Manopause ... or Depression?

Laura Mitchell's picture
By Laura Mitchell on July 6, 2017

We all know about menopause, the period of a woman’s life when hormone production ceases and her menstrual cycle ends.

But fewer people know about “manopause,” which can affect middle-aged and senior men. It is more subtle than menopause and not all men experience it, but its health effects are worth noting.

Also known as “male menopause,” manopause is marked by a decline in the production of androgens, especially testosterone. It often begins with slight decreases in a man’s mid-40s and tends to drop off more dramatically by age 70. As they age and their hormone production decreases, men may experience symptoms that include:

  • Increased fatigue
  • Decreases in muscle mass
  • Depression
  • Decreased libido and inability to reach orgasm

Mark Greenawald, M.D., a Family Medicine physician who is vice chair in the Department of Family and Community Medicine at Carilion Clinic and a professor of family medicine at the Virginia Tech Carilion School of Medicine, recommends that men who experience these symptoms consult with their primary care provider.

Your doctor will perform a physical exam and ask you about your symptoms. Be sure to include emotional changes as well as physical changes.

“These symptoms are not necessarily related to a decrease in testosterone,” he said. “Your physician will consider low testosterone as well as other causes, which commonly include depression.”

Dr. Greenawald also noted that depression often manifests in men as anger.

“They experience frustration and grief because they think they can no longer do things they used to be able to do,” he explained.

A blood test can measure testosterone levels and rule out any other underlying conditions. If testosterone levels are low, your provider may recommend changes to your diet or exercise routine designed to preserve muscle mass and improve energy and mood. In some cases, a provider may recommend hormone replacement therapy.

“There are some safety issues related to hormone therapy so patients need to be monitored,” said Dr. Greenawald.

He emphasizes that an accurate diagnosis is essential.

“Testosterone therapy does not treat depression,” he said.

For many men, age-related hormonal changes are not a health concern at all.

“You can have low testosterone and not experience any symptoms,” said Dr. Greenawald.

Everyone’s experience with age-related conditions like manopause and menopause is different, and your best resource is always your primary care provider.

Find more about men’s health guidelines for every age here.