All About The Penis, Men & Male Sexuality

The male andropause and the mid-life crisis

What is the andropause?

As I know only too well, as a man gets older, he produces less testosterone. This leads to a loss of erections, an under-used penis, perhaps even an inactive penis, and a loss of some vital male qualities. What I'm writing here is prompted by my own experience and is based on my experiences while seeking a solution plus some additional research. 

A man's lowered testosterone level can develop slowly, his testosterone dropping by about 1 or 2% a year from the age of thirty-something, or it can happen suddenly.

The most obvious sign of this is that his penis starts to behave differently: over the space of a few months he may lose his erections, his penis may even appear smaller, he starts feeling depressed, lacking in energy and libido, he may experience rapid climax and need premature ejaculation treatment, and his emotions become unpredictable and rather irritable.

 In the latter case, he's going through a change like a menopausal woman. And it's just as unpleasant. But this sudden drop only happens in about 3 - 5% of men, so first of all I want to talk about the more common picture of gradually declining testosterone.

Typically a guy starts to notice his testosterone dropping when he's in his forties, though it can happen sooner.

He loses his drive, his vitality, his sex drive and his motivation. His penis is less often erect. Fatigue sets in, sometimes depression too, and he begins to feel stressed and unhappy.

He realizes he's no longer able to keep up with the young bucks, and may feel this to be a serious self-esteem challenge, especially if he hasn't made what he considers to be a worthwhile contribution to the world or achieved something of personal significance. In a desperate attempt to keep his youth, he may find a younger woman or buy a motorbike. 

(Maybe I should add at this point that even though buying a motorbike or seeking to find new life for your penis by screwing a younger woman aren't actually compulsory parts of a male mid-life crisis - I didn't do either of them - a man going through this turning point will often do something that seems out of character. I left my job, and went traveling round the world.

That's one mid-life change I can thoroughly recommend to you - providing of course you do it in a way that doesn't jeopardize your well-being or that of others around you.)

But mid-life changes don't have to be like this: I think there's a natural sequence of life changes which require us to move into the role of "male elder" at some point, for the very good reason that one can't go on keeping up with the young men and their frantic pace of life for ever.

Moreover, young men need the advice and guidance of elders - older mentors, if you like. Though this mostly only happens nowadays in pre-literate societies, when a man becomes an elder, he gains a new role that compensates for the loss of his testosterone and his youthful vigor. 

But sadly it isn't often like that in our society. More mature men, already going through their own internal struggles as their potency and sex drive diminishes, may feel even more rejected or unwanted as downsizing or redundancy stares them in the face and the value of their life-long experience is discarded. As men, we so often tie our self-esteem to our jobs and the results of the movement into our fifties can be painful. 

The whole of this process - physical, emotional, and psychological - is the andropause. If you like, you can call the emotional and behavioral bit the mid-life crisis. To me, it's all part of the same process.

It's even worse, like I said above, when testosterone decline happens suddenly, perhaps as a result of illness, fatigue, burn-out, or simply because your genes predispose you to an early andropause. This can happen from the late thirties onwards.

And in fact this is exactly what happened to me at the age of 37 after a severe viral infection that laid me low for months. Like the slower onset andropause, the psychological symptoms included a loss of vitality, of what seemed like the very basis of my life energy, of my sexual drive, and the physical symptoms included poor circulation, tiredness, lack of energy, aches and pains, and night sweats. I'll explain what I did to get over this later on.

The andropause is the explanation of why the vitality and virility of millions of men has faded in middle age or later. It is the explanation of much misery, depression and unhappiness, loss of sexual performance, failing lives, failing health and failing relationships, and above all, it is the major cause of impotence and loss of sexual control and normal ejaculatory function. But it would be a mistake to see this as merely a sexual issue.

Testosterone permeates every aspect of the male body, every nerve, every muscle fiber, every brain cell. It isn't just about sexual desire and erectile capacity - there are testosterone receptors on every cell in the male body, and when there isn't enough testosterone to fill them, things begin to go wrong: in my case, which I don't believe is any different from any other case, at least in broad terms, the first thing to go was my sex drive, my night-time erections, and my energy. 

Next, my positive mood disappeared, my sense of emotional well-being vanished, and my self-esteem plummeted.

And lastly, along with the physical symptoms described above, my very sense of being male vanished, like someone had ripped out the essence of my masculinity.

When I finally realized I had a problem, and had my hormones checked, my testosterone levels were so low that they might as well have been non-existent. As a personal observation, the worst symptom of my testicles no longer doing their job effectively was that my penis began to shrink.

If all of this misery is caused by falling testosterone, isn't the obvious answer to provide testosterone supplementation?

You might think so, but there's been a big debate in the medical world about the merits of artificially increasing a man's testosterone levels. I don't really want to recap the debate here, basically because I'm very partisan. I think all men whose testosterone level falls to the extent that their enjoyment of life and ability to function effectively is impaired should be given the option of testosterone replacement therapy.

You'll see suggestions that such therapy can increase a man's risk of prostate cancer. However, if you read the research by people who know most about such cancer, you'll find that testosterone supplementation can actually be protective against prostate cancer.

