Another Kind of Pause

The increasing clinical and research attention directed toward the psychophysiological effects of low testosterone in men (and women) and the beneficial outcomes of replacement therapies has been stimulating and exciting in the past two to three years. Of course, research literature on the topic has been compiling for decades, but it can now be elaborated on in a more sophisticated way in the context of the evolution of psychiatric nosology and the immense advances in psychoneuroendocrinology.

I have been noticing that among respected academicians publishing in monthly journals, using the terms “andropause” and “male menopause” has seemingly been accepted by editorial staff and allowed to continue.

Our profession has had to live with the outcomes of naming syndromes badly with terms we’ve then been stuck with (“borderline” is probably the best example). So why are we allowing the propagation of “andropause?” I am unclear about the origins of the term, but this neologism is predictably troublesome. My Dorland’s Medical Dictionary defines menopause as, “cessation of menstruation in the human female, . . .premature failure of ovulation, possibly due to primary germ cell deficiency. . . .”

When authors of studies published by psychiatric journals (approved by editorial staff) include the term “male menopause,” one with a common-sense appreciation of language might be logically correct in assuming they were talking about cessation of menstruation in men. And “andropause”? This sounds more like a brand-name for a new women’s product that can be used to tone down her frisky male partner’s unrelenting advances. Or a new device for men to use when they want to get in touch with their feminine side.

Before our professional linguistics are overtaken by, like, you know, the pop media, whatever, we might want to develop a useful and accurate term for what has typically been called hypogonadism or androgen deficiency, or at least stay consistent, for now, with the DSM terminology that was previously labored over meticulously to avoid future nosological embarrassments.

I’d continue, but my castration anxiety is flaring up again. . . . I need a dose of andropause!