guessing the two hardest things to
talk to a doctor about our depression and low libido.
So the fact that you have to admit that there's
both in addition to all these other really undesirable symptoms.
I think that's why publicizing this condition is a good

(06:55):
idea because it might make a man take a holistic
look at us, at his health. But on the other side,
there are a lot of researchers and doctors out there
who are cautioning us against making male menopause sort of
a default thing that men go through, because not all
men go through it. It's that's why it's another difference
between male menopause and female menopause. Yeah, because the risk

(07:17):
of just throwing out this um, this male menopause diagnosis
is that you know, prescription drug companies are going to
castion on a big time and uh start selling a
lot of testoster and replacement therapies, which would be the
male equivalent of hormone replacement therapies that women take when
they go through menopause. For instance, men right now who

(07:39):
are diagnosed with low testosterone UM. According to this article
and the Daily Mail, there are forty three thousand such
men in the UK. Just to give you an idea, UM,
and these types of treatments that they get can be
will just be testoster and treatments administered by injection every
three weeks or every ten to fourteen weeks using skin patches,
gels or plants. So basically they are just amping up

(08:02):
the level of testosterone in their bodies. And from the
articles that you and I have read, Molly, in some
cases men will you know, almost immediately feel the difference,
especially in terms of amped up sex drive and energy.
But it seems like after a while, UM, it doesn't
really go to build up that muscle mass and really
the kind of the anatomical changes that happen with with

(08:24):
the low testoster and it's more of the I guess
emotional and sexual side effects that are improved. And it
sounds like it takes quite a while to figure out
the dosing and the and the means of administering the
testosterone that really works for you. There were accounts and
some of these articles that you know, a jail really
worked for one guy, but for another the injection was awful. UM.
But there have not been a lot of studies about

(08:46):
the long term use of testosterone injections, and the big
red flag to every researcher out there right now is
an increased risk of prostate cancer. So in response to
these health concerns, in two thousand two, UH, the Institutes
of Medicine in the US actually conducted a twelve month
study to reassess our knowledge about the risks and benefits

(09:08):
of testoster and therapy and older men, because there were
an increasing amount of men who are going on, you know,
getting these gels, these uh, these testosterone injections, not really
knowing what the long term side effects would be, and
a lot of these clinical trials were taking place among younger,
healthier men, so you don't really know what the effects

(09:29):
might be in the cohort that's actually being affected by
this um and the Institutes of Medicine basically concluded that
more tests need to be done to get um FDA
approval for these kinds of therapies and make sure that
there aren't any other like age related diseases that the

(09:50):
testosterin therapies will actually promote, So more studies needed for
these testosterone injections. The problem is is that a lot
of doctors are sort of at a loss for what
to do if you know, if you don't want to
pursue that alley. Uh. But then again, a lot of
them are saying you don't need to do anything. You
just need to make healthy lifestyle changes. Exercise, eat healthily,
perhaps take supplements under the guidance of your doctor, take vitamins. Um.

(10:14):
But I think the big takeaway from men is just
to look at a picture of health as a whole.
To combine the fact that you have symptoms related to
a rectile dysfunction, symptoms related to depression, and bodily changes
that are happening that may or may not be related
to a loss of a hormone. So that's where we
are with this right now. But we've got to answer
our question, Kristen, do men go through menopause? So from

(10:36):
our sources, Molly, I think that we could say that, yes,
this collection of symptoms does happen in a percentage of
middle age and older men. However, the term male menopause
is incredibly misleading, so it's really more of a language problem,
a terminology problem than um, I guess, misidentifying a medical issue.

(11:02):
I think you're right, it seems like you know, the
male menopause term has unfortunately stuck because it's easy for
us to create a picture in our mind of what
that would look like. But it seems like calling it
male menopause does a disservice to a lot of these
men who are trying to figure out what's going on
with them. Right there was an article that you and
I found in the British Medical Journal kind of assessing

(11:23):
whether or not male menopause quote unquote does exist, and
Um Duncan C. Gould and Richard Petty Um, who are
two physicians in the UK, said that Um, while yes,
the symptoms do exist, um, they suggested that instead of
terming it male menopause, they preferred something more along the
lines of male climacteric, which is comes from a Greek

(11:46):
word that means the rung of a ladder that's been
used in the past to suggest a decline in the
hormone concentrations, rather than the drop off that we think
of that's associated more with female menopause. Because, like you
said earlier, Molly, Um, what is it past the age
of thirty, men naturally have a one percent decrease annually
in the amount of testaster and that they produced, and

(12:08):
by the time there's seventy, that could even go up
to of um, the amount of testoster and they used
to produce. So yes, that happens, um, but calling it
menopause is is not not very accurate, not very accurate,
but perhaps just a good thing to know that that happens.
In fact, just as one last sort of anecdote, when

