Does male menopause exist?
Do fewer erections and less interest in sex sound familiar?
We know mood swings, hot flushes, low libido and depression can be some of the hormonal changes older women experience during menopause, but what is not well known is that some men will experience some of the same symptoms when they get older.
One of my favourite sayings is: "Male menopause is much more fun than female menopause. A female gains weight and gets hot flushes - a male dates younger women and drives a sports car."
The medical profession is still debating the existence of male menopause and some prefer to call it "andropause".
Women experience a drop in oestrogen during menopause and men can face a decline in the production of testosterone. For men, the hormonal change is often more gradual and not all of them experience it.
The most common symptoms of male menopause involve changes in sexual functioning: reduced ability to obtain or maintain an erection, declining interest in sex and fewer spontaneous erections during sleep.
Emotional changes include feeling sad or depressed, being moody and irritable and having trouble concentrating or remembering things, which can cause a decrease in motivation or self-confidence.
Various physical changes can occur, such as decreased bone density, declining strength and endurance, increase in fatigue and lethargy, having aches, pains and stiffness in joints and suffering from excessive sweating.
Some men experience swollen or tender breasts, loss of body hair and an increase in abdominal fat.
There is also the much-debated "midlife crisis", where some men find that having spent half a lifetime working and raising a family was not as fulfilling as they expected.
With the physical signs of ageing comes the realisation that old age is around the corner and this becomes a psychological issue not a physical one.
Some doctors are concerned that the issue of male menopause has become a commercial opportunity for drug companies and private clinics.
Several older men have told me they read so many advertisements promoting testosterone as a "wonder drug" that can rejuvenate your sex life that they wondered if they should give it a try.
Taking testosterone when they don't need it is pointless, I told them. I usually refer such cases to a men's sexual health physician, or a GP who specialises in this area, to first have their testosterone levels tested.
A diagnosis for testosterone deficiency involves several steps, including giving a full medical history, having a physical examination and providing at least two blood samples, taken in the morning on different days.
Andrology Australia has a brilliant website with more information and Brisbane doctor Michael Gillman, who focuses on men's health and male sexual dysfunction, has an excellent fact sheet on his website, which is certainly worth checking out.
It is important to be aware that many of these symptoms are a normal part of ageing; others can be caused by a variety of factors.
Many men who experience these age-related symptoms have unhealthy lifestyles; they may smoke or drink too much alcohol, do not exercise and are often overweight. These lifestyle factors may cause illnesses such as diabetes, heart disease, high cholesterol and depression.
However, if a man is healthy and starts to experience a diminished sex drive and difficulties in maintaining a strong erection, a visit to the doctor may help diagnose if he has low testosterone and more tests can rule out other possible conditions he may have.
Men are often in denial about their symptoms, they have an "it will get better" attitude, which is one reason the death rates of illnesses such as cancer and heart disease are much higher in men than in women and the reason why some men die prematurely.
Women should take note of changes in their male partners and suggest they seek medical advice as soon as possible because ignorance and denial can be a dangerous combination. It is important men explain their symptoms properly to their doctor.
A detailed history is essential to get a clear and accurate picture that leads to the right treatment plan.
So, if you think your man is suffering from male menopause, give him some support.
And, if you are a man who recognises some of these symptoms, don't be afraid to speak to your doctor.
There is still a happy and healthy sex life for both of you after the "menopauses".
Sydney Morning Herald