Is there really such a thing as the Manopause?
Hot flushes; insomnia; joint pains; loss of libido: for many women, the menopause is no fun. Why exactly women become infertile decades before they die is a much-debated mystery in evolutionary biology. Besides humans, the only other mammals whose females experience so early a menopause in the wild seem to be some species of whale.
But equal opportunity is the spirit of the age. These days health influencers, supplement companies and even some doctors talk about a male version of the menopause—variously called the 'manopause', 'andropause', or, for jargon-lovers, 'ADAM,' which stands for 'androgen deficiency in the ageing male'. Symptoms include a flagging libido, tiredness, shrinking muscles and growing body fat.
Do men really suffer from menopause, or something like it? On one level, obviously not. Menopause is defined by the end of a woman's menstrual periods, and therefore the loss of her ability to reproduce, usually by her early 50s. Men, by contrast, can stay fertile well into old age. (For instance, Al Pacino, an American actor, fathered a child at 83.)
In menopause, a woman's levels of the sex hormones oestrogen and progesterone fall sharply and suddenly. In most men levels of testosterone (the main male sex hormone) likewise start falling during middle age. But unlike in women there is no sudden drop. Levels decline gently, at a rate of around 1 per cent a year, and often stay within the normal range for a man's entire life.
Sometimes symptoms that might be ascribed to a 'manopause' may arise from the realities of middle-aged life. Tiredness is a common result of juggling work with family responsibilities. Flabbiness and atrophying muscles are the wages of years of sedentary office work and too little exercise.
On the other hand, some proportion of men do suffer from male hypogonadism, a medical condition in which the testicles do not produce as much testosterone as they should. Estimates of its prevalence vary widely: one review paper, published in 2020, cited one American study of ageing men that estimated 20 per cent of those in their 60s might be sufferers. But a separate European study put the figure for the same age group at just 3.2 per cent. The causes of hypogonadism are not always clear. But unlike the female menopause, it is not an inevitable consequence of ageing.
Menopausal women can be treated with hormone-replacement therapy (HRT). This aims to replace the missing sex hormones, and thus relieve unpleasant symptoms, using tablets or gels. Similarly, a growing number of men take testosterone-replacement therapy (TRT) to the same ends. Prescriptions have boomed in the past 20 years, though there is not yet a firm consensus on when men actually need it.
Still, testosterone—the original anabolic steroid—really is, in some ways, a fountain of youth. Men taking it will put on muscle, lose fat and recover faster from exercise (hence why taking testosterone is considered doping in most sports). The pros and cons of TRT are a subject for another article. But take care: side-effects can include baldness and, ironically, infertility. Add external testosterone and the body will compensate by making less. Reduced production in the testes can slow or even stop sperm production. By trying to relieve the symptoms of the supposed male menopause, men who take TRT risk replicating the defining feature of the female original.
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She was inducted into the Long Distance Running Hall of Fame in 1999. Nina Kuscsik, who campaigned for women's inclusion in long-distance running and then won the Boston Marathon the first year that they were officially allowed to race, has died aged 86. A funeral home notice said Kuscsik died June 8 of respiratory failure after a long battle with Alzheimer's disease. "Nina was more than a pioneer, determined women's running advocate, and celebrated icon within the sport," the Boston Athletic Association said in a social media post. "To us, she was a friend who will always be remembered for her kindness, joyful laugh and smile. "Nina held the distinct honour of winning the 1972 Boston Marathon, and recognised the platform that came with that triumphant moment, inspiring thousands of women to reach their own goals and finish lines in the decades since." Kuscsik graduated from high school at 16, studied nursing for two years and received her licence at 18 after petitioning to change a New York law that required nurses to be 21. She won state championships in speed skating, roller skating and cycling – all in the same year -- before turning to running when her bicycle broke. She ran the Boston Marathon four times from 1968-71 — before women were officially welcomed, a period retroactively recognised as the Pioneer Era — and then won the first official women's race in 1972. She was also the first woman to enter the New York race, in 1970, and was one of the "Six who Sat" – six women who refused to start the '72 New York City Marathon for 10 minutes to protest an Amateur Athletic Union rule that the women's race had to be separate from the men's. She won that year and the next year as well. She later served on AAU and USA Track and Field committees drafting rules for women's running. In addition to the more than 80 marathons she ran over her lifetime, Kuscsik set the American record for the 50-mile run in 1977 and won the Empire State Building Run-Up three straight years from 1979–81. She was inducted into the Long Distance Running Hall of Fame in 1999. Nina Kuscsik, who campaigned for women's inclusion in long-distance running and then won the Boston Marathon the first year that they were officially allowed to race, has died aged 86. A funeral home notice said Kuscsik died June 8 of respiratory failure after a long battle with Alzheimer's disease. "Nina was more than a pioneer, determined women's running advocate, and celebrated icon within the sport," the Boston Athletic Association said in a social media post. "To us, she was a friend who will always be remembered for her kindness, joyful laugh and smile. "Nina held the distinct honour of winning the 1972 Boston Marathon, and recognised the platform that came with that triumphant moment, inspiring thousands of women to reach their own goals and finish lines in the decades since." Kuscsik graduated from high school at 16, studied nursing for two years and received her licence at 18 after petitioning to change a New York law that required nurses to be 21. She won state championships in speed skating, roller skating and cycling – all in the same year -- before turning to running when her bicycle broke. She ran the Boston Marathon four times from 1968-71 — before women were officially welcomed, a period retroactively recognised as the Pioneer Era — and then won the first official women's race in 1972. 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"Nina was more than a pioneer, determined women's running advocate, and celebrated icon within the sport," the Boston Athletic Association said in a social media post. "To us, she was a friend who will always be remembered for her kindness, joyful laugh and smile. "Nina held the distinct honour of winning the 1972 Boston Marathon, and recognised the platform that came with that triumphant moment, inspiring thousands of women to reach their own goals and finish lines in the decades since." Kuscsik graduated from high school at 16, studied nursing for two years and received her licence at 18 after petitioning to change a New York law that required nurses to be 21. She won state championships in speed skating, roller skating and cycling – all in the same year -- before turning to running when her bicycle broke. She ran the Boston Marathon four times from 1968-71 — before women were officially welcomed, a period retroactively recognised as the Pioneer Era — and then won the first official women's race in 1972. She was also the first woman to enter the New York race, in 1970, and was one of the "Six who Sat" – six women who refused to start the '72 New York City Marathon for 10 minutes to protest an Amateur Athletic Union rule that the women's race had to be separate from the men's. She won that year and the next year as well. She later served on AAU and USA Track and Field committees drafting rules for women's running. In addition to the more than 80 marathons she ran over her lifetime, Kuscsik set the American record for the 50-mile run in 1977 and won the Empire State Building Run-Up three straight years from 1979–81. She was inducted into the Long Distance Running Hall of Fame in 1999.
