Wednesday, December 21, 2011


Most people are familiar with menopause and the symptoms some women experience due to declining hormone (estrogen) levels. But fewer people are aware that as men age, they too experience a decline in sex hormones (testosterone), and this can cause a host of troubling symptoms.

Known as andropause, the drop in testosterone levels can lead to low libido (low sex drive) and erectile dysfunction, fatigue, irritability, depression, poor concentration, loss of physical strength and decreased muscle mass.

Although menopause typically hits women in their late 40s, early 50s, some women start perimenopause earlier on. Likewise, even men in their 30s can start to experience some of the symptoms of andropause if their testosterone levels drop significantly (I have seen this quite frequently).

While the process of menopause is widely accepted as a natural part of aging for women, there seems to be less acceptance of andropause. Perhaps because strength, libido, and sexual prowess are so tightly bound with our image of masculinity. I hope this begins to change soon, because from what I see in my counselling practice, there are many men suffering from the symptoms of andropause, and shame and embarrassment only make the situation worse for them.

The loss of libido and problems with sexual performance come up as an issue frequently, both with couples I counsel in the fertility clinic, and those outside. Obviously a lack of libido can be a big problem for couples trying to conceive, and the pressure to perform in order to get pregnant usually only heightens the problem for the male partner. Even among couples not trying to conceive, the loss of libido can negatively affect the relationship. Even if the female partner understands on an intellectual level that there is a physiological component to the issue, she generally can't help but wonder if her partner is truly attracted to her - since we tend to have an assumption in our society that all men are always on sexual overdrive.

The situation only gets more severe if the man feels guilt, shame, or embarrassment since this generally leads to performance anxiety, which can continue to affect the couple's sexual relationship, even if the physiological problem (i.e. testosterone level) is corrected through medication or other treatment.

For couples facing this issue, the important thing is to first get medical attention, to rule out any other conditions that may be affecting libido, and to investigate whether treatment is warranted. Keep communication open and honest, and do not be ashamed, you are not alone. Although still not widely talked about, for many men, this is a normal part of the aging process that may not be preventable, but can be managed and treated. Also, if it becomes a problem in your relationship, get counselling as soon as possible. It does not have to mean an end to your romantic relationship or sex life.

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