Men and Women – hormonal symptoms – how many do you have?

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I have been reading an astonishing amount of information regarding “The change.” No eye-rolling guys, this effects you too!

For women there are three stages:

Perimenopause (the start of hormone changes as your ovaries begin to shut down). Menopause, when menses has ceased for at least 12 months.  The final stage, postmenopause when all of these symptoms are supposed to cease.

For men there is one stage of change into andropause. 

I wondered if men face some of the same changes and challenges, so I read a bit about “the change” for men; they also have a list of symptoms.

images (81)“The change” can start as early as 30 years old, or as late as 60 and the transition can last up to 10 years! Generally, women’s hormones fall faster than men’s.  Some may may start with mild symptoms (night sweats, hot flashes) for a few years (like I did) but that can suddenly change to erratic (migraines, anxiety, depression, fatigue, or mental confusion.)

At least 40% will experience extreme symptoms; a small percentage of these will be misdiagnosed as psychotic episodes. Some will have milder symptoms which may require little intervention.  And still others will sail through the whole transition with no problems at all.

It may surprise you to find out that your primary doctor, OBGYN, or urologist are not hormone specialists.  If your symptoms become bothersome, extreme, or erratic you may need to consult an Endocrinologist. Be aware that it sometimes takes several months to see a specialist, so plan ahead. (see symptoms list below)

Growing up, I had occasionally heard stories about “the change” from aunts and other relatives sitting around the table, but I never realized how prevalent it was until now.  “The change” was only whispered about in those small groups; the challenges they and their spouses/partners faced were never talked about openly.

Today the same stories of feeling dismissed by doctors, of confusion, of feeling out of control, or “going crazy,” are all over the internet albeit mostly in anonymous support groups.

images (83)It is 2015 and hormonal effects on our bodies are still dismissed as merely psychological. Many are told by their doctor to see a psychologist or start taking SSRIs, with no other intervention offered.  (SSRIs have been shown to offer some relief, but they are mostly being prescribed before any other testing is done. SSRIs are only covering some of the symptoms and not addressing the cause.)  There are several HRT choices for both men and women.  Some find relief with herbs, but most have no proof that they work.  I do not advocate for any one of these decisions; I am just trying to muddle through the information.

On the other hand, millions of dollars are spent on diagnostic testing for symptoms which patients report piecemeal to their doctors, either out of embarrassment, ignorance, or misinformation.  In this way, both the patient and the doctor are failing each other and not solving the big picture. As a patient, you must advocate and educate yourself.

Often failure to communicate happens because neither the doctor nor the patient are fully listening to each other in the fifteen minute rush the patient has to state his case, and the doctor has to document and code the interaction.  This is penny wise and pound foolish.

images (63)When most women enter perimenopause, they expect a few hot flashes and night sweats. They might even expect mood swings, vaginal dryness, and loss of libido. What they won’t expect, however, are overwhelming thoughts of doom and dread, panic attacks, high anxiety, heart palpitations, vertigo, dizziness, unrelenting insomnia, and feelings of losing control.

Yet a large number of women experience these symptoms and many others which you may not think are associated with perimenopause. In fact, so wild and unpredictable are some of the symptoms, a lot of women think they are going crazy.  

But they are not going crazy and neither are you if you have been experiencing any of these symptoms, and wondering what is wrong. I like to call perimenopause a full body contact sport, because it affects far more than just your menstrual cycles.

It is not unusual for women to have issues with their thyroid function, for example, or their adrenal glands, and a myriad of other complaints and ailments which seem to have no connection whatsoever to perimenopause.

[These] symptoms have been identified and associated with perimenopause.  They are listed here in no particular order of significance. Not every woman is going to experience all of these symptoms, nor the same intensity or duration. Everyone’s experience is unique.(

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66 Symptoms of Perimenopause For Women 

These are very real physical changes and conditions. Some symptoms alarm a woman that she may be suffering from a serious disease. Perhaps you know the more common ones related to menopausal symptoms in this list. But many of these may surprise you, as they have not been typically associated with this normal physiological transformation.

