We seem to have reached peak “get off my lawn” culture, with men having temper tantrums all over the damn place. Whether they’re typing shrill all-caps messages, foaming at the mouth with road rage or aggressively punching holes in your drywall, men seem to be angrier than ever. And with a “boys will be boys” cultural mindset that provides a free pass on bad behavior to men well into their final decades, it’s hard to know when, or if, these antics will ever end.
Would it make you feel any better to know that there’s not only a possible medical reason, but even an accepted syndrome designation, for this way many men have of interacting with the world?
Maybe not, but the term “irritable male syndrome” does exist, and in the two decades since it was coined, it’s become accepted in medical and psychological circles. While not a clinical diagnosis, experts say it’s an accurate description of a cluster of symptoms that often appears in aging men.
“Along with the term ‘andropause,’ which refers to male menopause, it’s a useful shorthand for describing what happens to men through gradual testosterone decline and hormonal changes,” said Dr Justin Houman, assistant professor of urology at Cedars-Sinai Medical Center.
Andreas Kindler via Getty Images
Gradual testosterone decline can contribute to a number of symptoms, including mood changes, low energy and fatigue.
According to Houman, the most common symptoms are:
- Mood changes, including irritability, lower motivation and feelings of depression
- Cognitive changes, like difficulty concentrating or memory lapses
- Low energy and fatigue that isn’t explained by poor sleep alone
- Reduced libido and fewer spontaneous erections
- Loss of muscle mass and strength despite regular exercise
- Increased body fat, particularly around the midsection
- Sleep disturbances, including insomnia or poor-quality rest
These symptoms don’t happen overnight, he said. “Male hormonal decline is gradual, with testosterone levels peaking in the late teens to early 20s, remaining relatively stable through the 30s, and starting to decline by about 1% per year after age 40. Most men start noticing symptoms like those listed above between 40 and 60, though lifestyle, chronic illness and genetics can accelerate or delay onset.”
How we got here
The term “irritable male syndrome” (IMS) was coined in 2001 by Dr. Gerald Lincoln, a Scottish scientist known for his work in endocrinology and reproductive biology. He was researching testosterone levels in sheep when he observed a correlation between declining testosterone levels and increased irritability and aggression in rams after the mating season. He observed similar behaviors in other males when their testosterone levels dropped, eventually identifying the syndrome in red deer, reindeer and even Indian elephants.
“It’s a state of hypersensitivity, anxiety, frustration and anger that occurs in males that’s associated with biochemical changes, hormonal fluctuations, stress and loss of male identity.”
– Dr. Jed Diamond
As years passed, the term was picked up by psychologists and men’s health experts to describe similar emotional and behavioral patterns they were observing in human men, particularly in relation to age-related testosterone decline or stress-induced hormonal shifts.
Psychotherapist and author Dr. Jed Diamond has written the books “Irritable Male Syndrome” and “Mister Mean: Saving Your Relationship From The Irritable Male Syndrome.” He described IMS this way: “It’s a state of hypersensitivity, anxiety, frustration and anger that occurs in males that’s associated with biochemical changes, hormonal fluctuations, stress and loss of male identity. While it does usually occur in men later in life, I’ve seen men in their 20s or 30s, who have poor diets, high stress and other factors, can also experience IMS.”
We react differently to this syndrome because it’s more likely to “sneak up” on those who have it and those who love them, said coaching psychologist James Davis. “The hormonal changes of women’s menopause happen in a relatively narrow window of time, but with age-related testosterone decline, it can be more of a ‘slow drip’ rather than a sudden moment. This means symptoms can often be passed off as being caused by aging, stress or a combination of both.”
While hormonal changes might jump-start IMS, other factors can play a role, Davis said. “Those hormonal changes make men more anxious, which in turn can lead to irritability. There can be a crisis of self-identity that comes from declining physical performance, loss of muscle and lowered libido. When you overlay the stresses of managing a career, finances and relationships, plus the state of the world in general, you can see that many factors could make a man more irritable. Then add in broken sleep, a lack of experience or framework for expressing vulnerability or issues and increasing social isolation, and you can see how multiple factors can pile up to impact an individual.”
One man’s experience
Israel Cassol is a podcaster who began trying to raise awareness of “male menopause” after he was diagnosed with the condition shortly after turning 40. He told the New York Post, “I was hesitant to share such intimate details of my life, but I needed to know if this was an issue others were facing. I couldn’t believe the response I received from men describing similar symptoms I had suffered from.”
These days, he still promotes issues of men’s health, offering this advice to HuffPost: “Men shouldn’t see this as a weakness or something shameful. It’s a natural part of life for many, and talking about it helps break the stigma around men’s emotional health. The sooner we recognize what’s going on, the sooner we can take steps to improve things, and that makes a huge difference not just for men, but for their families and relationships, too.”
Suspect you may have IMS? Here’s what to do
Diamond said that the first step should be a doctor’s appointment: “I’d say that any man over 45 who is experiencing these symptoms consistently should see their doctor for a blood test to check testosterone levels.”
What happens if those levels are low?
“There are effective lifestyle adjustments men can make to boost levels naturally, and there is also the option of testosterone replacement therapy, which is something that requires careful consideration,” Davis said.
What to do if a loved one seems like a likely candidate for IMS? Besides that medical evaluation, Diamond mentioned, Houman suggested encouraging healthy lifestyle changes like more balanced nutrition, regular exercise, good sleep hygiene and reduced stress. “Keep communication open and non-judgmental, and seek counseling if a relationship strain develops,” he said.
What happens next
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It’s important to demonstrate compassion for this issue, Davis explained. “You need to realize that this isn’t a personality change per se, but is likely a result of hormonal changes that affect behavior, emotion, cognition and even how that person shows up in the world,” he added.
He also said that this is an issue that needs more attention. “We need to bring andropause out into the open so that both men and women can appreciate what’s going on with male hormones and psychology at this time of life. Midlife men are the highest suicide cohort, with a rate almost five times that of women of all ages, so the issue is significant and we shouldn’t marginalize it by questioning its existence or attempting to downplay it,” Davis added.
Finally, Cassoll offered this encouragement: “Patience and understanding are very important, because men going through this phase don’t always realize what’s happening to them. It helps if loved ones encourage healthier habits and also create space for honest conversations without judgment. Suggesting a medical check-up can be really helpful, because it reassures the man that he’s not ‘going crazy,’ and that there are ways to feel better.”
