Manopause: Your Guide to Surviving His Changing Life by Lisa Friedman Bloch and Kathy Kirtland Silverman pptx

“As a family therapist, I am delighted that Manopause gives us a comprehensive way to look at men at midlife and to understand how their psychological and physical changes impact them a

Praise for Manopause

“Manopause is an entertaining and enlightening read

about an important and neglected topic As a midlife man, I was impressed with the sensitivity of the authors’ writing, and as a health psychologist, I was delighted with the solidness of their scholarship

I highly recommend this book to men and women I know it will help both genders navigate a heretofore challenging passage.“

— Fred Luskin, Ph.D., Director of the Stanford University

Forgiveness Projects, Professor of Clinical Psychology at the Institute of Transpersonal Psychology, and Best-Selling Author

of Forgive for Good, Forgive for Love, and Stress Free for Good

“Manopause is an extremely helpful book that sheds light

on an important and seldom-talked-about topic

It’s a must-read for both genders!”

— Marcelle Pick, MSN, OB/GYN NP, Co-Founder of Women to

Women and Author of Are You Tired and Wired?

“This is a terrific book! Not only is it well-written and friendly, it’s well-researched and enormously informative I can’t wait to share it with the women (and men) I work with who are struggling with the often mystifying physical and psychological changes that take place in men during midlife.“

— Laraine T Zappert, Ph.D., Clinical Professor in the

Department of Psychiatry and Behavioral Sciences

at Stanford University School of Medicine

“As a urologic surgeon and clinician for over 35 years, I am convinced that both men and women deserve the enjoyment that comes with complete sexual satisfaction Yet too often I have seen men deprive themselves of that satisfaction at midlife, due to ignorance of normal physical and mental changes Manopause does a stellar job of busting

through that ignorance, by giving readers facts about men’s hormonal and psychological shifts that will help them to eliminate negativity and

self-doubt, while enriching their sexual lives and relationships.”

— Dudley Seth Danoff, M.D., F.A.C.S., Founder and President,

Tower Urology Group, Cedars-Sinai Medical Center

and Author of Penis Power

“As a family therapist, I am delighted that Manopause gives us

a comprehensive way to look at men at midlife and to understand

how their psychological and physical changes impact them and all

those around them Just as Passages changed the way we view

menopause, Manopause will change the way we view the male

‘midlife crisis.’ After reading this groundbreaking book, you won’t

be able to look at yourself or your man the same way again.”

— Eva Ritvo, M.D., Former Vice Chair of the Department of

Psychiatry, Miller School of Medicine, and Co-Author of Concise

Guide to Marriage and Family Therapy

Man opause

Also by lisA FriedmAn bloch And KAthy KirtlAnd silvermAn

Dr Richard Marrs’ Fertility Book: America’s Leading Infertility Expert Tells

You Everything You Need to Know About Getting Pregnant

Man opause

Your Guide to surviving

His Changing Life

lisa Friedman bloch Kathy Kirtland silverman

HAY HOUSE, INC.

Carlsbad, California • New York City London • Sydney • Johannesburg Vancouver • Hong Kong • New Delhi

Copyright © 2012 by Lisa Friedman Bloch and Kathy Kirtland Silverman

Published and distributed in the United States by: Hay House, Inc.: www.hayhouse.

com ® • Published and distributed in Australia by: Hay House Australia Pty Ltd.: www.

hayhouse.com.au • Published and distributed in the United Kingdom by: Hay House

UK, Ltd.: www.hayhouse.co.uk • Published and distributed in the Republic of South

Africa by: Hay House SA (Pty), Ltd.: www.hayhouse.co.za • Distributed in Canada by:

Raincoast: www.raincoast.com • Published in India by: Hay House Publishers India:

www.hayhouse.co.in

Cover design: Christy Salinas • Interior design: Tricia Breidenthal

All rights reserved No part of this book may be reproduced by any mechanical,

photographic, or electronic process, or in the form of a phonographic recording; nor

may it be stored in a retrieval system, transmitted, or otherwise be copied for public

or private use—other than for “fair use” as brief quotations embodied in articles and

reviews—without prior written permission of the publisher.

The authors of this book do not dispense medical advice or prescribe the use

of any technique as a form of treatment for physical, emotional, or medical

prob-lems without the advice of a physician, either directly or indirectly The intent of the

authors is only to offer information of a general nature to help you in your quest for

emotional and spiritual well-being In the event you use any of the information in this

book for yourself, which is your constitutional right, the authors and the publisher

as-sume no responsibility for your actions.

