The biggest problem with the term ‘male menopause’ is that works too well, as an umbrella term for middle-aged ennui and loss of confidence.

It gives men something to hang on to as they wonder where the man-boobs or mood swings came from. Or where their sex drive, erections and enthusiasm for living disappeared to.

It’s selling both men and women short to lump their change of life symptoms together. Because there are completely different processes going on.

What confuses the issue is that both men and women can haver similar symptoms, but they haver them for different reasons.

What happens with women

For a woman, menopause is the end of her reproductive life. It’s said to have occurred when a women has not had a period for 12 months.

This can happen to some women as early as their 30s. Mostly, though, it occurs, on average, at about age 52.

Leading up to this is a drawn-out transition phase called perimenopause that typically lasts six years, but can last up to 12 years.

Many of the symptoms associated with menopause tend to occur during this transition phase, when oestrogen levels fluctuate and periods become irregular, longer, heavier and fewer.

These symptoms include:

•  Hot flushes. Hot flushes are the most common symptom of menopause, affecting about 75 per cent of all women. These flushes are caused by sudden, brief increases in body temperature. These usually start before a woman’s last period.
• Insomnia.
• Night sweats.
• Palpitations.
• Headaches.
• Vaginal dryness and thinning of the vaginal wall.
• Breast tenderness.
• Acne break-outs.
• Mood swings.

While perimenopause is drawn out, there is a suddenly component: about six months before menopause, estrogen levels drop significantly.

This drop triggers the typical symptoms of vaginal dryness and hot flushes. These can last from half a year to more than five years after onset of menopause.

Some research implicates menopause as a cause of Alzheimer’s, and is thought to explain why twice as many women develop Alzheimer’s than men. See our report here.

A 2019 study suggests that some menopausal women who experience night sweats will sleep longer overall – and this, in turn, appears to lead to a decline in prefrontal cortex cognitive functions like memory and executive function and otherwise thinking straight.

It’s this that causes ‘brain fog’ that some women report.

In men, a slower decline

Okay. Many men in their 40s and 50s report symptoms that are similar to those suffered by middle-aged women. But in the main, these symptoms aren’t caused by hormonal changes.

Yes, as men age, there is a decline in the male sex hormone, testosterone. But it happens gradually, usually less than one per cent a year, beginning from the age of 30 to 40.

Less common – only seen in six per cent of adult men under 80 – are chronically low levels of testosterone, according to a helpful piece from The Conversation.

These chronically low levels of testosterone are known as androgen deficiency. This may result “from accidents affecting their testes, experiencing severe illness, or treatment for prostate cancer”.

However, the natural drop in testosterone – that one per cent a year decline – “can be worsened by obesity, extreme stress and some medications or diseases, including drinking too much alcohol”.

So the ‘androgen deficiency’ you’re worried about, The Conversation authors say, is probably more of a lifestyle symptom and therefore should be tackled as such.

The symptoms of middle-age ennui

When some mean reach their late 40s to early 50s, they develop depression, loss of sex drive, erectile dysfunction, and emotional symptoms.

Other symptoms common in men this age are:

• Mood swings and irritability.
• Loss of muscle mass and reduced ability to exercise.
• Fat redistribution, such as developing a large belly or “man boobs” (gynaecomastia). These tend to be caused by a chronic loss of testosterone.
• A general lack of enthusiasm or energy difficulty sleeping (insomnia) or increased tiredness.
• Poor concentration and short-term memory

Men being men, we’ll tend to focus on the lack of sex drive and erectile dysfunction as the main issue. And we’ll hope that testosterone therapy will help. And it might somewhat (the research is mixed) if low testosterone is the problem.

The real answer here is to have a detailed conversation with your GP.

The numbers don’t add up

Erection problems affect around two in every three males over the age of 45 years. Meaning, they have occasional to frequent difficulty is getting or maintain an erection.

More than one in every 10 males cannot have erections at all. The problem is more common as you age.

But, as mentioned above, only six per cent of men have chronically low testosterone.

Hence, please accept that your unreliable sexual performance may be caused by an underlying medical problem, medication side effect, lack of exercise or excessive alcohol use. Or mental health struggles, such an depression or anxiety.

The sooner you have that conversation, the sooner your mood will improve, along with your mighty efforts in the sack.