The Male Menopause Myth

It’s commonly known that women going through menopause experience hot flashes, night sweats, moods swings, irritability, insomnia and weight gain, but these same symptoms are known to occur in men as well. They generally occur in men in their 40s to 50s, thought to be due to slowly decreasing testosterone levels, along with other symptoms such as loss of sexual desire or functioning, depression, memory loss, or chronic fatigue.

But what if I told you that I see young men in their 20s coming in to see me with the same exact problems? What I’ve discovered is that it’s really not mainly a hormonal issue, but a problem with their breathing. Let me explain.

What I’ve noticed in all these young men is that they all have in common a relatively narrow upper airway. When examined with a thin flexible camera, the space behind their tongues is very narrow, about 2-3 mm wide. This is mainly due to smaller jaw structures and dental crowding. Whenever someone with this anatomy starts to fall asleep, his tongue muscle starts to relax, and in deeper levels of sleep, it relaxes almost completely, leading to partial obstruction, and awakening. Once awakened, the man turns over. In most cases, they usually don’t like to sleep on their backs for this reason.

Most people compensate very well by sleeping only on their sides or stomachs. However, if there’s anything that narrows the upper airway, either due to inflammation (allergies or a cold), or structurally (fat), the tongue collapses much easier and the person gets less efficient sleep due to multiple arousals.

Inefficient sleep leads to an imbalance of the involuntary nervous system, leading to what are called "vasomotor" conditions, such as sweating, heart palpitations, and temperature fluctuations. So is a young man with a predisposed anatomy is slowly gaining weight, he may experience all the above "male menopause" symptoms.  If these obstructions last for more than 10 seconds, they are called apneas.

If you have more than 10 to 15 apneas every hour, then you may be diagnosed with obstructive sleep apnea. Untreated obstructive sleep apnea can lead to depression, anxiety, weight gain, erectile dysfunction, memory problems, hypertension, glucose intolerance, going to the bathroom often, heart disease, heart attack and stroke. The physiologic stress state that’s created also can lower one’s thyroid and testosterone levels, making it seem like he may have either hypothyroidism or low testosterone. 

So in a sense, the "male menopause" phenomenon does happen, but not for the reasons that you may think. The word menopause literally means cessation of menses. Since men don’t have periods, this is not an appropriate word. Instead, it should be renamed something alluding to the progression of a sleep-breathing disorder. Do you have any of these symptoms or know anyone who’s going through "male menopause"?

Please note: I reserve the right to delete comments that are offensive or off-topic.

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34 thoughts on “The Male Menopause Myth

  1. Im 20 nd ive been getting reallly warm nd such. And i never thought about a sleeping problem. I’ve always had a hard tome sleeping straight through the night nd dislike sleeping on my back. Wow.

  2. Sleep-breathing problems can predispose you to the symptoms that you mention, but any type of external stress can aggravate the internal stress that’s created by not breathing well. Cold or numb hands are a common symptom of upper airway resistance syndrome.

  3. This is a great article, thank you for spending time on this issue.

    I have a specific question. As you mentioned these symptoms can be brought on by another external stress, is that correct?

    I believe I get a good nights rest and don’t wake up feeling tired, nor have I gained weight. I have the occasional bad night the same as anyone else.

    So my question is, is it possible for a man in his early 20s to go through symptoms such as increased anxiety, hot flash (in left foot), and minor chest discomfort (or what seems like low blood pressure) without having male menopause?

    Thanks for you help!

  4. Tris,

    There are other possible aggravating factors that can bring on these neurologic symptoms. You can also have all your symptoms without gaining any weight, or feeling tired in the morning. Even a simple cold virus or an allergy can aggravate these symptoms. If you can’t sleep on your back, it’s likely you have a sleep-breathing problem.

  5. Great article Dr Park,

    I’ve been having heat flashes since I was 16 or so and I’m 22 now. I work 8+hours on the computer and I get the temperature swings, cold hands, occasional chest discomfort (doctor told me it was stress), palpitations, have a need to catch my breathe and take deep breathes, low blood pressure evident by blackened vision when standing after awhile, and I have a hard time gaining weight.

    I medicate a few times everyday with marijuana, which my doctor said is an anti-inflammatory. Would this help someone with upper airway resistance?

