Sometime around mid life many men find they begin to experience penis problems as part of a broader picture of failing sexual performance. For example, they may not be able to get an erection as they once did; they may not get erections in the night or early morning.
They may lose their desire to make love, or they find that they cannot sustain an erection. Their penis may appear to have shrunk. They may become grumpy, irritable and demotivated, and they may have physical aches and pains. All of these things - and many more - can be a part of the male andropause or mid-life crisis.
The andropause, and mid-life sexual problems in men
The typical story is of a middle age man who gradually loses his drive, strength, energy and enthusiasm for life and love. An all-enveloping mental and physical tiredness descends on him, often for no apparent reason.
He changes from being a positive, bullish person who it is good to be around to a negative, pessimistic, depressed bear with a sore head and it is increasingly difficult to live or work with him. At work he is seen to perform poorly and no amount of encouragement or urging will improve his performance.
At home, family relations tend to become increasingly strained, and social life and activities dwindle and wilt. His sexual life is usually a disaster area, with loss of sex drive and intermittent failure to achieve an erection leading to performance anxiety and eventually complete impotence. This creates a downward spiral of failing function both in bedroom and office. (From the book by Dr Malcolm Carruthers, Maximizing Manhood, page ix.)
One man's account of the andropause
The changes came over me very gradually, just around my fortieth birthday. I didn't know what was happening. Without realizing it, I became incredibly irritable, depressed and moody, losing my temper at random and with little or no provocation. Once I actually stormed out of the office when given an extra piece of work, and drove home, feeling entirely justified.
Of course the reaction to this was not good, and it forced me to consider what was going on. While I was counting up the other changes that had come over me, it occurred to me that I had lost much of my libido: you might think it's surprising I hadn't noticed this before, but I'm not married, and my last relationship had been nine months before.
From being ready for sex, whenever it was available, or even when it wasn't, with a firm erection most mornings, and a strong impulse to masturbate two or three times a week, I realized that I didn't really care about sex any more, and I wasn't masturbating at all.
My morning erections were weak and seemed smaller and less firm, which was particularly distressing since my penis is not very big anyway. And then the tiredness and depression started: I got out of bed feeling awful, and remained so all day. At one point I could hardly drag myself into the office.
Friends began to point out my failings - most often, it seemed, by avoiding me. But then, I didn't really want to do anything - even to see my friends, with whom I had spent many happy times. Somehow it all seemed too much effort.
At some point in the process I realized that my weight had gone up, and I had become, well, not to put too fine a point on it, fat. I ate and drank a lot, but it seemed like comfort eating, and my cholesterol level began to climb steadily.
Of course, it's always possible to rationalize things away, and I think this can be a source of comfort, especially when we don't have the knowledge of what is actually happening. And so I began to explain things to myself: "It's stress - and no wonder - look what's happening: the company is in trouble, extra pressure, threat of redundancy." And on a personal level: "I'm so dissatisfied and disillusioned with what I have achieved in life. No wonder I'm unhappy, stressed, grumpy."
This, I thought, must be the famous mid-life crisis, brought on in my case, I thought, by the sudden insight that I was probably half-way through my life and feeling that I had accomplished few things of significance.
Particularly significant was the fact that I hadn't been able to start my own family, a desire which, while rooted in my belief that I would be a fantastic father, was also something to do with a desire to leave something on the Earth after I had gone. But, I wondered, did the idea of a mid-life crisis explain the aches and pains in my body? The lower back ache? The tiredness?
What about the unexpected and unexplained hot flushes, which left me soaking in sweat at night, and the more embarrassing flushing of my face that occurred during the day, also apparently at random? Did it explain my impotence, by now, about a year after this had all started, almost complete?
And did it explain the fact that my penis seemed permanently shrunk and tiny? And there's no doubt I was depressed. I don't know what it was in the end that made me see sense, but I guess it was the sexual aspect of the situation. I booked into a men's clinic for a check up, and, discovered my testosterone was well below the levels considered normal.
Just what is a mid-life crisis?
It's obvious that a change from one phase of life to another has to be accompanied by psychological adjustment and a reassessment of one's identity. For women, the transition from the child-bearing years to the post-child-bearing years must be a profound experience. Before the menopause, a major element of a woman's sense of identity is her fertility, her menstruation, her ability to give life and birth to new people; after it, she has to redefine her sense of self to accommodate the knowledge that she is no longer fertile.
Could there be a similar process for men? Yes! Dr Malcolm Carruthers, Dr Eugene Shippen, and Jed Diamond have all studied the crises to which masculinity is subject in great detail. There are references to their work below, if you want more information.
So what about men in modern society? Do we have a similar transition? Dr Malcolm Carruthers - who has worked with thousands of male patients in his London clinic - thinks that the male mid-life crisis is emotional in origin but if severe enough or long enough may have physical consequences, especially if alcohol or drugs are used to blunt the pain of the crisis. Typically, he says, the age group most prone to the crisis is around 40, mainly between 35 and 45, which is earlier than the andropause, which usually starts around the age of 50, say 45 to 55.
Dr Carruthers suggests that many mid-life crises go unnoticed and are passed off as the effects of a change of job, a change of house, or a change of spouse. Only occasionally does the drama turn into a full-blown crisis in which the man may feel he is stuck in a career which under- or over-extends him, producing the prospect of burn-out; or in a dead marriage or relationship which gives him the choice of divorce or separation and its consequent traumas, financial ruin, and starting over again.
He also lists a number of factors that seem to predispose men to a traumatic mid-life crisis - in essence, these are things that destabilize him from childhood onwards: being born with a sensitive nature, distant or unloving parents, the loss of a parent, especially the father, loss or separation from a loved one or role model, and repeated failure or even repeated success in his career.
Sometimes the things that kept one going are simply not there: the friends move away, the children grow up, leave home and don't visit, the aged parents die, and your body can't keep up with the younger men in sport anymore. It is not surprising that escapist behavior might seem to be the solution: changing job, changing house, changing partner, changing lifestyle, getting the motorbike before it really is too late.
What to do about the mid-life crisis
There are solutions. Some men don't experience much of a crisis anyway, they just continue living through the first part of their life and into the second.
Others go through a period of great turbulence but then find a new course and approach for the second passage of their lives. This may involve a new set of challenges, a new direction, or a coming to terms with what they have got.
Often the new paths are more spiritual and less driven than those of their youth. But a few may succumb to disaster in the form of drug, alcohol and sexual addiction, or spend the rest of their lives drifting around aimlessly in a state of depression.
The book by Dr Malcolm Carruthers contains vital information on what you can do if this applies to you: "The mid-life crisis, even when it brings on depression, despair, anxiety or fear, is a time of great challenge, out of which come symbols of transformation. As we age, we human beings yearn for wholeness. We yearn for parts of ourselves that have been in the dark to find sunlight, and those that were sunburned to find shade.
We yearn for the parts that have been underdeveloped to grow, and those that were overdeveloped to be pruned. We yearn for the parts that have been silent to speak, and those that were noisy to be still. We yearn for the parts that have been alone to find companionship, and those that have been overcrowded to find solitude. In short, we yearn to live our unlived lives."
Continued on Andropause page 2 - go here! where we examine the sexual consequences of the andropause including erectile dysfunction and delayed ejaculation.