Has your husband hit the manopause? And how to fix him if he has
Grumpy. Tired. Paunchy. And no longer interested in you...
For the most part, I have managed to avoid those embarrassing mid-life crisis cliches that afflict so many men of my age: the need to buy a HarleyDavidson; getting down with the kids at Glastonbury; the inappropriately tight trousers worn without irony.
When I turned 40 I briefly flirted with the idea of treating myself to a vintage Ford Mustang. Thankfully, dignity got the better of me and I continued trundling around in my sensible, mid-range, mid-price middle-age-appropriate hatchback.
Now I’m nearing 50, my mid-life crisis (if indeed that’s what it is) has become less about recapturing lost youth and more about dealing with crippling existential anxiety. And
Men are just jealous because they can’t wear make-up MODEL CAROLYN MURPHY
when I’m not fretting about my place in the universe, I’ll be raging at the injustice of it all.
Life continues around me and yet I feel strangely locked out; not so much looking through a glass darkly as staring at a steel wall. My mind and body no longer feel connected. Emotionally I’m all over the place; railing against the world one minute, sobbing uncontrollably the next. My body remains in a constant state of achy fatigue.
My long- suffering girlfriend has taken the brunt of it. Dealing with my alarming mood swings hasn’t been easy.
Although I suffered from mild depression in my early 30s this felt different, more profound. Why, on the eve of my 50th birthday, had I become so irascible, so impatient, so unpredictable and distant around people I cared for? What was this woozy sense of unreality hanging over me and why did I feel so fuzzy and exhausted all the time?
I have a comfortable, interesting life, friends and a wonderful woman who loves me, so why did I find it so hard to focus on the positive? I slept fitfully and most mornings would awake with a sense of foreboding — unable to lift my head from the pillow, let alone leap at the challenges of the day. And when I finally made it through the front door and out into the waiting world, that sense of disconnection rendered me helpless. What was happening to me?
Had I simply morphed into an extreme version of a grumpy old man? Was I clinically depressed? or was there something else at play?
of course, many Inspire readers will recognise these symptoms, but it was only during lunch with a close female friend, now in her 50s, that the subject of the menopause — or manopause — came up.
For the past six months, Jayne had been suffering from hot flushes, mood swings, irritability, overemotional outbursts, insomnia and feelings of exhaustion and despair.
AFTER hiding under the duvet for weeks on end, she finally plucked up the courage to seek help and was about to begin a course of Hrt. Apart from the hot flushes, her symptoms sounded remarkably similar to mine.
‘ Perhaps you’re going through the andropause,’ she suggested with a wry smile. ‘the what?’ ‘the male menopause,’ she said, rolling her eyes.
Jayne proceeded to tell me about her boyfriend who was also suffering from menopausal symptoms.
‘ His mood swings were becoming intolerable and he found it hard to concentrate on anything,’ she said. ‘ to top it all, he lost interest in me physically, so I made him have a blood test and it turned out his testosterone levels were way down.
‘He’s now on supplements and the transformation has been remarkable.’
Jayne explained that like women’s menopause, the andropause is linked to a drop in hormones. After 30, most men experience a 10 per cent drop in their testosterone levels every decade. Unlike women, they probably have no idea it’s happening.
But if middle-aged men really do experience a similar kind of hormonal imbalance to women, why aren’t we more aware of it? Like me, none of my male friends had even heard of the andropause. Most were familiar with the menopause and some could even list a few of the symptoms, but they had no idea that men might be prone to something similar. the mainstream medical profession appears divided. My GP scoffed when I asked him whether the andropause might explain my erratic behaviour.
NHs Choices believes the term is unhelpful and misleading: the term ‘suggests the symptoms are the result of a sudden drop in testosterone in middle age, similar to that which occurs in the female menopause, but this is untrue’.
Although testosterone levels fall as men age, the NHs argues that the decline is steady — less than 2 per cent a year — and that this change is unlikely to be noticeable.
they suggest that menopausal symptoms in men are more likely a result of lifestyle factors or psychological problems. But I have a pretty good life, I don’t smoke or drink too much and as far as I know I have no major psychological issues. so I was surprised when my GP recommended antidepressants without much in the way of consultation.
I’d been prescribed Prozac and Valium during my earlier brush with depression, but had struggled with the deadening effect of the drugs. Better to feel something than nothing has always been my philosophy.
I wasn’t willing to take that risk again so I decided to get my hormone levels tested by one of the leading authorities on the subject.
Dr Marion Gluck is a world pioneer in ‘ bio- identical’ hormones to rebalance the body’s endocrine system. she’s the go-to specialist for menopausal women in the know, but has recently seen a steady trickle of men too, which she finds gratifying.
‘the only time I tend to see men in my surgery is when their wives or girlfriends have dragged them here,’ she says, wrapping a tourniquet round my arm in preparation for a blood test. ‘Men find it much harder to admit when something is wrong.’
Marion believes GPs are too quick to dismiss the mano- pause. she tells me that hormones regulate virtually every function in the body, so it’s important to recognise their significance to physical and mental wellbeing.
