What is MANOPAUSE?
An Age Old Problem with Roots in Male Biology
Authored by Ryden Anderson
A man stops into a drugstore with his young son. Walking past aisles of cold meds and Ace bandages, the boy spies a section of small, colorful boxes sporting the silhouette of an ancient helmeted warrior. Intrigued, he asks his dad about them.
“Those are condoms, son. A man wears one when he wants to have safe sex.”
“Oh,” the boy replies. “But why are there three in the box?”
“That’s for high school: one for Friday, one for Saturday, and one for Sunday,” his father answers.
“And what about this one?” the boy asks, pointing at a larger box.
“That’s for college,” Dad says. “Two for Friday, two for Saturday, and two for Sunday.”
The boy’s eyes grow wide as he spots the largest box of all—the 12-pack. “What’s that one for?” comes the inevitable question in awestruck tones, the boy already anticipating the answer.
The man pauses, sighing and staring wistfully down the aisle. “Those are for middle age,” he eventually explains. “One for January, one for February…”
My own father told me that one the other day as we were discussing my upcoming 36th birthday—which just happens to be the day I’m writing this. And while I’m not sure I was ever the four-times-a-night guy the kid in the joke imagines, I’ve noticed that certain things about my body and mind have started to change over the past couple of years. A lot of my friends say the same; a lot of guys over 30 do.
It’s a fact of life: you can’t stay in your twenties forever. But you don’t have to accept a slide into irrelevance and dissatisfaction as inevitable. You can take charge and take back your vitality. So let’s talk about manopause—the so-called male menopause—what it is and what you can do about it.
Manopause: What’s in a name?
Manopause is one of many names for a cluster of symptoms men may experience from their bodies’
decreased testosterone production as they age. Yeah, it’s kind of a dumb pun. Your doctor may call it “andropause” (which just means the same thing in Latin). In medical journals, it may be referred to as “late-onset hypogonadism,” “age-related testosterone deficiency,” or “age-related androgen deficiency.” All three of those terms highlight the difference between manopause and low testosterone levels (commonly known as “low T”) generally: men of any age can produce below-average levels of testosterone; what we’re talking about here is specifically related to aging.
Though popularized in a 2014 Time article, the term manopause in particular seems to have been coined back in 2000 by Stanley G. Korenman in an article published in the Western Journal of Medicine. There, he suggested manopause as a better term than male menopause, which researchers were already using, to avoid the false implication that the symptoms in men are related to menopause.
Menopause: Plural of manopause?
No, menopause doesn’t mean a bunch of middle-aged dudes cracking brews and grousing about their aching backs. It’s an entirely different phenomenon experienced by specifically different people (those with ovaries) for totally unrelated reasons. The two do have some similarities—namely, some overlapping symptoms and a broad association with middle age—but in biological fact, they have little to do with one another.
Menopause is a brief period of physiological changes caused by the ovaries’ ceasing ovulation, which results in a precipitous decline in hormone production over a relatively short period. No ovaries, no menopause. (In other words, guys, don’t worry: your balls aren’t closing up shop anytime soon. And that shrinking, shriveling thing that happens in cold water is totally normal.)
But testosterone levels do decrease with age, beginning as early as your late twenties. (And for what it’s worth, our ovary-carrying counterparts experience many of the same symptoms of aging, such a decrease in muscle and an increase in fat, unrelated to hormonal changes.) That’s the primary difference between menopause and manopause: menopause comes on fast, hits hard, and then it’s over; manopause creeps up on you and gradually worsens over time.
You might say it’s a bit like puberty in reverse. No, you’re probably not going to revisit your pizza-face phase. And no, your voice isn’t going to go all Mickey Mouse-sucking-helium on you. But the hormonal increases that caused all those bodily changes back in your teens are ramping back down.
Another difference is that menopause invariably ends in infertility. While some men with low T experience a reduction in—or even total loss of—fertility, that’s relatively rare. So if you thought you’d never need a condom again, think again. If you’re looking to baby-proof yourself, you might consider a vasectomy. It’s a noninvasive, reversible, outpatient surgery that turns all your baby bullets into blanks—if you know what I mean.
One more difference between menopause and manopause: if you’ve got ovaries, menopause is unavoidable; if you’ve got low T, though, you’ve also got options. But how can you even tell?
First, you’ll need to know what to look out for, so let’s talk symptoms.
Symptoms: Is it happening to me?
Okay, so this thing goes by a bunch of names—and it’s not menopause. What is it, then?
In a nutshell, manopause is the possible outcome of a decrease in bioavailable testosterone in older men. As we get older, our bodies tend to produce less testosterone. And in some men, this has consequences that negatively affect their quality of life.
The symptoms of age-related testosterone deficiency fall into two broad categories: physical changes and mental changes. Let’s look at the most commonly reported ones by category.
Physical Effects of Late-Onset Low T
The physical symptoms associated with manopause include:
- fatigue or loss of energy
increased body fat (especially in the torso);
- decreased muscle mass or strength;
- decreased bone mass or density;
- disturbances in sleep or changes in pattern; and
- decreased sexual performance—including erectile dysfunction.
Mental Effects of Late-Onset Low T
The mental symptoms associated with manopause include:
- reduced libido;
- irritability or volatile mood;
- difficulty concentrating or staying focused;
- decreased motivation and confidence; and