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Male menopause

 
, medical expert
Last reviewed: 04.07.2025
 
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Male menopause is not a myth, it is a reality and every man who lives to old age goes through it.

In this article we will attempt to examine this physiological process in more detail.

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Causes male menopause

Male menopause develops as a result of the physiological decline of all functions of the male body as a result of aging. Every man will have to go through this period. A number of factors can accelerate the onset of menopause:

  • Hormonal disorders.
  • Various types of trauma have been suffered, affecting both the male reproductive area and the hypothalamus region.
  • Chronic or acute infectious diseases.
  • Surgery performed on the testicles or in the hypothalamus area.
  • Radioactive exposure.
  • Stress, nervous exhaustion of the body.
  • Long-term use of a number of medications. For example, uncontrolled use of antibiotics.
  • Hypodynamia, a consequence of sedentary work.
  • Diabetes mellitus.
  • Persistent high blood pressure.
  • Chronic alcoholism.
  • Atherosclerosis.
  • Irregularity of sexual life.
  • Inflammatory diseases of the genitourinary organs.
  • Promiscuous sex life.
  • Benign and malignant neoplasms of the testicles or hypothalamic-pituitary system.

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Pathogenesis

As with women, men, on average, by the age of 40-45 begin to undergo a restructuring of the body associated with changes occurring with the fading of the functions of the hypothalamus and pituitary gland, disruption of the biological feedback with the testicles, as a result of which a progressive decrease in the level of testosterone in the blood is noted. The tissue of the testicles is gradually replaced by fat cells, and senile atrophy of the testicles occurs.

When testosterone levels in the body decrease, an imbalance occurs in the systemic functioning of the reproductive organs and endocrine glands, which leads to a decrease in libido and metabolic disorders.

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Symptoms male menopause

Endocrinologists can identify the following main symptoms of male menopause:

  • The appearance of "hot flashes": a rapid influx of blood flow to the face and head (less often to the lower extremities), expressed in reddening of the skin in these areas.
  • After intense physical or emotional work, a man may feel dizzy.
  • The appearance of "butterflies" before the eyes.
  • Erectile dysfunction (decreased libido, even impotence).
  • The appearance of causeless headaches that can last for several days in a row.
  • Tinnitus.
  • Persistent high blood pressure or sudden changes in blood pressure.
  • Urinary incontinence. Up to 45% of men suffer from this problem during this period.
  • Decreased sperm production.
  • Premature ejaculation (faster release of semen during intercourse).
  • Increased sweating.
  • Frequent urination.
  • The emergence of sleep problems.
  • A possible manifestation of the female type of development is an enlargement of the mammary glands (gynecomastia).
  • The appearance of heaviness in the lower abdomen.
  • Increased fat deposits in the female pattern: buttocks and thighs.
  • The skin loses its elasticity and firmness, becoming flabby. The same applies to muscle tissue.
  • Increased irritability.
  • Numbness of the upper and lower extremities, the appearance of a tingling sensation in them.
  • The functioning of the cardiovascular system is disrupted. Arrhythmia appears.
  • Rapid fatigue.
  • The appearance of shortness of breath.
  • Memory impairment and distraction.
  • The emergence of suspiciousness about one's health.
  • Indifference to others and the surrounding world.
  • Low self-esteem.

But it is worth reassuring men that such symptoms are temporary. This process is strictly individual: for some, this transition takes a couple of years, and for others, five.

More pronounced symptoms appear in patients with an unstable nervous system, in those who lead a sedentary lifestyle and/or have a history of chronic diseases.

First signs

The very first signs of approaching menopause in men in most cases are:

  1. Rapid fatigue even with minor loads. The appearance of shortness of breath and general weakness.
  2. Frequent urge to urinate. However, the urine stream is weak. Enuresis (bedwetting) may occur.
  3. The emergence of emotional instability, frequent depressive states, increased irritability, sometimes unfounded.
  4. The emergence of problems with sexual life.

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Mental disorders in male menopause

Due to its higher psychological stability, male menopause is less often accompanied by neuralgic disorders, but this does not mean that these manifestations are completely absent.

Symptoms of mental disorder during male menopause include the following facts:

  • Progressive neurasthenia. Emotional instability, manifested by a sharp change in mood from excessive cheerfulness to increased irritability. There is a depressive state.
  • The emergence of sleep problems. A person has difficulty falling asleep in the evening, he often wakes up during the night.
  • The man begins to feel a rapid decline in strength even after minor physical exertion.
  • Memory problems are observed.
  • Some of the stronger half lose interest in their once beloved work, family, and sometimes even in life (“everyone is bad and no one understands”).
  • At this time, a wife or girlfriend may observe increased, sometimes groundless, attacks of jealousy in her man. A feeling of doom appears.
  • It is during this period that statistics show a surge in divorces. Men, clinging to their fading youth, leave their families, going off to a younger lover or throwing themselves into "all-out violence."