When my blood test results are in they reveal my testosterone and thyroid levels are low. Marion isn’t surprised. the exhaustion I’ve been feeling, along with my inability to concentrate, are classic symptoms of a thyroid deficiency. My irritability and mood swings are a sure sign my testosterone levels are on the wane.
this came as a shock — I always thought male aggression came from an
excess of testosterone. Marion is keen to point out my symptoms may not be exclusively down to hormone deficiency; there are probably a number of factors at play, so it’s important these are taken into consideration when diagnosing signs of depression. this, according to Marion, is
where the NHS is failing patients. ‘Instead of blithely prescribing anti-depressants to anyone who complains about feeling low, doctors should take a more holistic approach, by asking why patients feel depressed.
‘The diagnosis should be built around contributing factors including hormone levels, lifestyle choices and mental wellbeing.’
For this reason she tends not to rely too heavily on blood test results. ‘I prefer to treat individual symptoms, not statistics on pieces of paper,’ she says. ‘Besides, there is no such thing as “normal” when it comes to hormone levels. What’s normal for a 48-year-old man may not be normal for a man in his 70s.’
Marion describes her diagnostic approach as like building a jigsaw, fitting each piece of the puzzle together until a bigger picture emerges. ‘Before prescribing any treatment I really need to understand the person I’m helping.’
The good news is that none of my symptoms appears to be unusual for a man of my age and Marion is confident that with some carefully planned hormone treatment, I will soon be feeling my old self again.
THe
middle years can be particularly tough for men as we take stock of our lives and wonder what might have been. It’s when those anxieties impinge on our ability to function that we should start to be more like women and seek help.
It’s liberating to know my symptoms may be down to a simple chemical imbalance.
I used to think negative feelings were beyond my control, but now Marion has collated the evidence and created a tailor-made solution, I’m hoping to shed some of the more destructive side-effects of the andropause.
Rather than using conventional hormone replacement therapy (HRT), Marion specialises in bioidentical treatment, which involves replacing existing hormones like for like. All the substances she uses are made from natural plant sources — usually wild yams or soya beans — to minimise any side-effects.
Many of Marion’s treatments are made to order at a specialist pharmacy in east London. A package arrives from the lab in Dagenham containing everything I need for the next six weeks, including lozenges with testosterone and dehydroepiandrosterone ( also known as DHeA, a hormone produced in the adrenal gland).
As well as taming the beastly rages, these promise to improve sex drive, build muscle and bone density, sharpen memory and fight the effects of ageing. A twomonth supply costs £100.
The Thyro Complex capsules regulate metabolic rate and keep thyroid levels up (the thyroid stores and produces hormones that affect the function of virtually every organ in the body) — £17.70 for 60 tablets.
She’s included two lots of dis- solvable magnesium powder (MegaMag Calmeze — £20 and MegaMag Night Formula — £26.21), the first to keep me on an even keel during the day, the second to help me sleep at night. There is also a course of highstrength Omega 3 fish oil tablets to help ease aches and pains.
On top of the medication, Marion has booked me in to see Amber, a psychotherapist who will assess my emotional state and come up with a lifestyle plan to complement the hormone treatment.
Amber gives me plenty of practical advice. She recommends adding structure and consistency to my daily schedule. Working as a freelance journalist can be isolating, so finding a routine and remaining sociable is important. She reminds me that opening up about my fears to people I trust will help me avoid falling into that male trap of bottling things up.
Her recommendation that I take up cycling has been a great stress reliever and the exercise has really helped de-clutter my mind. Nutritionally, both Amber and Marion have recommended I stick to a classic Mediterranean diet of olive oil, starchy carbohydrates, lean protein and plenty of fresh vegetables.
At the end of my six-week course I feel like a shinier, more focused version of myself. The magnesium has had a wonderfully soothing effect on my mood and I am sleeping more soundly.
WAKING up no longer fills me with dread and I increasingly find myself leaping from the mattress at 6 am, ready for whatever the day has to throw at me.
My girlfriend has noticed some significant improvements, too. The testosterone/DHeA lozenges have given me back my confidence, which in turn has made me more amorous. A sense of calm has returned and those angry outbursts have become more muted.
My whole body feels lighter and less creaky and I can now run around the park without collapsing in a ruddy- cheeked heap every few minutes.
I still get the odd flash of existential terror, but these days I’m able to take a step back and allow the feelings to wash over me rather than overwhelm my day.
While I appreciate how deeply depressing the change of life must be for many women, at least the condition has a recognisable name and there are treatments readily available.
It amazes me that men aren’t being offered that same level of help and support. There’s a reason over 90 per cent of Marion’s patients are women and it’s not because men aren’t suffering.
The fact that none of my friends had even heard of the andropause is frankly shocking.
But there are steps we can take. If you suspect your husband might be suffering, ask him to consult his gP for a full and thorough consultation.
He must be honest about his symptoms — feeling miserable is nothing to be ashamed of — and ask for a blood test. If testosterone levels are down enquire about supplements and don’t be fobbed off with anti- depressants until every option has been explored.
Men need to wake up to their physiology. Pretending that everything’s fine is no longer acceptable. It’s time to realise that there’s nothing admirable or courageous about holding everything in.
The world has moved on. Women have moved on. It’s time men moved on, too.
‘After treatment, men sleep better. They get back their zest for life and wives get back the men they first fell in love with.’ Dr MARION GLUCK