So the demand for these new erection drugs will no doubt be there. But men face a larger challenge to their virility and vitality than can be ““cured’’ by any magic bullet. Rather than focusing on impotence in isolation, they need to be aware of all the physical and psychological passages of middle and later life. This ““MANopause’’ is a five- to 12-year period during which men go through hormonal fluctuations, coupled with accelerated physical and psychological changes.
MANopause is more gradual and elusive than female menopause. Common symptoms are irritability, sluggishnessand mild to moderate mood swings. Physically, a man may notice a decrease in muscle mass and strength. The most familiareffect is a slump in a man’s overall sense of well-being. But the greatest fear, the phobic event that may become a self-fulfilling prophecy, is intermittent problems in gaining and sustaining erections. If a man rates himself only on speed and athleticism versus his younger, friskier self, the ““performer penis’’ will eventually fail him.
Underneath the male menopausal syndrome there may also bea man who feels he is losing control. Losing his job or beingpassed over for promotion in midlife, for instance, is tantamount to falling off the top of the heap in the chimpanzee hierarchy. In both humans and animals, defeat decreases testosterone. Therefore, the sudden loss of self-respect and dominance reduces male sex hormones, which may further dampen a man’s sex drive.
Until very recently, the American medical profession has large-ly ignored the syndrome of male menopause. Among themselves, many urologists refer to the problem as ““just putting some lead back in the pencil.’’ Urologists of the Lead Pencil School may tell patients their potency problems can be cured with a few office visits, a shot or an implant–and soon, perhaps, a pill. Technology-oriented, male-dominated medicine also often refuses to acknowledge the mind-body connection. ““We can get most men erections,’’ asserts Dr. Ken Goldberg, a pioneering urologist who runs a male health center in Dallas. ““But too oftenit doesn’t make a differencein restoring their confidence so they can function sexually on their own.''
It is much easier to prevent male menopausal impotence than to correct it, and that raises another problem with the ““potency pill.’’ Men don’t go to doctors nearly as often as women, and when they do go, they seldom ask questions, nor are they asked routinely about theirsexual health. Women, on the other hand, have come out of theirignorance and denial about menopause and are raising hell with their physicians. One of the benefits of male midlife slowdownis that it may motivate a man to get a good physical. But if hecan walk into a doctor’s office and ask for a potency pill, it may never be discovered that his impotence is a result of depression, for example.
The other crucial element ignored by the potency-pill approachis a man’s relationship with his partner. The wife or lover of an impotent man has a very special agony. She may not be able to discuss the problem with him without further deflating his ego. She may feel unfeminine, unwanted, rejected. Couples often walk around this 800-pound gorilla in the middle of the bedroom for months, even years. A potency pill may be a temporary confidence-builder, but couples who have grown apart almost inevitably will need counseling to overcome anxiety and rebuild trust.
Vast improvement in mid- and later-life sexual vitality can be gained by correcting an unhealthy lifestyle and cultivating more relaxed and realistic expectations of aging. That means exercise, good nutrition and finding a new level of intimacy with one’s mate. No matter what bullets the drug companies try to sell men, that’s where the real magic is.
