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Dr. Gregory Jantz, Ph.D.

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Irritable Male Syndrome, It's No Laughing Matter

Posted: 01/23/2012 3:38 pm

A couple of years ago, a friend of mine saw Menopause The Musical, a comedy billed as "the hilarious celebration of women and The Change." When she turned 50, she went with a bunch of her middle-aged female friends, explaining it was a rite of passage. I've always considered her going a courageous act of defiance against a culture that marginalizes the aging and venerates the young. We treat aging as a loss -- in vigor, vitality, strength, attractiveness, relevance and on and on -- so we expend a great deal of time, energy, effort and resources to forestall aging as much as cosmetically, pharmaceutically and surgically possible.

Middle-aged women have found a way to laugh about their changing bodies but middle-aged men haven't. In 2001, Dr. Gerald Lincoln of Scotland coined the term "Irritable Male Syndrome." His research was with the seasonal rise and decline in testosterone levels in Soay sheep. During the spring mating season, everything's great. After mating season, everything's not so great. Testosterone levels drop and the sheep become irritable and clash with those around them, causing injuries.

Men are not sheep, but they do experience an age-related drop in testosterone levels. In men, after age 30, as far as testosterone levels go, it's all downhill. Because of this drop, Dr. Lincoln's Irritable Male Syndrome (IMS) has been used when talking about the behavior of middle-aged men, with the attitudes and actions found in male mid-life crises. Middle-aged men experiencing a drop in testosterone levels go out and buy sports cars to feel younger; they become dissatisfied with old relationships and gravitate to newer, younger ones. They look back on the past and despair about the future. Testosterone levels drop and the men become irritable and clash with those around them, causing injuries.

Thinking about all of this, what struck me as odd wasn't that men become grouchy when they feel less like men. I get that. What struck me is the difference between how men react to this "change" and how women do. With women, it's a fact of life that has to be dealt with. There's no getting around it and you either are miserable or you gather up a bunch of friends and find a way to laugh. With men, we don't really discuss this aspect of life much. IMS may be the most recent sticker slapped over the old mid-life crisis label but as far as I can tell, IMS has been around for a few years and it hasn't gained much traction with men.

Andropause, the steady decline in hormones in aging men, is a term that has been around for a lot longer than IMS but I would venture to guess more men know what menopause is than andropause. If you go on Wikipedia and look up "andropause" you'll find there are a variety of terms used for this "condition" that, frankly, I've never heard of: SLOH (symptomatic late-onset hypogonadism), ADAM (androgen deficiency of the aging male), PADAM (partial androgen deficiency of the aging male). These are medical terms, not cultural terms. The latest cultural term being tauted, at least in commercials, is "low T," which apparently is vaguely acceptable.

Menopause is abrupt and impossible to ignore. Andropause is gradual and easier to ignore but ignoring it isn't really the answer for men. I'm not advocating for Andropause The Musical, but I think it would be healthier for all of us -- men and women -- if men found a way to stop getting mad or grouchy or irritable about this natural course of aging. I really don't think pretending it doesn't exist or acting out in "crisis" works very well. Maybe if we started talking about it honestly, with ourselves, our spouses, our families, our doctors, we'd find a way to get beyond the irritations and, by extension, the injuries they cause.

It may be the cultural norm to venerate youth and marginalize aging but, as men, we can decide to act apart from the crowd. We can decide to accept the consequences of age without equating them as loss. We can choose to think differently from the crowd because we are, after all, men and not sheep.

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