  6. Jon,

    Anything that you do to calm or relax your nervous system can help you to feel better. You can’t sleep on your back and one or both parents snore heavily, right? The fact that you’re having vasomotor symptoms means that your involuntary nervous system is out of balance. There’s a long list of conservative to gradually more and more aggressive steps to take, but start off by not eating or drinking alcohol within 3-4 hours of bedtime. If you do indulge in these habits, stop it and see how you feel. I also recommend you read my book it you haven’t done so already. Good luck….

  7. Rarely do I ever sleep on my back, but I wouldn’t say that I can’t. I just always gravitated towards sleeping on my stomach and when I found that sleeping on my stomach was causing some rather annoying lower back stress, I read that sleeping on your side with a pillow in between your knees is optimal. So now I sleep on a combination of mostly side and some stomach.

    My dad used to snore heavily but he almost never does anymore. I think he may attribute it to his tempurpedic mattress and body pillows.

    In regards to the imbalance of my involuntary nervous system, my mom said that my feet used to sweat even when I was a baby. And I’ve always had sweaty hands.

    Thanks for your advice I will try not eating or drinking alcohol 3-4 hours before sleeping and will report back here in a couple weeks

  8. I am a 57 year old male ,over the past two years i have been suffering with hot flushes perhaps once or twice a day at first I now get these regulary throughout the day more so mornings ,it is also the case that i never sleep much more than two to three hours a night when i awake it is really hard to get back to sleep.
    I have been to the doctors 7 to 8 times they originally sent me for blood tests where i had my hormone levels checked this was approx 6 months ago when they were fine.they are putting all my symtoms down to Anxiety.
    I don’t feel that i am suffering from anixety I would much appreciate if you could give me some advise.

  9. Dave,

    It’s likely that you’re having multiple breathing pauses that’s causing your vasomotor symptoms. Whether or not you snore, you should consider undergoing a sleep study. Breathing problems can also manifest as an anxiety problem.

  10. Dr Park, I am 56 and have many if not all the symptoms you discuss. I also am a severe asthamtic, with chronic sinusitis, tinititus, chronic ear infections. Sleep is very difficult, I can’t sleep on my back. My questions are:
    what can I do for night sweats? I wake up and my shirt is soaking wet. Sometimes the sweating is just around my neck.
    What can I do for more energy? Feel exhausted all the time.
    My wife now sleeps in another room due to my snoring, and constant stirring, since I can’t sleep.
    Regards,
    Steven

  11. i am 20 years old and all these problem i do have it gets so bad i get a pain in my head as well feels like a burning pain in a way also my eyes will start to hurt when this happens. but what is a cure or treatment

  12. I’m 21, almost 22, and have experienced all these problems escalate since I entered college. I’ve progressively gained about 60-70lbs from being very thin. I experience extremely bad hot flashes, headaches, frequent bathroom visits, insomnia, night sweats (often soaking the whole sheet or to the point I can’t sleep with a blanket, and extremely vivid dreams. Depression, anxiety and poor life performance has increased. It can be hard to leave the house, I hate sleeping for the fact it is uncomfortable and tedious. I live in Phoenix and would really want to know if this is treatable by a doctor here. School suffers, I can’t hold a job and my personal relationships are strained by living odd hours and acting distant. I have chronic asthma and feel myself wheezing more often in bed than out. Please help me find out something to help me.

  13. Hi Dr.,

    I found your article very useful. I have a story of sinusitis and never sleep on my back… I always slept without deriving a lot of satisfaction, and being very tired in the morning.. however, after a period of intense stress, I started feeling an intense feeling of heat in my face, and this is practically for most of my day and it has lasted for the past 6 months.

    I did blood tests, checked blood pressure, did a scan of my chest, heart, various nose visits. No one could find what my heat was coming from and they said I was just stressed and anxious.

    I live in the UK and don’t know who to get in touch to finally solve this issue. Is there any suggestion you could give me to improve my situation?

    Regards

  14. I’m a 42 yr old male & I have low testostrone, I weight 273 lbs & I am 5’11! I also work 3rd shift on the weekends, so I don’t get proper rest on the weekends! I have allergies as well, so saying all this to say, all most everything you were saying about menopause pertains to me.