This is exactly the condition men are commonly referred to as: “gray hair in the beard, devil in the ribs.”

Early male menopause

The following factors can trigger the development of early male menopause:

  • Inflammatory diseases occurring in the male genital area and pelvic region.
  • Impaired blood circulation in the genital area, including the testicles.
  • Inflammatory processes affecting the hypothalamic region.
  • Radiation exposure.
  • Chronic alcoholism.
  • A surgical procedure that resulted in the removal of the testicles.
  • General intoxication of the body.
  • Irregular sexual life.

If you consult a doctor - andrologist or endocrinologist - in a timely manner, you can stop the aging of the male body and improve its general condition.

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Complications and consequences

The consequences of this period are frequent colds and infectious diseases, which indicates a decrease in the body's immune forces.

The following complications may arise during male menopause:

  1. Disruption of the cardiovascular system increases the likelihood of developing coronary heart disease, including unstable angina and myocardial infarction.
  2. Disturbances in the vascular system and changes in blood flow in the brain contribute to the occurrence of hemorrhage – stroke.
  3. Development of Alzheimer's disease
  4. Development of malignant neoplasms of the genitourinary system (testicular cancer, prostate cancer, etc.).
  5. The emergence of psychosomatic diseases.

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Diagnostics male menopause

Diagnosis of male menopause begins with an analysis of the patient's complaints.

  • A man's complaints.
  • Examination of the patient.
  • Conducting laboratory tests:
  • Conducting additional instrumental studies:
    • Ultrasound examination of the prostate gland and bladder.
    • Conducting an electrocardiogram and echocardiography.
    • Magnetic resonance imaging of the brain.
  • Differential diagnostics.

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Tests

A geriatrician and a urologist may order the following tests:

  • Urine analysis.
  • Complete blood count.
  • Immunogram.
  • Tests for tumor markers (blood test for prostate-specific antigen (PSA)).
  • Biochemical blood test.

Instrumental diagnostics

Instrumental diagnostics are the most informative and highly accurate research methods. In this case, the following is prescribed:

  • Ultrasound examination of the pelvic organs, prostate gland, kidneys.
  • Electrocardiogram.
  • Ultrasound examination of the thyroid gland.
  • Conducting magnetic resonance imaging of the brain. In this case, the attending physician is interested in the pituitary gland area.
  • Other examinations if necessary.

Differential diagnosis

Male menopause is differentiated from all diseases that can develop in isolation from male menopause:

  • Depressive disorders.
  • Sleep disorders.
  • Prostate cancer.
  • Urinary incontinence.
  • Endocrinological diseases caused by pathology of the pituitary gland and hypothalamus.

Treatment male menopause

To treat male menopause, you need to seek help from a doctor - an andrologist, and it would not be superfluous to consult other specialists: an endocrinologist, urologist, cardiologist and other related specialists.

The essence of a comprehensive approach to the treatment of male menopause:

  • Psychological aspect of treatment. If necessary, a professional psychologist works with the patient.
  • Medicinal assistance depending on the symptoms may include hormonal supportive drugs (correction of hormonal disorders), biogenic adaptogens, immunomodulators, sedatives and antispasmodics. In case of severe depression of the patient, antidepressants may be prescribed. It is possible to use medicinal herbs.
  • Adequate physical activity with adequate rest.
  • Physiotherapy treatment.
  • Auto-training also shows good results with the right approach.
  • Adjustment of diet and eating regimen.

If a man has already been diagnosed with complications, for example, in the form of ischemic heart disease, then treatment is carried out with special cardiac drugs. Prevention of the development of Alzheimer's disease.

Testosterone-containing pharmacological agents will help normalize a man’s hormonal background.

Medicines

Medicines used to treat male menopause are replacement therapy or therapy that eliminates the symptoms of male menopause.

Pharmacological agents are prescribed to the patient only in case of pathological manifestation of menopause.

To relieve a patient's deep depressive state, the attending physician prescribes antidepressant drugs to the patient. These may be: pirozidol, vero-amitropilin, miansan, befol, gidifen, bioxetine, deprenone, trazodone, mianserin, nialamide, efectin, triprizole and others.

The drug that relieves depression, triprizole, is introduced into the treatment protocol only in severe cases, as it has a broad spectrum of action and a large list of side effects that may occur when taking it.

