<i> Male</i> Menopause? : The Physical Causes Aren’t as Clear, but the Effects Can Be Every Bit as Disturbing

It’s not about hormones. Fertility isn’t an issue. Libido has something to do with it--but not much. And there are no hot flashes.

So what is this male menopause?

It’s part of the aging process. It’s mystery, myth, misnomer-- meno , after all, comes from the Greek word for menstruation . It’s another catchy name for that time of life when some men swap the station wagon and the wife for younger, flashier models.

“Generally speaking, there is no male menopause that is in any way similar to female menopause,” says Dr. Grant Gwinup, professor of endocrinology and metabolism at UC Irvine.

There is normal aging and midlife Angst, but no main physiological event, such as the end of menstruation, Gwinup says.

Neither is menopause in men predictable with any real certainty, says endocrinologist Loren Lipson, chief of geriatric medicine at the USC School of Medicine.

“(The symptoms) don’t happen across the board and they don’t happen abruptly. You can say the average age for female menopause in the United States is 51.4 years. You can’t say that for men,” Lipson says.

“My gut feeling is they’re talking about midlife crisis. (There) are probably changes that occur in some men and not in others, and it happens over a long period of time.”

But is it menopause?

Dr. Aubrey M. Hill of Ashland, Ore., says it’s time to call it andropause--as the Europeans do--and recognize it as a natural transition in men’s lives that is often unsettling but is ultimately a step toward deeper contentment.

Hill, a family physician and 71-year-old author of “Viropause/Andropause: The Male Menopause,” describes andropause as a medically identifiable syndrome that is a collection of physical, emotional and behavioral midlife experiences. He says he draws his conclusions from his medical practice and from personal experience.

“I’ve been practicing for 41 years. And I’ve been through it,” he adds.

There is even a red convertible Jaguar in his past.

With or without a sports car, all men experience a midlife crisis to some degree between 40 and 60. But 15% fall into the more intense andropause, Hill contends. Often it is ushered in by the body’s quiet reminders of aging: slow-healing sports injuries, balding, slight decrease in libido and fear of sexual dysfunction, he says.

But the biggest contributor to andropause is a culture that values youth and still measures men’s worth by the size of their financial portfolios, Hill says.

Visit the Greek Islands, as he does, or study non-industrialized societies and you won’t find middle-aged men pondering, “Is that all there is?” or adorning themselves with the trappings of youth.

“My theory is that male menopause is a product of our society. I would say (society is) about 80% of the problem.”

Men’s reactions can vary from increased alcohol use, malaise and sleeplessness to unhappiness at work and infidelity. For about 15%, the symptoms are severe enough to require medical attention, Hill says.

His answer is holistic. Throughout his book, he describes cases in which he not only prescribed hypertension medication or low cholesterol diets, but also “goal and priority adjustments.” Such treatment can be pedestrian but effective, he says.

One man gave up jogging--and all its aches and pains--for walking. The mild defeat to his ego was soon superseded by a feeling of improved fitness and energy.

All midlife changes are not so easy, but even the small, positive adjustments can bring a type of maturity that is its own reward, Hill says.

“Problems minimize themselves. You have the knowledge and expertise to handle the problems that do come up,” he says. “Your self-worth or self-esteem increases. You see each day as a day filled with contentment.”