Library of Congress Cataloging-in-Publication Data

Bloch, Lisa Friedman.

Manopause : your guide to surviving his changing life / Lisa Friedman

Bloch, Kathy Kirtland Silverman.

p cm.

Includes bibliographical references.

ISBN 978-1-4019-2712-7 (pbk : alk paper) ISBN 978-1-4019-3106-3

(digital) 1 Middle-aged men Psychology 2 Midlife crisis 3.

Middle-aged men Sexual behavior I Silverman, Kathy Kirtland II.

To my precious daughters and treasured son,

Alexis, Caroline, and Jordan, and

to my extraordinary man, Jonathan, thank you for your patience, enthusiasm,

and immeasurable support

— Lisa

To Matt, for the great man he would have been

To Alan, for the remarkable man he is

— Kathy

Foreword by Louann Brizendine, M.D xi

Introduction xv

paRT I: undeRsTandInG YouR Manopause Man Chapter One: The Manopause Quiz 3

Chapter Two: What It Means to “Be a Man” 27

Chapter Three: The Manopause Problem 47

Chapter Four: Good Men, Bad Behavior 73

paRT II: LIvInG wITh YouR Manopause Man Chapter Five: Your Manopause Man’s Emotional Awakening 91

Chapter Six: Emotions and Behaviors Go from Bad to Worse 117

Chapter Seven: Testosterone and Your Manopause Man 135

Chapter Eight: Manopause Sex, His Penis, and Your Relationship 155

Chapter Nine: Intimacy with Your Manopause Man 189

Chapter Ten: Family Matters at Manopause .209

Chapter Eleven: Manopause Men at Work .229

Conclusion: Your New and Improved Manopause Man 257

Endnotes 265

Bibliography 275

Acknowledgments .279

About the Authors .283

were kindred souls Like me, they were fascinated by the differences

between women and men, and by the robust effect of hormones

on men’s behavior I have dedicated my own professional life and

decades of work as a neuropsychiatrist, first at Harvard University and

today at the University of California, San Francisco, to clinical work

in understanding how hormones affect our brains, and how the

dif-ferences between the male and female brains influence the way the

sexes function, feel, and communicate in their everyday lives and

re-lationships The moment I learned about Lisa and Kathy’s research, I

knew that Manopause would be a wonderful addition to our existing

body of knowledge about men at midlife, and, as it speaks to women,

that it would enlighten them about the complicating forces that

con-verge on their men during this pivotal, yet somewhat secretive, time

Manopause surpassed my highest expectations It brings men’s

midlife change out into the open It not only makes the reader feel

less burdened and alone, but also uplifts her by teaching her how to

move through this delicate time period while focusing on its positive

aspects—and there are so many to experience Manopause guides

Manopause

women to lovingly assist their men, while making their own lives

bet-ter in the process

As the founder of the Women’s Mood and Hormone Clinic at UCSF,

and the co-director of the Program in Sexual Medicine, I have

coun-seled many midlife couples during the last 25 years, and I am acutely

aware of the confusion that midlife hormone changes can produce for

both genders—particularly for men, whose brains make them world

champions at blocking their emotional reactions In my practice I have

seen that as men’s hormones shift at midlife, so does their reality They

feel tendencies that are new to them They may become more

respon-sive to cuddling and bonding, and, as the authors explain, have an

improved capacity to empathize and read subtle facial expressions And

they may be less territorial, and less compelled to fi ght for a place in the

pecking order While these characteristics may be a welcomed relief to

their women, they can terrorize men Lisa and Kathy expertly, and with

anecdotal stories, explain why this is

Manopause will help you to understand that the changes in your

man’s behavior, including his sexual and emotional changes, are not

your fault They are not occurring because of something you did or

did not do As you read, you will see that manopause men are only

trying to fulfi ll what they believe women and society want and expect

from them—to be strong, brave, and independent; to suppress their

fear and pain; to hide their softer emotions; and to stand confi dently

in the face of challenge What I have discovered through my research

is that men’s desire to fulfi ll these expectations is so strong that their

brain circuits actually architecturally change to refl ect the emotional

suppression that is required of them

If you are dealing with the outward signs of a midlife male shift—

with the irritability, anger, and withdrawal that it can produce—this

book will help you see that the manopause challenge is only a

prob-lem if you ignore your man’s veiled doubt, uncertainty, and negative

behavior Manopause will help you to unravel his secrets, explore the

shameful unknown, alter his goals, and assist him in reshaping his

manhood pressures as he starts down the road to inner peace This

could be your man’s last chance to fi nd the authentic person inside, to

reach his ultimate potential, and to become his “real self.” Manopause

can help you be the midwife who delivers him to himself

But be careful not to use this book to overthink or overanalyze him, at least out loud Because, at fi rst, if your man thinks you under-

