It is common for penis-owners to develop depression, erectile dysfunction, and a loss of sex drive as they age. This is typically seen when they reach their late 40s or early 50s. This can be referred to as andropause, or in other words, “male menopause.” The term male menopause, however, can be misleading. It causes issues in the way “it suggests the symptoms are the result of a sudden drop in testosterone in middle age, similar to what occurs in the female menopause. This is not true.” This confusion and uncertainty on the truth of male menopause will be explored in this article. The effect of a lack of discussion of menopause can be seen clearly in the workplace, especially in terms of menopause and sick pay. Menopause is seen as an insufficient reason for taking time off work, meaning many facing the effects of it are faced with having to work whilst experiencing symptoms of menopause. Others have no choice but to leave their workplace entirely. Issues with menopause and the workplace will be discussed later on in this article.
Changes in hormones are a natural part of aging; for penis-owners, as they age, they may experience a decrease in testosterone levels, resulting in physical and emotional changes. This change in hormone levels is not equivalent to the hormone changes in women. In vulva-owners, after ovulation ends, hormone production levels plummet significantly in a short period of time—this is known as menopause. For those with a penis, this decline in hormones is not as dramatic. The decline in testosterone is steady, around 1-2% a year from the age of 30-40. Most older penis-owners still have testosterone levels within the normal range, with an estimation that only 10-25% have low testosterone levels. Because of this steady fall, low testosterone levels in older penis-owners often go unnoticed. Although hormone levels can be checked by blood tests, they are not routinely done. Furthermore, many with low testosterone levels may experience no symptoms. Signs of low testosterone include:
Reduced sexual desire
Erectile dysfunction
Breast swelling
Hot flushes or sweats
Decreased energy
Poor concentration
Sleep disturbances
Mild unexplained anemia
Signs and symptoms that are associated with low testosterone are not always specific to low testosterone. Aspects like age, medication, and weight can result in similar ways. Stress and anxiety can also result in erectile dysfunction and reduced sexual desire, both signs of low testosterone. This stress can be brought by work or relationship issues, money problems, or a “midlife crisis.” In some cases, where lifestyle or psychological problems are not deemed to be responsible for these symptoms, it may be the result of hypogonadism. This is where your sex glands produce little to no sex hormones. Hypogonadism can be present from birth, with signs of it being delayed puberty and small testes. Treatment for this involves testosterone replacement in order to allow testosterone levels to return to normal. Testosterone can be taken orally, as a gel, injection, or patch. Treatment in children and young adult penis-owners involves three to six months of testosterone supplementation via injection that stimulates puberty and the development of secondary sex characteristics.
Howard Jacobs, professor of reproductive endocrinology, questions whether “male menopause” really provides a helpful analogy for the aging man. Jacobs confidently states: “I really do not find the analogy of the female menopause helpful in understanding or trying to manage the problems of senescence in men.” Whilst this study was scientifically complex, it highlighted the aforementioned difference in the speed that which hormone levels fall. “The key difference from the menopause, however, is the gradual nature of the change in men compared with the precipitate fall of estrogen concentration in women.” Calling this fall in testosterone “male menopause” insinuates that the effects are as sudden and drastic as female menopause—this is not the case.
In order to discuss male menopause, there needs to be a greater discourse about menopause as a whole. Meera Bhogal, who runs support and informational groups for Asian women says menopause is “seen as a white middle-class women’s disorder,” and discusses the cultural taboos that prevent those from Asian backgrounds from being able to speak about periods or menopause. Women’s health specialist, Dr. Nighat Arif further backs this claim, stating that “Black, Asian and Minority Ethnic women are being left out of the conversation [of menopause] when it comes to the UK’s biggest employers, the NHS.” Women make up 77% of the NHS, with the average working-age being 43. But when they hit their perimenopause and menopause, one in ten of them leave. “Forty-percent of these women are from ethnic minorities. There’s nothing for them, no research, and nothing they see about menopause features non-white women yet it’s ethnic minority women driving the NHS.” In the US, the subject of menopause goes undiscussed in the workplace. Helaine Olen mentions in an article for The Washington Post that “seeking accommodations for menopause or even acknowledging it is often tantamount to putting a target on your back.” This can also be reinforced by age discrimination and the refusal to employ older people due to the effects menopause can have on productivity. Private employers are not required to offer sick pay or paid medical leave, meaning vulva-owners are forced to work whilst experiencing detrimental side effects of menopause.
Though it is an obvious and intuitive truth that everyone goes through changes as they age, there is no real, positive discussion about it. Encouraging discourse on menopause, both in the female and male sense, will allow people to learn more about their bodies and natural changes. Greater discussions and understanding of this may encourage workplaces to change their policies about sick pay when experiencing symptoms of menopause.
By Stephanie McCartney