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Male Order for the 'Male Menopause'

Last week, it was reported that the East Midlands Ambulance Service - among several NHS trusts - is making ‘male menopause’ policies, one of which allows men suffering from the supposed condition to receive a year of paid leave. In case you were wondering, yes, it was difficult to write that sentence with a straight face. The NHS does not currently recognise the ‘male menopause’ as a real medical condition, so it is unknown why they would make policies to accommodate it. 


The ‘male menopause’ (also called andropause) is a single term to describe a collection of symptoms experienced by some men when they reach middle age. These include depression, loss of libido, erectile dysfunction, weight gain, insomnia, and loss of muscle mass. There are some who attribute these symptoms to the decrease in men’s testosterone level as they age, thereby claiming that these symptoms are a direct equivalent to the female menopause, which is experienced when oestrogen levels fall. The NHS, however, is keen to quash this explanation. According to its website, “although testosterone levels fall as men age, the decline is steady at about 1% a year from around the age of 30 to 40, and this is unlikely to cause any problem in itself…this label [male menopause] is misleading because it suggests the symptoms are the result of a sudden drop in testosterone in middle age, similar to what occurs in the female menopause. This is not true.”


Whoever wrote the NHS ‘male menopause’ webpage had a clear no-tolerance policy towards it and its silly male creators, making for quite the comic read. It states that the label is “misleading” and “unhelpful”, and that the menopausal-like symptoms experienced by some men are largely lifestyle based and could therefore be eased by a change of diet, exercise and sleeping routines, stress level, and many other lifestyle factors. It holds no punches in its explanation of this:  “psychological problems are typically brought on by work or relationship issues…A ‘midlife crisis’ can also be responsible. This can happen when men think they have reached life's halfway stage. Anxieties over what they have accomplished so far, either in their job or personal life, can lead to a period of depression.” In other words - stop appropriating women’s issues as a scapegoat for your sad, underachieving, sexless, little lives. It won’t wash. 


For those men that still cling to biology to explain their mid-life problems, there is a condition called ‘late-onset hypogonadism’ (LOH) or ‘functional hypogonadism’ which is characterised by low concentrations of testosterone in the blood alongside the so-called ‘male menopause’ symptoms. This condition, however, is still unlikely to cause most cases of ‘male menopause’ as it affects only 2.1% of men. 100% of women, however, will go through menopause. Lorraine Boule, a psychologist at Sheffield University, criticises men who turn to biology rather than personal responsibility to explain the condition of their lives: “I don’t believe these problems have anything to do with the male menopause. Men need to look at what else is going on in their lives, rather than trying to find some biological explanation.” 


Who knows, perhaps the male appropriation of female biology won’t stop at the menopause - why not rebrand male incontinence pads as male sanitary towels? Though obviously VAT-free, unlike all the actual sanitary towels until 2021. Perhaps a male coil? Though with a mandatory month off work after its installation, just in case the poor men want a rest. Fun though it is to joke about men thieving women’s health problems in a risible attempt to explain their troubles, the lighthearted jokes actually detract from the serious and sad truth that women’s health is still a genuine joke to much of medicine and society. 


Currently, the Equality Act prohibits discrimination against workers on the basis of sex (as well as other factors) but the menopause isn’t mentioned within this bracket: all legislative attention regarding sex discrimination tends to focus on maternity or sexual harassment matters. Consequently, women are not entitled to time off work for the menopause, only its symptoms if they are deemed sufficiently debilitating. Even the suggestion, therefore, that men should be entitled to up to a year off work for ‘male menopause’ - in its own right rather than just its symptoms -  is sickening. Many women claim that men would not suffer the same medical and professional disregard, disrespect and lack of provision as women currently face if they were to menstruate and have the same female-only medical conditions or processes. However, given that men never experience female-only health issues, it is too easy to dismiss these claims as unfounded feminist fuss. The ‘male menopause’ debacle, however, proves that these claims are absolutely true: men have taken an aspect of women’s health for themselves and managed to convince certain NHS trusts that they deserve working rights for it, something that is not currently afforded to women with, you know, the actual menopause. 


It is shameful that women are made to feel embarrassed about the mere discussion of the menopause (let alone the process of it) while men launch an unabashed conversation about their own version of it. This embarrassment, in combination with the symptoms of menopause, can have devastating effects on middle-aged women in the workplace. The ‘brain fog’, sleep deprivation, depressions, and lack of concentration associated with the menopause lead

many women to either consider themselves, or be considered by their workplace, unfit to work. 90% of menopausal women consider the menopause to have negatively impacted their performance at work, with one third of them having considered leaving work or reducing their hours as a result. Growing numbers of women also take their employers to court, claiming unfair dismissal due to their experience of the menopause. Despite such clear evidence of menopausal struggles in the workplace, Dr Vanessa Beck, an expert in work and organisation at the University of Bristol, says that data on this subject is very difficult to gather “because it’s not something people tend to talk about in exit interviews.” Embarrassment lingers over the topic, making positive change very difficult to implement as few people openly address the problem. 


We have already established that there are no biological grounds on which the ‘male menopause’ should be allowed to use the specific medical term ‘menopause,’ but perhaps the most disrespectful aspect of the appropriation of this term is the suggestion that the social, mental, emotional, and financial implications of both the menopause and ‘male menopause’ are in any way equatable. Experience and time spent in an industry means that middle age should be the prime of anyone’s career, but we have seen that the menopause makes many women either lose confidence in their work or lose their job unfairly. It goes without saying, however, that middle-aged men continue to saturate the senior positions of the majority of organisations, meaning the ‘male menopause’ clearly has no effect on their professional, and therefore financial, lives. To even dare use the term ‘menopause’ in relation to themselves proves how ignorant men can be to the menopausal struggles of their female colleagues, friends, and family, and therefore how much progress needs to be made in educating men both in the workplace and in ordinary life about the real menopause and its real consequences. 


So, to those men who still want to claim to be menopausal, I’m afraid you have to accept the menopause as a package deal. Heavy bleeding, confusion, sleep deprivation, stress, depression, hot flushes, loss of self-esteem, unfair treatment in the workplace, unfair treatment with GPs, societally enforced embarrassment, and hormone fluctuations, all while not being allowed to talk about it because men might find it yucky. Still interested? 


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Tags: #NHS #menopause #malemenopause


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