And as for the idea that testosterone causes aggression, well, it's most likely untrue. Testosterone actually makes a man show more of his existing primary personality features: in other words, it does not cause men to behave aggressively unless they already are aggressive.

There are those who ask why you would want to raise the testosterone level of a forty year old to that of a twenty year old.

I can only reply that when you have experienced the effects of losing your testosterone, and the miraculous impact of receiving supplementation, you wouldn't hesitate for a moment to support the idea. In this field, at least, personal experience would be a great tutor for the clinicians who argue against testosterone supplementation.

Imagine finding you experience premature and early ejaculation and need a cure for it at age 50!

Measuring the effective testosterone level in a man's body is a fairly complicated process. His total testosterone is not a good guide to anything because much of it is not available to his body. It's the amount that's free that needs to be measured, which is why any man who is thinking this all sounds like his experience, must find a specialist in male hormonal medicine to get an assessment of his condition. 

The causes of low testosterone

Put simply, either your testicles fail or your pituitary - which controls the testicles' activity - fails. In either case, the hormonal mechanism that has ceased to function can be effectively replaced by hormonal supplementation. You can read more about this condition, called hypogonadism, here.

It's also important to understand that middle-aged men produce more estradiol (a hormone similar to estrogen) and this can sit on his testosterone receptors and prevent his male hormone from doing its job. The effects of excessively high estradiol levels on a man's maleness and health are very negative.

Dr Eugene Shippen discusses this issue at length in his book The Testosterone Syndrome. He also points that some testosterone supplementation can make this situation worse - again, a good reason to seek out an expert who knows what he is doing. Other books worth reading include Dr Malcolm Carruthers' excellent works, which include Maximizing Manhood.

Testosterone Replacement Therapy

To cut a long story short, it took me a while to find someone who was knowledgeable and informed enough to help me. Goodness knows what happens to all the other men with this problem, who don't have the determination, knowledge or, I have to say, the money, to get this sorted out.

If you go down this road see an expert, otherwise you're likely to be told "your testosterone is in the normal range;" "you're just depressed;" "you're impotent because you're depressed;" "there's nothing wrong with you;" and so on.

The simple truth is that while these statements may be true, they are much more likely to be denials of your experience and your awareness of what's going on in your own body by doctors who are not trained to understand the male hormonal system in mid-life.

There are several effective ways of taking testosterone supplementation. Oral preparations are now safe and don't damage the liver (unlike the early methyl testosterone, which is not safe), but their effect is short lived and depends on what you've eaten. They're not really any good, in my experience, though you may get a short lived kick out of them.

Much more effective is the classic injection into the buttock of testosterone compounds designed to last two weeks. It's not a great solution, but, believe me, the discomfort of the shot is far better than the effects of testosterone depletion.

There are also patches, which you can put on your skin, though they can make your skin sore and the uptake of the hormone is quite low.

New research is coming up with better methods of getting the testosterone into the body all the time: newer options include preparations designed to release testosterone slowly, patches that don't irritate the skin, and so on.   

The fist method my doctor and I tried was the implantation of crystalline pellets of testosterone in the sub-dermal fatty tissue just above my buttocks. This worked well, up to a point, but the problem was that I tended to get a large initial release of hormone (in fact it was like being a horny teenager again!) followed by a slow decline in my hormone level as the pellets dissolved.

Since they are designed to last for up to six months this can be a problem. What I wanted was a regime that mirrored the natural level of my own testosterone (in my twenties, preferably!).

The newer form of testosterone gel applied to the skin can work very effectively, but I also found the injectable two-week shots of testosterone very satisfactory.

Despite the fact that I tried Viagra, and it worked well, I haven't needed it since I went onto testosterone replacement therapy. And all of the symptoms that I associated with my andropausal experience - emotional, psychological, and physical - have disappeared. 

Some other benefits of hormone replacement therapy for men

Testosterone maintains the fitness of the ejaculatory muscles of the genital region and the muscles that close off the blood flow from the penis when you get erect.

When your testosterone level falls, these muscles gradually fade away and you can't get a decent erection or have a powerful ejaculation. In most cases, therefore, hormone supplementation has a powerful impact on erectile functioning.

One expert claims that even though restoration of sexual function may take a while as the muscles and nerves regenerate to a fully effective state, the majority of his patients are restored to full  sexual function. 

However, some men don't get their erections back even with added testosterone, for many things can get in the way of an erection, including drinking, smoking, fatty deposits in the arteries, and the actions of certain drugs. 

If you want to know more about hormone replacement therapy, see where you will find suggestions about how to locate a good doctor.

Other pages of penis problems

My penis is too large / too small
My foreskin is too tight
Problems with arousal
I can't get an erection
Urethral opening abnormal
Torn frenulum - breve
My penis is twisted
Erectile dysfunction
Penis problems solved!
Andropause & mid-life crisis
Penile problems & injuries
Yeast Infections
Sex addiction & obsession
Sexually transmitted infections
Testosterone declines with age

Other sections on the site

The penis, masculinity and sex
A Cultural History Of The Penis
Penile & Other Problems