Does the male menopause exist?
The male menopause is genuinely real, but it progresses so gradually that many men do not recognise their symptoms as hormonal; anyone experiencing fatigue, loss of libido, or mood complaints from middle age onwards would do well to discuss this with a doctor, and partners are encouraged to do so together.
Yes, the male menopause is real, but it works very differently from the female one. From around age 35 to 40, testosterone (the main male sex hormone) drops by roughly 1 to 3 percent per year. This gradual process is also known as andropause.
In women, the ovaries stop functioning abruptly. In men, the decline unfolds over decades, and men remain fertile well into old age.
Some middle-aged men develop symptoms such as fatigue, reduced interest in sex, and mood swings. A link with the hormonal decline has been established, but whether testosterone actually causes these symptoms is still debated.
Stress, heavy physical strain, and sleep problems are associated with more severe symptoms, as a combined look at 9 studies shows. These factors can also speed up the hormonal decline.
Something worth noting for couples: both partners can be dealing with hormonal changes at the same time. Treating only one of them may be insufficient, or may even be counterproductive.
The claims are based on a mix of combined study overviews, and older individual studies. The evidence for the hormonal decline itself is reasonably solid; the evidence for a direct causal relationship between that decline and symptoms is weaker and mainly based on associations.
Which hormone levels are tested during menopause?
During menopause, the hormones measured most commonly are FSH, LH, oestradiol, progesterone, testosterone and AMH; elevated FSH combined with reduced oestradiol (below 20 pg/ml) is the most reliable sign that menopause has begun, but always have your results explained by your doctor, as body weight and background influence reference values.
Does my weight and metabolism change during the menopause transition?
During the menopause transition, your body composition changes profoundly: more fat mass, less muscle and more dangerous abdominal fat. Your total weight on the scale may barely shift, yet something genuinely significant is taking place.
Can you delay menopause with lifestyle or diet?
Avoiding smoking, eating less red meat, and eating more citrus fruit and oily fish appear to have a favourable influence on the age of menopause. However, evidence from controlled experiments is still entirely lacking.
Do men need estrogen for their health?
Yes, men need oestrogen for strong bones, healthy blood vessels, and fertility. Both a deficiency and an excess are harmful, so it is a matter of finding the right balance.
Which supplements actually help with menopause?
Red clover isoflavones and black cohosh have the strongest evidence for reducing hot flashes; soy isoflavones also help to some extent. For bone health, vitamin D is well supported. The effects are modest, and for severe complaints it is best to discuss the options with your doctor.
What complaints are most common during menopause?
The most common menopausal complaints are joint and muscle pain, fatigue and sleep problems; hot flushes are the most characteristic but do not top the prevalence rankings. If you recognise several of these complaints, it is worthwhile discussing them with your GP, who can consider what may help for each one.