I remember a line from my younger years, about how men don’t suffer from PMS once a month; they suffer from it all month, every month. Now that we’re not worried about PMS and periods any longer, we could probably make a similar joke about men going through menopause, since as a rule they seem to get crankier as they get older, Except that it wouldn’t actually be a joke. It’s for real.

There’s a certain karmic justice in the idea that men can suffer what menopausal women do.

It’s not officially called “male menopause,” though that’s a helpful shorthand to describe the issue and timing. The medical term is andropause. One thing that can bring it on is stress, and since the world today is nothing if not a bubbling stew of anxiety and dread, brace yourself for this to become a national emergency. Indeed, researchers estimate that one in five men over 50 are in some stage of andropause.

In the midlife years, testosterone production declines by about one to two percent every year. (You would think this would ultimately make wars less likely, but the old guys seem to fake it if they can’t make it.) Unlike menopause in women, when estrogen production goes off a cliff, testosterone decline in men is a slow slide that starts with a guy buying a red sports car. Add this to human design’s “unfair” column: The hormone machines in men don’t run out of the ingredients needed to make testosterone.

“Not every man will experience [andropause]. But the symptoms are very real,” says Luigi Simone, MD, a family medicine physician at Scripps Clinic Encinitas with a special focus on men’s health. “There’s a reason it’s called male menopause. It’s because it can produce many of the same symptoms as female menopause.”

Read More: Post-Menopause Sex Woes: Quit Blaming Women

Hot Flashes in Men?

On the face of it, there’s a certain karmic justice in the idea that men can suffer what women do during menopause. But the truth is that men–as a generalization, I know–aren’t as used to rolling with weird things happening to their bodies as women are. This can mean that spouses and partners may have to share the pain as men grapple with the symptoms.

Yet many symptoms can go undetected.

Here’s one symptom that is guaranteed to get a man’s attention.

Irritability: Couldn’t that explain most any man, at most any time?

Fat redistribution that can lead to belly fat: That could be due to more Netflix time on the sofa, especially during COVID.

Weakness: See above.

Insomnia: He may blame it on your tossing and turning.

Poor short-term memory: Hasn’t he always been asking you some version of, “Have you seen my keys?”

Hot flashes: Wait, hot flashes?  No matter, sweaty men don’t raise alarm bells like sweaty women.

Depression: Well, something’s wrong with you if you aren’t depressed right now.

The one symptom that is guaranteed to get a man’s attention is the inability to get it up any longer.

The ED Problem

“Oh, I miss those days, when you had a boner you could hang a towel on!” That’s an especially memorable line uttered by Bryan Cranston’s character in the movie Last Flag Flying, and it likely sums up the feelings of most men of a certain age.

The sweet innocuousness of couples in separate bath tubs in TV ads belies the angst behind it all.

Men losing the woody of their dreams has been a boon to big pharma, which has reaped untold billions hawking Viagra and the like. (While women are still waiting for medical help to goose their own libido, but that’s another story.) The sweet innocuousness of couples in separate bath tubs in TV ads belies the angst caused by the little penis that couldn’t.

When men have sex problems that’s when they have to face the possibility that they’ve got low testosterone and may be going through their own version of “the change.” Just as hormone replacement helps women like us regain our equilibrium, men can receive testosterone therapy to address their issues. But we, the human race, need to decide if more testosterone in the world is really a good thing. What do you say?

Read More: When One Wants Sex and the Other Doesn’t. How To Save A Lustless Marriage