It is prescribed with a starting dosage of 0.025 to 0.050 g. It is recommended that the patient take triprizole orally immediately before bedtime, with a small amount of water. Do not crush the tablet. To reduce irritation of the mucous membrane of the digestive tract, doctors recommend taking the drug immediately after meals.

If necessary, the dosage can be increased to 0.15 - 0.2 g daily, divided into three doses. The duration of treatment is prescribed by the doctor individually, but this period can be up to three months.

Contraindications to the prescription of the drug in question are increased individual sensitivity to one or more components of the pharmacological agent, as well as if the patient has a history of myocardial infarction, acute alcohol intoxication, severe cardiac pathology, closed-angle glaucoma, and a number of others.

If depression is not so pronounced, mild sedatives may be prescribed: Novo-Passit, Valerian, Allapinin, Myolastan, Agri, Sibazon, Mint tablets, Barboval, Nitrazepam, Amitriptyline, Validol, Diphenhydramine, Siduxen, Phenazepam, Flormidal and many others.

Novo-passit is taken orally, one tablet three times a day. It is better to take the medicine before meals. If there is a medical need, the dosage of the medicine can be doubled.

The drug in question should not be prescribed to a patient if he or she has an increased individual sensitivity to one or more components of Novo-Passit.

Barboval is taken orally with a sufficient amount of liquid in a dose of 30 to 50 ml. The duration of drug therapy is ten to fifteen days. If necessary, the course can be repeated.

The drug is not approved for use only in case of hypersensitivity to the components of the drug.

Depending on the test results, hormone replacement therapy may be prescribed. Testosterone-containing drugs may be prescribed: Nuvir, Testosterone, Andriol, Testosterone Propionate.

Methyltestosterone-containing drugs may be prescribed: methyltestosterone and methyltestosterone-NS.

Sustanon and Durandron may be prescribed.

The hormonal drug testosterone is prescribed by the attending physician in a strictly individual dosage. It depends on the level of deficiency of this hormone in the man's body. Initially, this can be a dose of 25 ml, taken twice or three times a day. The duration of the therapeutic course is from one to two months.

Contraindications to this drug include increased individual intolerance to one or more components of the drug, as well as if the patient has a history of kidney disease, hypertrophy or prostate cancer, diabetes, severe liver dysfunction, etc.

In case of weakened erection, biogenic adaptogens are prescribed: amrit, ginrozin, immunal, lucram, gerbion echinacea, rhodascon, panaxel and others.

Immunal is taken one tablet three to four times throughout the day.

Contraindications for this drug include individual intolerance to one or more components of the drug, as well as if the patient has a history of HIV infection, autoimmune pathologies, multiple sclerosis, blood disease, tuberculosis.

When pain occurs, the patient receives one of the painkillers: Nurofen, Spazmalgol, Apizartron, Amidopyrine, Diclofenacol, Spazmalgin, Feloran, Influnet, Paracetamol and a number of others.

Paracetamol is prescribed to the patient in a dosage of one to two tablets two to four times a day, but the daily amount of the drug taken should not exceed 4 g.

Contraindications to taking paracetamol include severe kidney and/or liver dysfunction, alcoholism, anemia, and hypersensitivity to the components of the drug.

Folk remedies

Traditional medicine methods can reduce the negative effects of the climacteric period in men. They will improve immunity, effectively fight infections, relieve pain, normalize blood pressure, and lead to regression of the inflammatory process.

But folk remedies can only be used with the permission of the attending physician, since if used without justification, they can cause more harm than cure.

Basically, in medicinal recipes used for the problem under consideration, single herbs or collections of them are used.

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Herbal treatment

Here are a number of herbal treatment recipes that can help alleviate or reduce the intensity of symptoms that occur during male menopause.

Recipe #1

  1. 30 g of plant material, which is shepherd's purse, steam in 200 ml of just boiled water.
  2. Leave for an hour, then strain.
  3. Drink half a glass three times throughout the day.

This infusion can be taken both at the onset of menopause and as a preventative measure to prevent the development of negative symptoms associated with the onset of male menopause.

Recipe #2

  1. Collect hawthorn flowers. To prepare the infusion, you will need three tablespoons of raw material, which are placed in a container.
  2. 600 ml of raw water at room temperature is poured on top.
  3. Place in a dark place and forget about it for eight to ten hours.
  4. After the time has elapsed, place on the fire and leave for no more than seven minutes from the moment it boils.
  5. Wrap the container with the “medicine” and let it sit for about half an hour.
  6. Strain and take 200 ml before the first meal; for the rest of the day, it will be more effective to take it after meals.

This decoction reduces the intensity of climacteric symptoms.

