The Male Menopause Myth

October 28, 2008

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"?

Written by Steven Park · Filed Under Blog
Tagged: ,erectile dysfunction, heart disease, hot flashes, hypertension, insomnia, male menopause, mood swings, night sweats, obstructive sleep apnea

17 Responses to “The Male Menopause Myth”

MR on January 21st, 2010 7:33 pm

I found the <a href= “http://www.bodylogicmd.com/bioidentical-hormone-therapy”>bioidentical specialists</a> just in time. My male menopause was getting out of hand, and bioidentical hormone therapy really helped my situation.
Jerald on July 19th, 2010 9:06 am

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.
nathan on March 8th, 2011 8:53 pm

can excess stress in a young mans life cause hotflashes, anxiety, and numbing hands?
Steven Park on March 9th, 2011 4:17 am

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.
Tris on March 12th, 2011 8:18 am

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!
Steven Park on March 14th, 2011 6:33 pm

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.
Jon Fowler on April 12th, 2011 6:57 pm

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?
Steven Park on April 12th, 2011 7:06 pm

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….
Jon Fowler on April 14th, 2011 10:25 am

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
Dave on April 19th, 2011 2:43 am

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.
Steven Park on April 19th, 2011 6:03 pm

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.
steven holloway on May 10th, 2011 2:42 pm

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
Steven Park on May 10th, 2011 6:43 pm

Steven,

You should consider seeing a sleep specialist to make sure you do or don’t have sleep apnea.
Tyler King on September 18th, 2011 7:35 pm

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
BP on January 30th, 2012 2:31 pm

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.
Sal on March 27th, 2012 5:42 pm

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
Rod on April 11th, 2012 12:25 pm

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?