Observations Medicine and the Media

Men and midlife crises

BMJ 2010; 341 doi: http://dx.doi.org/10.1136/bmj.c5661 (Published 10 November 2010) Cite this as: BMJ 2010;341:c5661
  1. Margaret McCartney, general practitioner, Glasgow
  1. margaretmccartney{at}doctors.org.uk

Press reporting on the male menopause focuses on its underdiagnosis, reports Margaret McCartney, but is the “andropause” just another case of unnecessary medicalisation?

The “male menopause” is mainstream. The Channel 4 television show Embarrassing Bodies recently investigated the topic, often nicknamed the “andropause.” But instead of asking the pertinent question of whether this contentious diagnosis were fact or fiction, the medical presenters focused instead on the current alleged problem of underdiagnosis.

“There is a condition in males called the ‘andropause,’ where your testosterone levels start to dip . . . which can be treated so easily,” said the presenter, Pixie McKenna, a general practitioner. Forty five per cent of men in their 60s experience it, with symptoms of irritability and low sex drive, says the programme, and the best treatment is testosterone.

Advertisements from the drug company Schering-Plough claim that past the age of 30 men’s testosterone concentrations drop by 10% a decade. Its website on andropause (www.andropause.com) suggests that not many doctors think of andropause when considering vague symptoms and invites readers to an online quiz. There, if you admit to having a lack of energy, feeling more grumpy than usual, and being less good at playing sports, and if you tend to fall asleep after dinner, then you merit testosterone testing, which can lead to treatment that “is shown to be highly effective at relieving andropausal symptoms, usually within 3 to 6 weeks. …

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