Andropause - by Tim Davis

This is an extremely interesting area of men’s health. Most men experience a change in their health around about midlife (45-50). In general terms there is a slowing down in metabolism - a lessening of physical energy, flexibility, recovery time from illness and in reflexes. It can for some men also be a vulnerable time when the way they have identified themselves in the first part of their lives starts to change. The ambition, vigour and high libido, all part of the yang energy of youth, begin to fade. This is sometimes referred to as a ‘midlife crisis’.

If the goal is to recapture the vitality of youth then that may not be possible. If it is to find a satisfying way of being with oneself that incorporates the physiological and emotional changes that are happening, this may be possible. It is interesting that many poets and artists do some of their most creative work in the second part of their lives. In Chinese Medicine this stage of life is recognised as the start of wisdom. In Chinese as well as Western medicine there is a physiological basis for these changes and therefore a link between a physiological change and experience. Chinese medicine can directly support this change through treatment of the channel system which is a way of supporting and influencing the physiology.

In one of the major passages of the Su Wen (written 2000 years ago) it states “In the fortieth year, kidney yin energy is naturally depleted by half, being depleted by living. In the fiftieth year, the body becomes heavy, and the ears and eyes are no longer sharp. In the sixtieth year, there is yin wilt, Qi (energy) is greatly depleted, there is emptiness below and fullness above.” From this passage we can see that at forty years old, yin is depleted by half simply as a result of the normal ageing process.

There is also an awareness of the progressive weakening of men’s bodies as they age; this perspective is very useful as it orientates treatment towards specific areas of the meridian and channel system. As an example, I have noticed in my own practice that many men have lower back and knee problems over the age of forty-five. Treatment is therefore often focussed on these two areas but also upon the kidney meridian as the underlying declining meridian. This would be different to treating someone in their twenties with a back problem, where declining kidney energy is not necessarily an issue.

The kidney meridian, as well as being associated physiologically with the lower back, is also associated with willpower and ambition. In mid life the will gives way to wisdom, so treating the kidneys during this phase of life can help this transition. In a younger man at a different phase of his life, treatment on the kidneys can strengthen and firm the will and channel it into ambition. It is therefore within the scope of Chinese medicine to provide a context and a treatment protocol to assist the so-called ‘midlife crisis’.

In mid life I do not see the changes as a failure of the body that needs to be corrected, rather as an evolutionary process with its gifts as well as its losses. This perspective has important implications in the treatment of men and supports a move away from the predominantly negative stereotypes and clichés associated with ageing.

There is, however, a caveat to the above point that is worth mentioning; Andropause as a Western disease category refers to a collection of endocrinal somatic and psychic changes experienced by men in middle age and beyond. Mostly it is accepted that these are the normal signs of ageing. However in some people there are abnormally low levels of testosterone (hypergonadism, testicular failure), in these cases ART androgen replacement therapy is usually given.

Treating men has always been part of Chinese medicine. Treating specific men’s diseases has until recently been background. A growing interest in alternative health and fertility, together with more research and translation of Chinese source material has prompted more men to seek help from practitioners such as myself. I hope I have shown that Chinese medicine offers a highly specialised and effective treatment for many men’s diseases.