    What do I do next?

  15. I have night sweats almost every night and sometimes i will be very hot the entire night. i wear BreathRights every night but my wife says i still snore. Any answers would really help.

  16. hello dr park, im a man of 26 years old from the netherlands and have hotflushes non stop during the night, its going hand in hand with my body temperture dropping below 36 celcius sometimes 35.3 celcius. i’d have different kinds of sleeping tests had in the past and i had no disorder.
    then they thought of feir so they’d give me propanol but also that dind’t work.
    i have really no clue what causes this hotflushes. and the docters in the netherlands also not.
    so i thought that may be you would know something what could help.

    kind regards
    Jeroen Link

  17. oja i forgot to say i can succesfully threat it with allot of oxazepam but that is no option anymore

  18. Hi Dr.Park,

    I’m a 25 year-old male and I’m haven’t been able to sleep well in a a while. During the day and night, I experience hot flashes, anxiety and lack of concentration. I have not really felt this massive wave of unpredictable emotions. A lot of it is because lack of sleep, I assume. What are your thoughts and what should I do?

  19. Dr. Park, is there any other cause? I am a 20 y.o. male with hot flashes, night sweats, irritability, mood swings, dissociation, and have been through sleep studies where they determined i don’t have apnea. What can cause said symptoms without involving sleep?

  20. Cameron,

    Before you look for other answers (such as hormonal issues), an endoscopic exam in the office will be able to show if you have a major sleep-breathing problem, even if you don’t officially have obstructive sleep apnea. You can literally stop breathing 20 times every hour and not have obstructive sleep apnea on a sleep study. Please read my articles on upper airway resistance syndrome. Good luck.

  21. I have had all the symptoms mentioned above, however, I have been diagnosed with “SEVERE CENTRAL SLEEP APNEA”. I began having dull, aggravating headaches and neck stiffness in my latter teens. The chronic headaches have been increasing in their severity for over 30 years. I have been fighting the problem by waking up and forcing myself to do physical work, while in the construction industry. I have continued to have severe, daily headaches with growing fatigue, feeling more tired, each day, than when I went to sleep, the night before. During a period of eight years, during my twenties, I was involved in six relatively serious I have been seen by a variety of medical physicians specialists who treat the: eyes, spine, headaches, acupuncture, biofeedback, hypnosis, TMJ, orthodontics, chiropractic, physical therapy, neurologists, orthopedics… and many more. A little over 3 years ago, I was diagnosed with “SEVERE CENTRAL SLEEP APNEA”. After being provided with a BIPAP breathing machine, along with trying about 20-to-30 different masks, the only way I am able to get any amount of sleep is to, very securely, strap the mask to my face after taking several muscle relaxers that literally knock me out / unconscious, to the loud squeaking, tooting and air blowing in my eyes, and / or ripping the uncomfortably tight mask off my face. Several times, I had awaken with bleeding occurring at my nose bridge. In other words, I have been unable to locate a specialist that can not only diagnose such a problem that may have been present for over 30 years, but to understand that being “non-compliant” may not be a choice, but there may be an underlying cause that needs to be treated in order to eliminate the inability to breathe when asleep. Please help, or direct me to a professional that is able to. Thank you.

  22. my husband is 22, and has night sweats like he wets the sheets, he sleeps on his side or stomach and has short wind. Sometimes he has to take a deep breath and says he feels like passing out. Is something seriously wrong with him?

  23. My husband is 40 yrs old & has been getting headaches, he cannot sleep through the night he frequently uses the bathroom at night & gets hot flashes then he’s cold again

  24. This is what ive been waiting to hear! I have problems sleeping which has steadily gotten worse and worse in recent months! Hot and cold flushes are constant especially at night. My legs when in bed get insanely hot. Ive gained wait, become what i can only describe as being a manic depressive, lazy/lethargic. When i do eventually sleep itl be for no longer than two hours at a time and my body clock is nothing short of insane! This appears to be the only logical cause, it just fits. I will mention this to my doctor and i thank you for this page!