1. Change in Menstrual Cycle, Cycles may get closer together or farther apart, lighter and shorter in duration or much heavier, lasting longer than one has been accustomed to. Menses may seem to take forever to begin with dark spotting for days until you actually flow, or you might feel like you have your menses every two weeks.
2. Menstrual Flooding can come on with sudden onset and feel like you may hemorrhage to death. Or it can be a gradual build up just when you think your menses will end and you start gushing for days. Flooding commonly accompanies the woman with uterine fibroids as she transits into menopause.
3. Headaches, Migraines, especially before, during or at the end of your menses debilitate and radically interferes with normal functioning.
4. Decreased Motor Coordination, Clumsiness, almost begins to make the woman who experiences this feel like she is a bit spastic, certainly less than graceful during perhaps an already awkward period in her life.
5. Lethargy, a persistent feeling sluggishness physically and mentally, that seems to negate ones ability to do much.
6. Physical Exhaustion , and Crushing Crashing Fatigue that can come on so suddenly and grip you into feeling like you will collapse unless you stop this instant.
7. Exacerbation of any Chronic Illness or Existing Condition transpires as hormones decline or deviate from their normal balance.
8. Insomnia, this includes a new or unusual pattern of either difficulty falling asleep, or dropping off to sleep for a few hours and then awakening with the inability to return to sleep.
9. Sleep Disturbances sometimes are from nightmares, night sweats, or just a vague sense of restlessness keeping you up or disrupting your precious revitalizing retreat from this realm of responsibilities.
10. Night Sweats often begin between a woman?s breasts, initially a night or two before her menses, waking her from sleep, later more profoundly disturbing with up to total body saturation, followed by damp or sweat drenched chills.
11. Interference With Dream Recall interrupts the sense of normal sleep, if you are someone accustomed to vivid or at least some detailed memory of your dreamtime.
12. Muscle Cramps can occur anywhere in the body from legs to back to neck, and sometimes reflects the need for more calcium, or simply that your progesterone levels are too low.
13. Low Backache often worsens before or during menses, but if your hormones remain at low levels, you can experience it on a regular basis.
14. Gall Bladder Symptoms of pain, spasms and discomfort felt in the right upper abdominal quadrant under the ribs, which may be accompanied by belching, bloating, and intolerance to certain foods reflect the increased liver load with declining hormones.
15. Frequent Urination, or sensations that mimic urinary infections is a disturbing symptom often unrelieved by actual urination. It is often experienced as the sensation of needing to urinate all the time, even immediately afterwards.
16. Urinary Incontinence, the uncontrollable and spontaneous loss of urine, or the Urge for Incontinence, can occur suddenly or feel continuous, and not only in response to coughing, sneezing, jumping or running.
17. Hypoglycemic Reactions happen when suddenly your blood sugar crashes and you must have food now.
18. Food Cravings, often for sweets or salty foods, but can include sour or pungent foods.
19. Increased Appetite, especially at night and after dinner contributes to that unusual and unwanted weight gain.
20. Dark Circles Under Eyes can also be caused by adrenal exhaustion and thyroid dysfunctions, but no amount of sleep seems to eliminate it.
21. Joint and Muscle Pain, Achy, Sore Joints, Muscles and Tendons, which sometimes develop into actual carpal tunnel syndrome, or give rise to the questioning of other disease possibilities.
22. Increased Tension in Muscles demonstrates itself in those hunched up shoulders as you work or talk about anything uncomfortable, along with promoting lower back pain and a stiff neck.
23. Increased Hair Loss or Thinning anywhere on body, including your head, armpits, pubic area.
24. Increase in Facial Hair especially under your chin, or along your jaw line. It may be defined by generalized hair growth, or a specific and coarse single strand of hair that pokes out, even curls.
25. Unusual Hair Growth, around Nipples, between Breasts, down your back, places where your hair was finer, less coarse.
26. Acne, quite disturbing to any woman who dealt with this in adolescence and never thought it would recur.
27. Infertility causes grief in the woman who postponed pregnancy in her earlier years and now wishes to conceive, carry to term a healthy baby, and discovers she is unable to do so.
28. Loss of Breast Tissue begins with the decrease of progesterone production. Women often feel as though their breast have become empty sacs devoid of their normal fullness, with or without sagging.
29. Breast Soreness/Tenderness/Pain/ Engorgement and swelling, occurs particularly a few days to one week before bleeding actually begins, which usually potentiates complete relief of any pain or swelling.
30. Painful, or tender nipples have been described as this exquisite localized pain only in the nipples and suggests estrogen excess.
31. Cold Extremities feels quite strange especially in the presence of a hot flash, the combination of which is not impossible.
