Although it isn’t as sharply defined as female menopause, male menopause is a catch-all for the gradual cascade of mental and physical health issues that men face as they approach and pass middle age and their testosterone drops. Wherever possible, I will insert “man” puns into the symptoms and conditions. Consider yourself warned.
Female menopause—as defined by the loss of fertility—happens to every woman no matter her genetics or lifestyle, dietary, or exercise choices. It’s a simple fact of human biology that women undergo menopause and the subsequent decline in sex hormones. They can certainly mitigate the negative symptoms with hormonal therapies, herbal concoctions, diet, and other means. Some will never experience any negative symptoms associated with the change. But a woman’s supply of eggs is finite. Fertility isn’t a lifelong state for women.
Not so with men. The health of an aging man entering “manopause” or male menopause depends almost entirely on the choices he makes, the food he eats (and how much of it), and the exercise he does or doesn’t do. This is liberating, but it’s also daunting: You can’t really complain if you aren’t doing anything about it. It’s all up to you. And even if it’s not up to you, acting as if it is gives you the best shot at countering the negative effects.
Today, I’m going to explore the most common changes that befall middle-aged men, why they happen, and what you can do to reduce their impact on your life.
They lose muscle: According to Harvard, after age 30, men begin losing about 3-5% of their muscle every 10 years. I’m a little skeptical of that notion—it sounds like one of those “facts” that people parrot without knowing the provenance—but it’s definitely true that and all else being equal, men lose strength as they age.
They lose energy: While the previous study found that age-related insulin resistance is more a function of age-related weight gain than chronological age itself, it did find that age was a strong predictor of reduced mitochondrial production of ATP.
Their bones get weaker: Middle aged men have a lower risk of osteoporosis than middle aged women, but it’s still an issue.
They suffer mojo deficiency: Getting hard gets harder.
They get anxious: It’s not one of the classic menopausal symptoms, but it’s common. The mid 40s to the early 50s is a strange time for men. There’s a lot at stake. Either you’ve “arrived,” and you’re worried about losing everything, or you’re still drifting, and you’re worried about ever achieving anything. When I was in my mid 40s, it was my anxiety about building a life I was truly proud of that got me to take a big risk and start Primal Nutrition (with almost nothing in the bank and a wife and two kids at home).
Anxiety is there. If you harness and use it as fuel for focus and purpose, anxiety can help you.
Consider this: If you’re 45 years old and you’ve spent the last twenty years getting 6 hours of sleep a night, sitting for 12 hours a day, and eating fast food five nights a week—all that damage is going to accumulate. Bad sleep compounds. Bad food compounds. A lack of exercise compounds. Part of the whole manopause thing is that middle age is when the body begins to really buckle under the weight of an unhealthy diet and lifestyle.
Lift heavy things twice a week. This will build muscle, strengthen bone, and improve depression.
Move around a lot at a slow pace. Long walks, hikes, easy runs/swims/cycling. Move as much as you can without making it an intense workout.
Sleep 8 hours a night. Start there and titrate up or down depending on your symptoms. But 8 is probably what you’ll need.
What About Testosterone?
Another major issue is low testosterone. As men approach middle-age, the testicles stop producing as much testosterone, and testosterone levels drop. The drop off is more gradual than a woman’s shift into menopause, but it’s a drop nonetheless.
Testosterone plays a mechanistic role in every single one of the symptoms or health conditions I listed above:
It helps you gain and maintain lean muscle mass. Testosterone activates the satellite cells that initiate muscle growth.
If you’re suffering from these issues and the healthy diet, exercise, and lifestyle measures aren’t working like they should, talk to your doctor about your testosterone testing and even testosterone replacement therapy. Get tested, get your blood work done, and see what’s going on.
Oh, and there’s one more common characteristic among middle aged men that could be causing problems: statins.
The Possible Role Of Statins?
About half of men over the age of 45 are taking statins. Now, I won’t get into the question of whether statins are advisable or even work. I’ve covered that territory before. I suggest you visit those posts. Suffice it to say, it’s a personal decision between you and your doctor based on a number of factors.
That said, statins undoubtedly contribute to many of the negative health effects associated with male menopause. They do, because they’re so good at what they do:
Statins lower cholesterol levels by inhibiting the HMG-CoA reductase, an enzyme that sits upstream of cholesterol synthesis. The problem is that many other important production pathways lie downstream of HMG-CoA reductase, too—not just cholesterol (although that’s also important). When we block HMG-CoA with statins, we impact the production of CoQ10, Vitamin K2, and even testosterone. Why do these compounds matter for middle-aged men?
Believe it or not, despite the studies and symptoms and correlations described in today’s post, there is plenty of hope to go around. All is not lost. The day can still be won. Your testicles, however middle-aged they may be, can still produce sperm and testosterone—and you can make the necessary lifestyle modifications to make it happen.
Mark Sisson is the founder of Mark’s Daily Apple, godfather to the Primal food and lifestyle movement, and the New York Times bestselling author of The Keto Reset Diet. His latest book is Keto for Life, where he discusses how he combines the keto diet with a Primal lifestyle for optimal health and longevity. Mark is the author of numerous other books as well, including The Primal Blueprint, which was credited with turbocharging the growth of the primal/paleo movement back in 2009. After spending three decades researching and educating folks on why food is the key component to achieving and maintaining optimal wellness, Mark launched Primal Kitchen, a real-food company that creates Primal/paleo, keto, and Whole30-friendly kitchen staples.