Menopause for Men? It's Not a Downhill Slide

Men, just like women, also go through a climacteric, though the form and degree of the transition differ. A climacteric is defined as the period of transition from the Reproductive Stage to the Non-reproductive Stage.

For women, it commonly includes the period from when menstrual cycles start becoming irregular until a few years after menopause. For men, it refers to the time around the age of 50 when various hormonal deficiencies in the body lead to a variety of symptoms.

The word Climacteric comes from the Greek word for 'ladder,' and it has come to signify the 'downhill path' of life.

If we were to use the metaphor of an apple tree for a person's life, the climacteric would be likened to the cold wind of late autumn. In the spring, delicate green leaves sprout. The tree then thrives in the summer, producing a lush, deep green canopy and beautiful blossoms. In the autumn, it bears its fruit, and in the winter, it sheds its brilliant exterior, gathering its energy back into its roots.

The climacteric is not a period of decline but the chilly late-autumn wind that signals this final, reflective season of life.

The symptoms of male climacteric syndrome often have many similarities to those experienced by women.

Physical Symptoms

• Urinary & Reproductive: Decreased libido, erectile dysfunction, and scrotal sweating may occur. Urinary symptoms such as frequent urination, a weak stream, the sensation of incomplete bladder emptying, and nocturia (waking at night to urinate) are also common.

• General Health: Fatigue, digestive issues, and loss of appetite can develop.

• Musculoskeletal & Circulatory: Circulatory disorders like dizziness, hot flashes, and heart palpitations may arise. Musculoskeletal issues such as frozen shoulder, low back pain, and osteoporosis can also occur.

Psychological Symptoms

Feelings of emptiness and a sense of disillusionment can lead to psychoneurotic symptoms like depression, irritability, and a loss of concentration.

Key Differences Between Andropause and Menopause

A major difference between male and female climacteric is the pace of the hormonal changes. Unlike female menopause, which is characterized by a rapid decrease in hormones, male andropause progresses slowly.

For women, menopause marks a rapid decline in ovarian function, leading to a sharp drop in estrogen. In men, however, there is no abrupt fall in male hormones, as both hormone levels and sperm production decrease gradually over time.

Furthermore, another key distinction lies in their prevalence: while female menopause occurs in almost all women, male andropause only appears in a smaller proportion of men.

This is also mentioned in the ancient medical classic, The Yellow Emperor's Classic of Medicine (황제내경, 黃帝內經)- Suwen (소문, 素問).

At age eight, a man's Kidney energy becomes strong, his hair grows long, and his teeth are replaced. At sixteen, his Kidney energy flourishes, his essence (Jing) overflows, and he gains the ability to reproduce. From age twenty-four, his Kidney energy is harmonized, and his bones and muscles become firm. From thirty-two, his bones and muscles are at their peak and his physique fills out. At forty, the Kidney energy begins to decline, his hair starts to fall out, and his teeth begin to decay. At forty-eight, his face becomes haggard, and his hair turns white. At fifty-six, his Liver energy declines, making it difficult to move his muscles. His essence is depleted, and his Kidney energy is weakened, leading to physical frailty. At sixty-four, his teeth and hair fall out.

From the age of forty, men can genuinely feel that their bodies are not what they once were. This is a significant observation, especially since the 40s are typically a time when men are deeply engaged in their careers and experiencing a great sense of achievement.

This paradox reveals that a time of outward flourishing often coincides with a period when the inner self begins to weaken. Ancient wisdom referred to a man's 42nd year as a "Great Misfortune" (대액, 大厄), likely because from this point forward, the body starts to show signs of illness and a person experiences considerable physical and mental struggles.

By moving through this phase and the subsequent climacteric years in their 50s and 60s, a person gradually matures and forges a more profound and well-rounded life.

The process described here illustrates how a person is born, gradually accumulates blood and qi (life force) to fill their body as they mature, and then, upon reaching a certain milestone, begins to return that accumulated energy to the natural world, gradually diminishing themselves.

This is not just true for the human body but also for one's work. We spend a great deal of time accumulating wealth, knowledge, people, and desires. However, once a certain period passes, we inevitably start to focus our energy on giving back to society, teaching others, and leaving a legacy.

Perhaps by simply understanding the process of our own lives, we can achieve enlightenment.