32. Being Accident Prone, bumping into things, not even realizing it until the bruise reveals itself later and then lacking the ability to recall the causative incident feels perplexing and a little scary at the prospect of something more damaging.
33. Hot flashes initially may be described as mild to severe flushes of heat waves, and for some women these evolve into intense outbreaks of sudden heat with sweating and turning bright red all over.
34. Loss of Sexual Energy, our Libido, can be marked by a gradual or sudden disinterest in sex, to the development of an actual aversion.
35. Painful Sex often described as if one?s vagina would tear open at the point of penetration along with feelings of abrasion during intercourse.
36. Vaginal Dryness, Irritation, sometimes accompanied by a consistent unusual discharge – typically odor free, negates a woman?s ability to be sexually active, or able to enjoy or be comfortable in her body.
37. Dizziness, feeling lightheaded and the loss of physical balance, and even a bit wobbling at times, requires pause in movement to prevent falling over or deepening into vertigo or feeling faint.
38. Ringing in the Ears, Tinnitus, can be experienced as a pulsing sensation, a whooshing sound, an almost musical or buzzing sound with a fuzzy sensation.
39. Abdominal Bloating comes on suddenly often after eating, or seems to be all the time, and can be visibly evident making you feel that you look like you are pregnant.
40. Weight Gain disturbs most women, particularly when it seems to happen over a couple of days, settles in the waist, buttocks and thighs, promoting a visceral thickening from the waist down, the classic middle-aged figure.
41. Fluid Retention, Edema, commonly with swelling in the legs and ankles, though not limited to this area and it is unrelieved by urination.
42. Palpitations or Heart Racing usually comes on suddenly, without warning or provocation, and dissipates spontaneously. The experience can be so wild and intense that a woman may become alarmed and wonder if she is having a heart attack.
43. Irregularities in your Heart Rate may feel more like your heart has just done a flip-flop or skipped a beat.
44. Constipation/Diarrhea, intermittent or alternating, results from declining hormone levels, which increase the demands on liver function and alters intestinal motility.
45. Tendency towards Candidiasis can increase, even if you have no prior known history ? and if you do, it may worsen.
46. Gastrointestinal Distress, Increased Flatulence, Unrelieved Gas pains, Indigestion, Nausea all can reflect intestinal changes due to hormonal imbalances.
47. Slow Digestion often goes along with the bloat ? what previously took four to five hours to digest, now seems to take all night. It seems worse in the evenings.
48. Lack of Appetite may be experienced as more of a lack of interest in food, going to the frig and standing there with the door open and staring blankly. Feeling completely uninspired, you busy yourself with something else and forget that you need to eat.
49. Changes in Body Odor especially disturbing when it seems to focus in the groin area, but can be anywhere on the body.
50. Puffy Eyes, not only from sleep disturbances, but also can accompany low progesterone.
51. Facial Pallor alternating with Facial Flushes is often intermittent with hot flashes.
52. Flare up of Arthritis worsens with low progesterone levels and increase sugar intake.
53. Loss of Bone Density, Osteoporosis, is not only an elderly woman?s disease, though it seems to develop over an extended period and is triggered by the decline of hormone production.
54. Dry Hair, Change in Skin Tone, Integrity, and Texture, becomes more wrinkled, and may begin the thinning process.
55. Changes in your Fingernails characterized by easy breakage, bending, cracking and getting softer.
56. Itchy, Crawly Skin with a strange sensation like insects crawling around under the skin ? quite different than the dry skin feeling.
57. Muscle tone seems to slack and sag, and loose its previous response to normal exercise.
58. Pelvic Pain can be random and independent of cycles and may feel continuous for some women.
59. Dry, Itchy Eyes felt in the deep posterior aspect of the eye socket, as well as superficially.
60. Teeth Aching or the experience of a strange sensation in one?s teeth or gums, often accompanied by an increase in bleeding gums.
61. Change in the normal Tongue sensation, which can be accompanied by a feeling of burning in your tongue and roof of mouth, malodorous breath or change in breath odor, and/or a bad taste in your mouth.
62. Memory Loss or Lapses in time, makes one feel disoriented and less focused, especially when you go into another room to get something specific and seconds later cannot remember what you went to retrieve.
63. Feeling Faint for no known reason (this does not include standing up too quickly)
64. Tingling in Extremities not only feels weird and like your hands or feet are falling asleep, but if persistent can be a symptom of diabetes, B12, potassium or calcium deficiency, or a compromise in blood vessel flexibility.
65. Sensation of Electrical Stimulation, or Shock occurring in the tissue under the skin, and may signal you that a hot flash will begin.
66. Increase and worsening of Allergies occurs as hormones become imbalanced, so can our immune system.