  25. Hi im 27yr old and I’ve been dealing with this problem for about a year now I’m constantly sweating but I’ll be shivering cold with goosebumps and all I’ve been dealing with depression and social anxiety for about 4 years now and recently this sweating and feeling cold has only been going on for the last year and the insomnia is bad it makes me stay up all night to about 6-7 am and since I’m disabled I feel just horrible already not being able to work and this new problem just threw the icing on the cake I just don’t know what to do I’m willing to do anythanythinging to feel a little normal again for my family’s sake

  26. my husband is 38 he has lost 70lbs in 6months has sever sweating and sheets are soaked and pillows, he has no sex drive and whatever i do i can not get him to get an erection, i have a feeling he has sleep apnea, he also is or was a huge drinker until a month ago like a 30pk of beer in a day in a half, and smokes…….suggestions???????

  27. Hi. Dr. Park,
    I’m a 23 year old and for the past 3 to 4 years, I have had most of the symptoms you’ve described. I definitely have more significant issues with sweating, hot flashes, and fatigue (possibly due to sleeping problems). I believe my hot flashes come from stress as I can tell during situations where I am uncomfortable both mentally and/or physically, the hot flashes come and they bring an uncontrollable sweat. These flashes usually last anywhere from seconds to ten minutes plus depending on the situation and is most extreme around my face and head. At times during a typical 80 degree Fahrenheit day, minimal sunlight can hit me and I can start sweating profusely around my face and neck. While this doesn’t happen enough to embarrass me too much, it does happen at least once a day. Even simple tasks like doing laundry or wiping something down can at times cause me to sweat like crazy out of nowhere. Also, at night I sometimes have trouble falling asleep; it can take just a few minutes or it can take hours and it’s quite unsettling. Some nights I wake up multiple times, some nights I sleep all the way through, but I always catch myself at first lying on my back and gradually shifting sideways then to the stomach; I’m most comfortable on my side. I have been getting a lot of night sweats all over my torso and legs although lately, the night sweats haven’t occurred as often. But it comes to the point where the sweat wakes me up at night either due to contact with cold air or from the actual beads of sweat trickling down and tickling me basically.

    I come from an Asian background and so my parents tell me that there is a lot of “fire” in my body. I have gotten physicals with almost perfect results for my age except for my liver which isn’t bad but a little lower than normal levels in terms of health. I have also done acupuncture with a Korean doctor who told me that my lungs aren’t 100% and that when I breathe, I don’t take full enough breaths (I do notice myself taking many medium sized breaths compared to some of my friends who take deeper breaths not as often). He said that there isn’t enough oxygen travelling through my body which causes me to sweat and feel tired. He gave me a Korean herbal medicine/tea called “Hanyak” last year to relieve some symptoms. While it worked temporarily, my body just went back to its normal over-sweating, fatigued self.

    I’m 5’11” and I try to keep myself reasonably fit. In high school, I played a lot of basketball and golf but nowadays, I just lift weights at the gym. Around 4 years ago, I was consistently going to the gym bringing my weight up from 150lbs to 160lbs (didn’t really have issues with sweating). Then I stopped going to the gym completely for about 2.5 years and fluctuated between 150 to 155lbs during that time (this is also when the sweating and hot flashes really got crazy). I started going to the gym again about 2 months ago and currently weigh 167 on an empty stomach (the weight gain was a combination from better eating habits, a vacation to Taiwan where I ate some 4 meals a day for 2 weeks, and consistent weight lifting routines). The sweating gets out of hand at the gym. A 1 hour workout on concentrated muscle groups can almost make half my shirt drenched in sweat; I need to wipe the sweat off around my face and neck after each set of whatever it is I’m working on. My diet consists of at least 2 meals a day (lunch and dinner, but I do eat breakfast also on some days). I used to eat a lot of protein and carbs with very few vegetables and fruit but after going to a doctor for a physical about a month ago, I have changed my diet to about 40% protein, 25% fruits & vegetables, and 35% carbs. The doctor recommended I bring my diet to 30% protein, 30% fruits & vegetables, and 40% carbs because “Asians cannot eat as much protein as Americans” but the reason I eat a lot of protein is because of my workout routine (I go to the gym at least 3 times a week). As for liquids, I keep away from sodas unless I’m drinking alcohol; the alcohol consumption is only in social situations. I probably don’t drink as much water as I should (the equivalent of about 4 regular water bottles a day and 6 on gym days) and I do drink juice and milk every now and then. As for coffee and tea, I understand that caffeine causes us to sweat more but my coffee and tea consumption is pretty high (about the equivalent to 3 cups of coffee every 2 days because I feel chronically fatigued). I smoke cigarettes occasionally, usually when drinking but I do smoke marijuana almost everyday. I have been smoking marijuana consistently for the past 4.5 years at least and by consistently I mean almost every day. I’ll be honest it’s recreational and not medicinal although I feel my symptoms can be helped by smoking marijuana. You might say the fatigue comes from the constant smoking and I think that might be one issue. I did want to test this out and so I stopped smoking for an entire quarter of college (11 weeks) and still had issues with falling asleep, sweating, and fatigue.

