The male menopause is a myth and men who claim to suffer from it may simply be overweight or drinking too much, new research suggests.
A study of 1,700 men, the largest so far, has concluded that "there is simply no support" for the existence of the condition. The finding by Professor John McKinlay of the New England Research Institute has sparked a furious debate between British doctors.
The male menopause has been the subject of controversy since it was first described in the 1930s. Proponents of the condition prefer to call it the andropause, due to the androgen hormone deficiency that men suffer in mid-life. "Believers" claim that up to half of men over 50 and two thirds of those over 60 suffer from the andropause.
They say that a drop in men's testosterone levels as they age causes them to suffer the same symptoms as menopausal women, such as loss of libido, night sweats, aching muscles and depression. Testosterone replacement patches, implants and pills for men, similar to the oestrogen versions for women, are being prescribed on the NHS.
Professor McKinlay's research is part of his Massachusetts Male Ageing Study, and was presented at the annual meeting of the British Fertility Society yesterday.
He said that whereas women's oestrogen levels fell rapidly when they reached middle age, male testosterone levels dropped at a much slower rate of about 0.5 per cent a year. This slow reduction meant that the sudden onset of symptoms such as aching joints and night sweats could not be blamed on hormones.
But weight gain and alcohol consumption did contribute to hormone reductions. "Men who put on weight will have a fall in testosterone levels," Professor McKinlay said. "What they need to do is go on a diet and increase physical activity, not be treated with a patch. We are medicalising lifestyle problems and the natural process of ageing."
He concluded: "Unlike hormone changes in middle-aged women, male hormones decline quite gradually with age and there is simply no empirical support for a syndrome."
Professor McKinlay also attacked "pseudoscientists" and drug companies which, he claimed, were misrepresenting scientific data to publicise the condition and cash in by making treatments for it. The latest product to hit the male menopause market in the UK is Testogel, made by the pharmaceutical giant Schering. It is an alcohol-based gel, enriched with testosterone, which is absorbed into the skin. Treatments cost up to £600 a year.
Professor McKinlay said: "Testosterone replacement therapy is a drug in search of a condition. The pharmaceutical sales for these products are greater than the GDP of some countries, but the simple fact is, they don't do any good.
"I could do someone as much good by slapping them on the shoulder."
A strong lobby of doctors insists, though, that the condition is real. Dr Malcolm Carruthers, a men's health expert, said: "I see men who come into my surgery with classic symptoms of the andropause. They are underperforming in the bedroom and the boardroom, their marriages are falling apart and they are in a depressive state. Once they go the HRT, they do get better." He added: "There is overwhelming scientific evidence that the andropause does exist. Just because there is a more gradual decline in testosterone does not mean it does not affect men's health. It's the level to which they drop. It's like falling from a high building - it's only the last six inches where it begins to hurt."
Dr Ian Banks, president of the Men's Health Forum and a GP, is another sceptic. He said: "Men, far more so than women, like a quick fix. They don't want to have to sit and talk through their emotional problems.
"They would much rather come into the surgery, say they are going through the male menopause and then walk out two minutes later with a patch stuck on their forehead ... though saying that, they often want to put the patch elsewhere on their anatomy."
A SPOTTER'S GUIDE TO THE MALE MENOPAUSE BY JOHN WALSH
A. Unusual interests. Has the patient developed a suspicious recent passion for three or more of the following:
1) Electric guitars?
2) Morgan open-top roadsters?
4) A skull ring?
5) A metal neck-chain?
6) Early Bruce Springsteen records?
7) A complete set of Billy Joel albums?
8) A Harley Davidson catalogue?
9) Jack Daniel's bourbon?
10) Handguns/ hunting knives/ crossbows/ Nazi memorabilia?
B. Destinations. He used to be content to spend summer vacations in Umbria or the Dordogne. Is he now studying brochures for:
1) White-water rafting in the Appalachians among bears, alligators and predatory hillbillies?
2) A dude ranch in Montana, from where he will "ride the herd" to Texas surrounded by supportive fellow cowpokes?
3) Beginners' fortnight in the casinos of Le Touquet?
C. Media consumption. Has he suddenly become a fan of:
2) Heat magazine?
3) Charlie's Angels?
4) Any film featuring Charlize Theron?
5) Articles in The Independent Business Section about Elle Macpherson's lingerie company?
6) Buffy the Vampire Slayer?
7) The Agent Provocateur website?
8) Articles condemning the appalling prevalence of internet spam promising Hot Lesbo Teen Action on Hidden Webcams?
D. Fashion sense. Has he recently acquired, without explanation, one of the following:
1) Leather jacket from Cecil Gee?
2) Matrix-style leather coat from Ozwald Boateng?
3) Leather waistcoat?
4) Leather trousers from William Hunt?
5) Distressed RAF leather flying jacket from Millets?
6) Leather forage cap in style of Dylan, Lennon etc?
7) Leather knee-length boots with huge straps?
8) Leather socks (limited stockists)?
E. Expenditure. Has he recently spent alarming amounts of money on:
1) Bang & Olufsen home cinema with 55-inch screen and single leather armchair with holders for Diet Coke bottle and popcorn?
2) Second house in Cornwall with pool and tennis court?
3) Eighteen cases of 1982 Chateau Pichon-Longueville?
4) Tiny flat in Streatham for vital afternoon meetings with important, though unspecified, young Thai clients?
5) A 90-foot fibre-glass yacht called Hellraiser?
6) A tattoo on his inner forearm reading "Charlize 4 Ever" in Arabic?Reuse content