stand him as intimately as Manopause will help you to do, it might

frighten him and make him push you away The book may also give

you some personal challenges As you begin to see your man’s

deep-est drives through male-colored glasses, you may realize that you

have to take a deeper look at yourself as well It’s only right that you

share this time of reevaluation and rejuvenation

Manopause is a goal changer, both for your man and for you

Use it as a secret encyclopedia about your man at midlife Keep it on

your bedside table so you can refer back to it Let Manopause help

you gain a greater understanding of who both of you are during his

manopause years, and guide you with a wonderful road map for

ne-gotiating the potentially rich and plentiful years ahead

introduction

As Kathy looked around the room, every second booth seemed

to hold a couple, lunching together Men were looking appreciatively

at their companions Hands were being held and meaningful glances

exchanged It was her birthday, but Kathy couldn’t have felt more

isolated, hurt, and angry It had been less than a month since she had

spotted a woman with her husband’s car A woman half his age A

woman who turned out to be his mistress He had supposedly driven

100 miles south on a business trip, but there was his car And there

she was, loading grocery bags into the trunk Since then life had been

chaos; hours and days had been filled with confusion Who was this

man she had spent decades with, and what had caused this startling

shift in his behavior? Were there signs she missed, even subtle ones?

How could she have been so stupid? Had their communication

fal-tered? Was she looking old . .  fat . . . undesirable? Maybe she was

Maybe it was all her fault Kathy stared at a couple in the corner, the

man considerably older than his companion She wondered if some

other unsuspecting woman was about to get an emotional gut punch

She wanted to flee It was torture to sit there, feeling the shame of

losing her husband, feeling so very visibly alone She forced herself to

stay How could she disappoint Lisa and their friends? Checking her

watch, she felt worry kick in on top of her anxiety Lisa knew what

pain she was in and how fragile she was It had taken a week of

arm-twisting to get Kathy to agree to come at all Where could Lisa be?

While Kathy was trying to remain appropriately calm at a ful restaurant, Lisa was at Cedars-Sinai Medical Center

beauti-It had been a sleepless night for Lisa Her husband, Jonathan, had spent it writhing in pain For the past two weeks, he had taken pre-

scribed painkillers and tried to pretend that his hernia wasn’t getting

worse But that had become impossible Pacing the bedroom, he fi

-nally let Lisa call his doctor, reminding her that if surgery was needed,

he would have to wait a week, until after he gave a keynote speech at

a business conference in New York

The next morning the doctor confi rmed the hernia required

sur-gery, to be done as soon as possible But from that point on, he might

as well have been talking to Lisa and Jonathan in different languages

Lisa heard that the surgery should be immediate; if the hernia burst,

it would be a much more complicated operation, with potentially

permanent damage Jonathan, on the other hand, heard what he was

hoping for, that it could wait a week He said he would carve out time

for the surgery the following Friday Lisa was fl abbergasted As

Jona-than rose to leave, she protested Didn’t he hear what the doctor was

saying? Didn’t he understand that if he wasn’t treated immediately,

there could be serious consequences? Jonathan told Lisa she was

overreacting It was just one more week of pain; he could handle it

Lisa was incredulous Why would her husband reject the doctor’s

ad-vice? What was wrong with him? Jonathan shot back How could she

not recognize how important this speech was to him? Lisa asked the

doctor whether, if the surgery was performed early the next morning,

Jonathan could fl y in a few days He replied that it would be less of a

risk than ending up in a New York emergency room, in the hands of a

surgeon he didn’t know Jonathan fi nally came to his senses Relieved,

Lisa looked at her watch and panicked all over again She was terribly

late for her lunch with Kathy She didn’t want her to wait alone at the

table, even for a second

Lisa rushed in and sat down next to Kathy, apologizing profusely

The rest of their girlfriends started arriving Laurie, juggling an

or-chid plant, greeted Kathy with a heartfelt kiss Sarah walked in She

seemed distracted, but still embraced Kathy with a meaningful hug

It was the fi rst time they had seen each other since Kathy’s separation

Everyone paused as Natalie entered the room Her deep brunette hair

was now light platinum Natalie made light of it, saying, “You only

live once, right?”