Recipe #3

  1. St. John's wort has also proven itself well; 15 g of it is enough for this recipe.
  2. Mix the herbal raw material with a glass of water and place in a water bath. From the moment the water boils, keep it under the lid for a quarter of an hour.
  3. Set aside and let stand for another 45 minutes. Strain.
  4. Drink one tablespoon, six times a day.

Relieves menopausal symptoms.

Recipe #4

  1. In this case, you first need to collect the following mixture: blackberry leaf - 25 g, motherwort herb - 20 g, sweet woodruff - 20 g, marsh cudweed - 15 g, hawthorn flowers - 10 g. Place all ingredients in one container, chop and mix thoroughly.
  2. You need one tablespoon of the herbal mixture, poured with a glass of boiling water.
  3. Wrap and leave for an hour.
  4. Strain and drink as tea throughout the day.

It is enough to drink this medicinal mixture for ten days for a man to feel significantly better.

Homeopathy

When men enter menopause, homeopathy can offer the following medications:
Testis compositum is recommended to be taken according to one of the following regimens:

  • 2.2 ml (once) in two to three doses during the week.
  • In case of exacerbation of the situation, this amount should be taken daily for three days. Then 2.2 ml (once) in two or three doses during the week.

Contraindications for taking Testis compositum include only increased individual sensitivity of the patient's body to one or more components of the drug.

The analogues of the drug under consideration are impluvin, tetracin calcium, ginseng, tetlong-250, cordyceps extract, ginkgo biloba, silenium, tetraspan, and new homeopathic medicines appear every day.

Diet for male menopause

A diet for male menopause will help you get through the “difficult period” more easily:

  • A good source that stimulates the production of male hormones is fish and seafood. Crustaceans and mollusks occupy a special place here.
  • A man's diet should definitely include a sufficient amount of fruit. They should be consumed raw. Give preference to fruits of green, yellow or orange shades. Such gifts of nature are rich in luteins, which, along with testosterone, also activates the production of growth hormone.
  • Some vegetables should also be taken without heat treatment. Number one on this list is pumpkin. No man should ignore it. You should also remember zucchini (a storehouse of sodium), yellow pepper, eggplant, all green varieties of cabbage (a source of indole-3-carbinol), celery and avocado (the most powerful biologically active vegetables, activate the production of androsterone), all greens.
  • Berries. The most useful in this regard are: watermelon, blueberries, cherries, pomegranate, raspberries, strawberries, cranberries, black currants.
  • One should not forget about grain porridges. Here rice grains come first, followed by pearl barley, buckwheat, millet (coarse porridges with a high fiber content).
  • Spices, of which there is a great variety today, have also proven themselves to be excellent. In our case, the most acceptable are onions, cardamom, curry, turmeric, capsicum and garlic.
  • Various types of vegetable oil also help to activate the production of male sex hormones. The most effective are walnut, sesame and olive oils.
  • Chocolate, coffee, bee products, and walnuts are good for restoring libido.
  • It is necessary to reduce the consumption of salts, carbohydrates, smoked foods, fast food and semi-finished products.
  • Dry red wine in small doses.

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Prevention

Timely prevention will help prevent or alleviate emerging pathological symptoms. Experts recommend:

  • Review your diet and compare it with the recommendations of nutritionists.
  • It is necessary to undergo timely and complete therapy for inflammatory and infectious diseases.
  • Lead a healthy lifestyle, give up bad habits.
  • Avoid stressful situations.
  • Monitor your weight, avoiding either sudden weight loss or gaining extra pounds.
  • Have regular sexual intercourse.
  • Avoid contact with epidemiologically unsafe social groups.
  • Be selective in choosing a partner, preferably one at a time, this will reduce the risk of catching serious sexually transmitted diseases.
  • Avoid taking medications without medical supervision, especially antibiotics.
  • Active lifestyle, outdoor recreation.
  • Playing sports.
  • Moderate loads should be alternated with adequate rest.
  • Visit your doctor regularly for preventive examinations.
  • When the first signs of menopause appear, it would be a good idea to consult a specialist.
  • Wearing underwear that restricts movement is unacceptable.

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Forecast

It should be immediately remembered that male menopause is not a disease, but a natural physiological process of restructuring the body. Therefore, the prognosis for the period in question is quite favorable.

Many men do not even admit the thought that they may have menopause, writing this fact off as a woman's fate. But if a person understands the problem, he is not always ready to share it even with a doctor, which is fundamentally wrong. Male menopause can be experienced in different ways: independently with severe pathological symptoms or with the assistance of a qualified doctor, leading a normal, full life. It's up to you to choose! But isn't a quality life worth putting in a little more effort to make it come true?

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