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Last updated November 5, 2017, originally published January 4, 2015
By L. Carr, Contributing Columnist

Is male menopause real? Do guys go through physical, emotional and
psychological changes as they age – do they suffer the manopause?
Many experts believe that the so-called manopause is not just the
equivalent of “man-flu” – an overblown reaction to certain health
conditions – but something completely genuine and problematic.

Up to five million men in the US are affected by manopause, say
researchers at Northwestern Memorial Hospital, but the actual number
is probably much higher as most men suffer in silence. It seems women
are not the only ones suffering from declining hormone levels and
associated physical and mental ailments as they age. Men are affected,
too. But how? And what can you do about your symptoms if you too
are going through the manopause?

What Is the Manopause?

The manopause is not as clearly defined as the female menopause,
when a woman experiences a drop in estrogen levels that causes
menstrual periods to stop and puts an end to her ability to get
pregnant. Men do, however, suffer the effects of a decline in another
hormone – testosterone.

Unlike menopause in women, the levels of hormones in men drop
slowly and hormone production does not stop completely, leading some
scholars to question whether "manopause" exists at all.

In fact, a 2014 study from the University of St Andrews and the
University of Edinburgh, UK, found that as men age there is variance in
their levels of testosterone but no proven decline.

This study found that the average levels of testosterone in men peak at
15 nmol/L at age of 19, then declines to an average of 13 nmol/L by
age 40. But after age 40, they found no evidence of a marked
consistent decline. ]

However, certain hormonal changes in men can bring about signs and
symptoms which are often referred to as the manopause, male
menopause, andropause, or hypogonadism.

What Are The Symptoms of Manopause?

Scientists from the University of Manchester, Imperial College London,
and UCL (University College London), UK identified in 2010 the
collection of symptoms that make up the male menopause.

The researchers looked at a population of 3,369 men aged between 40
and 79 who completed questionnaires about their health. They also
gave blood samples.

The scientists found that out of 32 possible symptoms, only nine were
significantly linked to low testosterone and manopause.

The most striking symptoms of manopause were

  • decreased frequency of sexual thoughts (sex drive), and

Other symptoms linked to low testosterone and the manopause are

  • inability to walk more than 1km (a little more than half a mile)

  • lack of ability to take part in vigorous activity

  • lack of ability to bend and kneel

  • loss of energy

  • depression, and

  • fatigue.

Some men may suffer sleep disturbances, increased body fat, reduced
muscle strength, a decrease in bone density, enlarged breasts, loss of
body hair, hot flashes, fuzzy thinking, excessive sweating, difficulty
concentrating, or a lack of self-confidence.

However, many of these symptoms affect men at all ages, regardless of
testosterone levels or whether they are going through the manopause,
which is why it is often difficult to arrive at a diagnosis of “male

What Causes the Manopause?

When a man hits 30, his testosterone levels drop steadily by a small
amount – around 1 percent each year. It is said that declining levels of
testosterone play a part in creating the male menopause symptoms that
millions of men experience. However, it seems that testosterone is not
the only culprit. (Read more about the alarming
decrease in
testosterone levels around the world.)

The British Association of Urological Surgeons says manopause tends
to affect mainly older men who have low testosterone levels but also
heart disease, hypertension, diabetes, and obesity.

This means that several different factors may combine to create the

Other underlying issues like stress, smoking, lack of exercise, and sleep
deprivation can also affect men’s experience of the manopause.
Other researchers, such as scientists at the Massachusetts General
Hospital in 2013, believe that the manopause could be caused not by a
lack of testosterone but actually a drop in estrogen.

Late-onset hypogonadism, where the testes produce few or no
hormones, may cause the manopause.

Testosterone replacement therapy is used by men who are going
through the manopause with low testosterone levels. But there are
other ways you can boost your sex drive, increase your vitality,
concentration, and strength as you reach a certain age.

We looked at the available scientific evidence to find out how to fight
the symptoms of manopause.

Lose Weight and Fight Manopause

The results of a 2012 study from St. Vincent's University Hospital,
Dublin show that weight loss can boost testosterone levels in middle-
aged men going through the manopause and suffering also from
prediabetes – by over 50 percent. The researchers looked at more than
900 middle-aged men and found one in four had low testosterone

What they found was that losing weight boosts testosterone. In fact,
the incidence of  low testosterone dropped from 20 percent to 11
percent in the group of men who took part in physical activity and lost
weight through lifestyle changes.

Losing weight reduces waist size, increases energy and stamina, and
also helps boost self-esteem -- crucial for this stage of life that men
pass through.

Take Tribulus Terrestris as a Manopause Cure

Tribulus terrestris is also known as puncture vine and it is a traditional
medicine used in China and India.

Experts claim that tribulus raises levels of testosterone and can help
treat manopause symptoms. Research in the 1980s from Bulgaria
seems to suggest that this is the case, although there have not been
any large studies completed recently into the effectiveness of the herb.

Does Maca Work to Control Symptoms of Manopause?

Maca, a traditional Peruvian root vegetable, is used as food and
medicine. In the past, maca was used to increase energy and enhance
sex drive in men.

However, be careful. Recent research suggests caution be used before
maca becomes a manopause treatment of choice. A 2003 study from
the Universidad Peruana Cayetano Heredia, Lima, Peru reports that
maca does not affect testosterone levels in men.

Oat Straw for Manopause?

Green oats, wild oat extract, and oat straw are all names for the
products made from unripe oat straw from the oat plant.

Many claim that oat straw works to reduce symptoms of manopause by
increasing the amount of free testosterone in the blood. However,
research needs to be conducted into the effectiveness of oat straw
before these popular claims can be substantiated.

Treat the Manopause with Horny Goat Weed

It sounds crazy, but the herb popularly known as "horny goat weed" –
because traditional wisdom states that goats that ate the herb became
strangely sexually active – is used to treat symptoms of aging and
sexual dysfunction in men. A 1989 article by Chinese scientists Kuang
AK, Chen JL, Chen MD claims the herb increases testosterone levels but
further research is needed.

Exercise to Fight Manopause Symptoms

If using an herb called horny goat weed sounds like too much folklore
and not enough science, consider one key way you can help beat
symptoms of low testosterone, manopause, or andropause – exercise.

But make sure that exercise becomes a habit as a one-off session at the
gym will not result in any increase in testosterone or changes in your
emotional state, according to researchers at the University of Southern

Complete your strength training workout in the evening as this seems
to have a bigger effect on testosterone, use more muscles, have
shorter rest periods, and lift heavier weights rather than doing lots of
lighter reps in order to have the greatest effect on testosterone.

Carnitine Helps Treat the Symptoms of Manopause

Carnitine is a nutrient that your body uses to transform fat into energy.
Carnitine supplements are said to help improve male sexual function as
well as symptoms of male aging such as depression and fatigue. A 2004
study from the Headquarters of Società Italiana di Studi di Medicina
della Riproduzione, Bologna, Italy compared carnitine to testosterone
for treating male aging symptoms and found that both improved mood,
fatigue, and erectile function.

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Strength training helps to
decrease symptoms of
manopause, studies show.
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