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Differences Between the Mid-life Crisis and Male Menopause (Andropause)

Time and again in newspaper articles and television programmes, and even medical debates, these two conditions are written and talked about as though they were one and the same. They are not, and this confusion prevents either condition from being recognised or treated. Let’s run through a check-list to spell out the differences:

Age – The Mid-life Crisis usually is confined to the ages of 35 to 45, while the Male Menopause is characteristicaly 45 to 55, as with the female menopause. However, if there was previous damage to the testes, such as from mumps, alcohol or vasectomy, the Male Menopause may happen earlier.

Childhood – A disturbed, unsupportive childhood, starved of love and affection, especially if accompanied by physical or mental abuse, is much more common in the background of someone experiencing the Mid-life Crisis.

Triggers – The death or serious illness of a parent or close friend is a common trigger of the Mid-life Crisis, as such events bring you face to face with your own mortality. They make you feel that you are next in the firing-line, which brings up thoughts and feelings about the meaning of your life, and your past, present and future goals and acheivements.

Paradoxically this crisis can come after a period of success even more often than after a dismal failure. It may even come when you find the love of your life, either in a person or an occupation, but feel it is too late or an impossible dream. As the word suggests, it is decision time, but you agonise over the choices. You consider changing your job, your partner or your whole way of life. By contrast, the Menopause comes after redundancy, after heavy financial losses, after the business has failed, after divorce, rather than during the period leading up to them.

Relationships – The Crisis is by its nature often very much about personal and business relationships. Questions about whether you want to go living with that person, or working with another, or in that organisation, are often uppermost in your mind. You think about them again and again, and you even may dream about them again and again at night.

During the Menopause, you are more likely to feel too weary to want to make any changes, and too tired to even dream about doing so. Because of this lethargy, your marriage and business relationships may be falling to pieces around you, but you feel powerless to do anything about it.

Sex-drive – This is most often increased during the Crisis, either as a form of escapism, or as a conscious or subconscious way of bringing matters to a head. Sometimes however when a man is depressed by these events, as with other forms of depression, the libido may decrease. With the Menopause the libido is almost always decreased, though occasionally there may be an affair to try to revive waining sexual powers.

Potency – As with most things there are few absolute rules about this, but apart from obvious physical causes such as diabetes, or the side effects of medicines such as those used to lower blood pressure or treat depression, or where triggered by severe psycho-sexual problems, only during the Menopause is potency consistently decreased over several months or years.

Physical Symptoms – Fatigue, aches, pains and stiffness in the joints, nights sweats and other physical symptoms which are typical of the Menopause are usually absent in the Crisis.

Hormone Patterns – These are nearly always normal during the Crisis, unless there is deep depression or heavy drinking. Though total testosterone is often normal during the Menopause, the free, biologically active testosterone is typically decreased, as described in the next chapter. There are also often other more subtle markers of this condition to confirm the diagnosis which can be found by careful and extensive hormone profiles of the blood.

Responses to treatment – The treatment of the Crisis is mainly by councelling and support to help the person resolve the issues which are troubling them. Tranquillisers or antidepressants can occassionally be effective for short term treatment if anxiety or depression are overwhelming. However they can be addictive, and actually delay solving the problems which life has thrown up.

Dr Malcolm Carruthers is one of the very few UK based physicians who specialise in the diagnosis and treatment of testosterone deficiency. With a broad training in general and laboratory medicine, for the last twenty years he has specialised in Men’s Health, andrology, particularly treating the Andropause aka Male Menopause .

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