(12:29):
we were reading this article in the Daily Mail about
a guy who had who about the diagnosis of this,
his wife was talking about how she thought he was
having an affair. You know, he was never interested in her.
He was always moody and distant. Uh, he was mean
to the kids, and it was just you know, it
really reached havoc on their home life, and she was
convinced that he was about to leave her. Turns out,

(12:49):
you know, it was just this medical condition, Andrew pause,
andropause or what did you say, climactic? I mean, I'm
no words Smith, but that's never going to replace climatic.
Now that kind of sounds like the opposite a male
climactic sounds like something that might happen if you take viagra.
So I don't I don't know if it's going to
catch on perhaps, but we did our duty to publicize it.

(13:10):
And on a side note, guys even though, Um, this
male menopause term is something that seems to have popped
up more recently in the news cycle. Research on it
goes back to a landmark paper in nine four that
accurately described the symptoms associated with it, which were then
reversed by a testasphone replacement, but not by placebo and

(13:33):
the male participants in the study. So it's not necessarily
a new phenomenon. But I think that you know, mail
mail menopause is just such a catchy phrase. It grabbed
my attention, it did, and hopefully it grabbed yours, and
you clicked and got this far in the podcast, and
maybe some of you out there have stories to share
about this phenomenon. Maybe you've experienced man these symptoms or

(13:56):
your spouse has, and we would love to hear from you.
The email address, as always is mom Stuff at how
stuff Works dot com. And we shall wrap up with
a little listen to mail. All right, So first off,
I have a correction that both Annie and Rachel sent
to us about our Wilma Mankiller podcast. Um, both of
them sent up. I'm going to read Annie's email, She

(14:18):
writes NPRS Fresh Air in tribute and an old interview
with her. It is from that interview that I think
a correction should be made to the podcast. In her
interview with Terry Gross, man Killer recounted the car crash
you talked about. Indeed, her friend was killed in the collision,
but she wasn't in the car with man Killer. Man
Killer actually collided with her friend, or perhaps more accurately,
her friend collided with her. Apparently they were driving towards
each other on a one lane per side road and

(14:40):
the friend was attempting to pass in a no pass
zone and ran Ryan into Mankiller. That really stayed with
me when she told the interview, just imagine the odds.
Car collisions happen every day, but it's not often the
person you hit or the person who it's you as
a friend. From what I remember from the interview, it
affected her even more than the typical car crash in
Juice tragedy might have, just because the circumstances were so extraordinary.

(15:01):
All right, Well, we have one here from Jacob and
this is about our political quotas podcast um and he said,
in your political quote of podcasts, you pontificated on what
female politicians would look like in office when they were
not the token female. We'll look no further than my
beloved Washington State. We have our two term Governor, Greg
war who is now our first female governor, state senator,

(15:24):
State Senate Majority Leader Lisa Brown, and to count them
to female unit U S Senators, Senator Patty Murray is
one of the most powerfulomen in the Senate and she
is number four in the Senate in overall political power.
The great states of Maine in California join us and
having two women represent us as senators. Not to blow
Washington sorn, but that's quite a record, very interesting, So

(15:48):
thank you, Jacob. And to wrap things up here, I
have an email from Aiden about our podcast on androgyny.
As someone who has lived in two gender, I'm transgender female.
To mail, I can tell you that a majority of
people are very uncomfortable with an androgynous person, appearance, behavior, whatever.

(16:09):
Most people tend to lump someone like this is masculine
woman or feminine man and won't really let you identify
as neither. This is just my experience, of course, and
maybe it's different in other places. But when I first
began taking hormones, that quickly became very disconcerting to other people.
To try to discern my gender, and they would usually
assume that I was a very young boy. I got

(16:29):
a lot of dirty looks in the women's bathroom before
I got the confidence to go to the men's room.
Simple things like bathrooms are more complex issues like our
insistence on categorizing people in Our society's lack of willingness
to grant people rights will probably hold us back for
a while from androgyny being acceptable or even preferred. It
would be really neat to have the no gender tag
on a passport or driver's license, though, so thank you,

(16:52):
Aiden and again. Our email is Mom Stuff at house
stuffworks dot com. You can also follow me and Molly
on Facebook and it and as always, you can check
out our blog during the week, It's stuff Mom Never
told You, and you can find it at how stuff
works dot com. For more on this and thousands of
other topics, is that how stuff works dot com. Want

(17:15):
more how stuff works, check out our blogs on the
how stuff works dot com home page. Brought to you
by the reinvented two thousand twelve camera. It's ready, are
you

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