    I’m sorry this is so long Dr. Park, these issues are really taking their toll on me and I just want you to have a good idea about my physical condition. These issues add unnecessary stress to my already stressful life. I definitely have some stress issues that stem from school and my last job I worked at which was a restaurant (I don’t know if this is true but they say one reason you grow white hairs is from stress and lately, I’ve been getting an abnormal amount of white hair growth being able to pluck some 30 white hairs each time my mom helps me to pluck them). Anyways, I really want to know what I can do to stop this over-sweating and the hot flashes and to help me rid myself of this chronic fatigue.

    Thank you for your time.

  28. In my younger years I was a binge drinker and still sometimes fall off the wagon for a day …I am a smoker and have been since my early teens, I have never been able to sleep normally, I missed 40 something days of kindergarten for example. I just turned 39 and I have been having sweating bouts during the day out of no where, my hands are numb and swollen every day I wake up, I can sleep for 15 hours and still be exhausted, I have always had a very hard time sleeping, falling asleep etc..

    I have always self medicated with something because of anxiety and depression and I am now on Klonopin for the anxiety and a very low mg of Suboxone because of a pain killer addiction I battled for a couple years. I am concerned that the medication I am on may be causing some of the symptoms but when I look back at my history, it seems to make more sense that I may have a sleep issue. I have never been able to stay on a regular sleep schedule and still fight daily to get on one and stay on it.

    I have pretty much every symptom related to this, fatigue, numb hands, a hard time sleeping which has lately turned to talking in my sleep a lot even waking myself up talking, the hot flashes feel almost like I am experiencing opiate withdrawal which is impossible since I am on medication to prevent the symptoms of it, my sex drive is pretty much non existent, I have a very hard time getting and maintaining an erection which I had attributed to the Klonopin but that may not be the case….

    I am just now realizing all of these symptoms may be connected and I have to stop all the medication in order to know how I actually feel normally. I will be making an appt. with a general practitioner and I guess my question is, should I see some kind of specialist? Or in your opinion is a family Dr. going to have the expertise in this type of field to be able to pinpoint what the cause could be.

    I really appreciate your post here and I know it was more directed at young men but I still feel like I am pretty young, too young for all of this to hit me anyway. I was fine up until a few years ago these symptoms started coming on. Well all except the sleeping issues, anxiety and depression…As far as the physical symptoms, they have just made themselves more prevelant recently.

    Thank you for allowing me to comment here and thank you in advance for your advice.

  29. Dr. Park,

    What do you recommend as the best course of action for a young male experiencing all the described symptoms whofeels that his breathing may be to blame as hypothesized above? Also, it’s hard to get anyone in the medical field to come to a simalar conclusion since it’s a simple, counterintuitive, and underlying solution to many other complex problems. Should he just take it upon himself to have a sleep study done based off observations rather than medical recommendation? And once diagnosed with some form of disruptive airflow/apnea for someone who is young, do you see surgery as a viable option given the cost/benefit analysis factoring in age. Granted it varies on an individual level, but broadly speaking, what are your thoughts for the best treatment plan for someone with the profile described in the “male menopause” article?

  30. Ya I been waking up last 10 months like I can’t breath heart is pounding had my heart checked good but still doing it now I’m starting to get severe hot flashes last over an hour but after I eat when I take this sleep pill called mid nit drug free it helps me sleep but it’s starting to scare me I feel out of breath alot