For Victor Meldrew, from One Foot In The Grave, it was a defining feature of his character. Basil Fawlty was surely in the throes of it. And in the real world, Oscar-winning actor Jeremy Irons blamed his mood swings on the condition after he turned 50.
Yet many doctors say it’s a myth dreamt up in a test tube by profit- hungry drug companies.
I’m talking about the male menopause. Yes, the male menopause.
Presumably to spare middle-aged men’s blushes, some GPs prefer to use a more masculine description, ‘irritable male syndrome’ — defined in the dictionary as ‘a behavioural state of nervousness, irritability, lethargy and depression that occurs in adult mammals following withdrawal of testosterone’.
There was no rhyme or reason to the flushes — they would often occur in the evening when I thought I was relaxed, or while I was having a cup of tea and reading a book
I laughed out loud when, a couple of months ago, a (female) friend suggested the male menopause might be the reason I was having difficulty sleeping and also enduring sporadic hot flushes.
There was no rhyme or reason to the flushes — they would often occur in the evening when I thought I was relaxed, or while I was having a cup of tea and reading a book.
Sometimes I would break out in a cold sweat. My face would go pink. A minute or so later, everything would be normal again.
The bigger problem was falling asleep. Sometimes I would be tossing and turning for two hours, continually checking the clock, before I finally dropped off. I bought some herbal pills from the chemist but they worked only now and then.
The bigger problem was falling asleep. Sometimes I would be tossing and turning for two hours, continually checking the clock, before I finally dropped off
The expectation of yet another sleepless night invariably made me irritable the next evening.
Was this the male menopause?
Frankly, the idea was mortifying. It’s bad enough that my hair is thinning. I would never have lived down the ribbing from friends and family. In fact, I’d never have told them.
But something wasn’t right. My diet hasn’t changed, my weight is almost the same as it was a decade ago, and I take the same vitamins — echinachea to ward off colds, vitamin B to boost my losing battle to prevent a Friar Tuck bald patch, and vitamin C because I was raised to think it was good for me.
Then I spotted the monthly email from my GP, Dan Wright, the medical director of Freedom Health in Harley Street. Talk about timely. It was headlined: ‘Male Menopause’.
I was intrigued. He wrote: ‘We have all heard of menopause. It is usually an affliction associated with women as they age. You may be surprised to hear that the menopause can affect men as well.’ I was not surprised but astonished because he is a proper doctor.
The email continued: ‘Male menopause generally affects men over 50. The condition is also known as testosterone deficiency, androgen deficiency or late-onset hypogonadism.’ The listed symptoms included problems sleeping, mood swings, forgetfulness, fatigue, hot flushes, fat build-up around the abdomen and hair loss.
It was a Eureka moment.
‘It’s me,’ I thought. I was on the telephone immediately to book an appointment. And then I went on the internet and discovered that debate about the existence of the male menopause had been raging back and forth for more than 65 years.
Even the learned British Medical Journal opined on the subject back in 2000, running a series of articles by experts on both sides of the argument. A paper from the Centre for Men’s Health, in London, published in the Journal of Ageing in 2015, listed symptoms including joint pain, low libido and depression. Governments have spent money on research.
It was a Eureka moment. ‘It’s me,’ I thought. I was on the telephone immediately to book an appointment
Other doctors, I also found out, refer to it as the andropause. There is even an Andropause Society, based in Hampshire, to ‘raise public, medical and scientific awareness of the short and long-term consequences of testosterone deficiency syndrome (or “male menopause”)’.
The society also wants to increase understanding of how the condition contributes to type 2 diabetes, excess weight, high blood pressure and heart disease (see box, below).
But many doctors who study the effects of ageing sniffily dismiss male menopause as a fiction invented for the benefit of grumpy hypochondriacs.
My head swimming with these newfound facts, four weeks ago I was sitting in Dr Wright’s comfortable room. Having heard my list of aches and pains, he decided first to do a ‘well man’ check, looking at my weight, height, blood pressure and cholesterol levels.
My head swimming with these newfound facts, four weeks ago I was sitting in Dr Wright’s comfortable room
There was a urine test for type 2 diabetes and kidney infection, and I had to spit into a tube to check my lung capacity. I passed everything with flying colours.
Blood tests ruled out anaemia and liver dysfunction. But as part of the examination I was told I should be eating plenty of red meat, eggs and tuna.
That is because vitamin D can help to boost testosterone levels by up to 90 per cent, according to researchers at Graz Medical University, in Austria. If, like me, you don’t get much sunshine, add more tuna and eggs to your diet.
And I’ll also be eating meat, as a meat-free diet is believed to lower testosterone levels — but all things in moderation, obviously.
So, infuriatingly, it’s back to the butcher’s, as I’ve been living for years on a diet of grilled chicken and white fish.
Then Dr Wright broached the sensitive subject of male menopause, saying: ‘Some people downplay its significance by calling it a midlife crisis. I believe it’s a medical condition and that male menopause can have a serious effect on a man’s wellbeing.’
Whether you call it the menopause or midlife crisis, the symptoms are linked to the testosterone produced in our bodies. Repeated studies have shown that men’s levels decline as they age: by 70, they have between 25 per cent and 50 per cent less than men who are 20. This is a truth acknowledged by both male menopause supporters and refuseniks.
Where there is disagreement is on the effects of this fall.
I decided to have my levels tested — the test is called the andropause profile and it looks at various substances that relate to how much testosterone is in your body. For instance, key factors include your levels of luteinising hormone (LH) and follicle simulating hormone (FSH).
Dr Wright explained that these are produced by the pituitary gland, at the base of the brain, and work together to regulate the production of testosterone in the testes.
Then there is something called DHEA (dehydroepiandrosterone), a form of sex hormone that is present in the blood of both men and women. This can be changed by the body into stronger hormones such as testosterone, or into the female hormone oestrogen.
Was this the male menopause? Frankly, the idea was mortifying. It’s bad enough that my hair is thinning. I would never have lived down the ribbing from friends and family. In fact, I’d never have told them (file image)
SHBG (or sex hormone binding globulin) is a protein made by your liver that binds tightly to three sex hormones found in both men and women — oestrogen, dihydrotestosterone (DHT) and testosterone. SHBG carries these three hormones throughout your blood and, significantly, controls the amount of testosterone your body tissues can use.
Finally, there is your testosterone. This is an androgen — that is, it stimulates the development of male characteristics. The test also looks at your ‘free androgen index’, which measures the testosterone in your blood and compares it with the total amount of testosterone and SHBG in your body.
Think you’re going through the male menopause? In order for testosterone testing to be offered on the NHS you need to meet one or more of several criteria such as:
Persistent loss of libido and/or erectile dysfunctionOsteoporosisThe blood tests were taken in the morning because testosterone levels, which fluctuate during the day, are at their highest first thing. There are two treatments recommended by Dr Wright. They are the Nebido injection, into the buttock, which contains a long-acting form