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Most men have never even heard of Andropause. It is different from the menopause women experience in that the production of female hormone drops suddenly.  

While in men, there’s a gradual decline of hormone levels over more years.

For men the fear of loss of their libido has many psychological and physicals effects.

1. diminished sex drive,

2. Osteoporosis,

3. reduced muscle bulk and strength,

4. night sweats,

5. physical, emotional and psychological changes

6. infertility,

7. fewer spontaneous erections,

8. depression,

9. loss of body hair,

10. swollen breasts,

11. palpitations,

12. shrunken testes,

13. height loss,

14. fatigue,

15. irritability,

16. nervousness,

17. reduced self-confidence,

18. decreased motivation,

19. poor concentration,

20. memory loss,

21. sleep problems,insomnia,

22. increased body fat, especially in the stomach area

23. anemia

24. increased sweating

25. hot flushes

  • Be honest with your doctor. Work with your doctor to identify and treat any health issues that might be causing or contributing to your signs and symptoms — from medication side effects to erectile dysfunction and other sexual issues.
  • Make healthy lifestyle choices. Eat a healthy diet and include physical activity in your daily routine. Healthy lifestyle choices will help you maintain your strength, energy and lean muscle mass. Regular physical activity can even improve your mood and promote better sleep.
  • Seek help if you feel down. Depression in men doesn’t always mean having the blues. Depression can cause men to suppress their feelings and become more aggressive or irritable. Men also might try to self-medicate by abusing alcohol or other substances.
  • Be wary of herbal supplements. Herbal supplements haven’t been proved safe and effective for aging-related low testosterone. Some supplements might even be dangerous. Long-term use of DHEA, for example, has no proven benefits and might increase the risk of prostate cancer. (mayo clinic)

There are a few overlapping symptoms between the sexes, but generally female changes are more complicated than males.

Here we are in the 21st Century and the same discussions are still taking place, only they are no longer whispered about in small circles.  The internet is full of millions of people screaming for relief, and looking for support and answers to their questions.

Many are falling victim to dubious “natural” remedy sites, book peddlers, and unproven vitamins or herbs.

There are also an astonishing amount of doctors who know nothing about hormonal issues and yet they prescribe hormones like candy.  Trying to sort through it all is mind boggling, time consuming, and often full of contradicting information.


Male menopause: Myth or reality?

What Are the Signs of Male Menopause?


Botticelli – Venus


women: Aging Icons


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