Everyone was worried about Kathy And as she shared details,

revealing her hurt and vulnerability, it became obvious that her

introduction

husband’s actions didn’t set the stage for a warm and carefree

birth-day lunch Lisa, trying to shift topics, started asking about what was

happening in the other ladies’ lives And the answers that came back

started revealing a pattern: after the initial niceties, the façades

crum-bled—each of them eventually admitted to having problems with

their men Laurie’s husband, David, had lost his job and had become

aimless He used to be a go-getter, but now he was working toward

nothing, and he had become angry and controlling Sarah’s husband,

Adam, had become hard to live with, too He’d been battling their

son for months, fi nding fault with everything he did The tension had

gotten to be more than she could bear Natalie was having problems

with the new man she was dating Even though they had a lot in

com-mon, and they enjoyed spending every minute together, they hadn’t

been physically intimate All of the women were confused and upset

All of them had questions—both about their man’s behavior and their

part in it

After the meal, Lisa and Kathy were waiting for their cars, and they couldn’t help but notice how drastically the conversation had

changed over their years of spending birthday lunches together

Fash-ion, fornicatFash-ion, and frivolity used to be the hot topics Then, small

job promotions, fi rst mortgages, and exciting vacations After which

came mommy talk about sippy cups, school admissions, and kids’

sports leagues But this birthday was different Now the discussions

were suddenly all about problems—all sorts of problems—with men

Were they just being overly sensitive? Or were they uneducated about

what was going on and how to handle it?

As you’ve probably guessed, we are the Lisa and Kathy in the above narrative And that day in August was a turning point in our

lives Little did we know that the awkwardness, pain, and confusion

we felt would push us to search for answers that would ultimately lead

to the writing of Manopause.

After lunch that day, we started discussing men at midlife more and more As writers, we’d spent years researching people’s interac-

tions so we could craft compelling stories for the big screen, the small

screen, and nonfi ction books We had been given insight into the

stories of many marriages when we were researching our book on

fertility, and we knew from those interviews the varying dynamics of

hundreds of couples Plus, we had observed our own and our friends’

couplings over decades And never before had we heard such a

per-vasive tone of confusion, frustration, and discontent Was this just a

cluster epidemic, we wondered, limited to our own little world? Or

was this more widespread?

We began to put out feelers to friends around the country, and

we got some interesting results Everywhere, women in our age

range, and younger, were experiencing similar changes in their men

Maybe they were just getting a little irritable and touchy Maybe they

were getting downright diffi cult to live with Or maybe, like Kathy’s

husband, they had an agenda all their own We decided we were on

to something and had to go full bore into this project

But we soon learned that our exploration was going to be more

challenging than we had anticipated The fact that men change at

midlife is a topic that our society chooses to ignore When we sit

around a dinner table, join together for a family gathering, chitchat at

a cocktail party, or strike up a conversation after a meeting, we

uni-versally avoid acknowledging, admitting, or discussing the fact that

men go through their own version of menopause We all know they

do, but no one talks about it Unless, of course, you happen to be in

a very intimate group of female friends talking about the men who

matter to them There, midlife men being diffi cult or changing might

be a more open—though not very well understood—subject

A woman’s midlife change doesn’t seem to carry as strong a

stig-ma One reason for this is Gail Sheehy’s groundbreaking book, The

Silent Passage, which helped menopause emerge from the shadows

Before she initiated an open discussion, menopause was considered a

totally negative, socially unmentionable change of life After Sheehy’s

exploration of its many aspects, women realized that while it was a

time of change, much of that change could be positive They could

embark on a liberated and energized second stage in life As authors

and social commentators, we felt we could do a similarly positive

ser-vice for men, and for the women who care about them, by examining

their midlife changes, as observed from a female perspective

introduction

This is important, because until men’s passage is recognized, explored, and socially accepted, we all will be doomed to varying

degrees of confusion, misunderstanding, and discontent Men will

continue to suffer through hormonal and psychological changes

without the means or knowledge to interpret them And women will

suffer along with them Change, in varying degrees, is inevitable for

all men That is why it needs to become a topic we can be

comfort-able with and openly discuss

Currently, the words that are commonly used to name and scribe this pivotal time in a man’s life have been rooted in a medical

de-vocabulary They include such confusing and unhelpful terms as

an-dropause, viropause, endopause, male climacteric, male menopause,

climacteric male menopause, and midlife crisis There doesn’t seem to

be much consensus among experts as to which term to use or what,

exactly, each of them means Some will tell you that they refer only to

hormonal changes and the physical fallout from those changes

Oth-ers will advise that they also include psychological and social changes

Ironically, the most commonly used phrase, male menopause, is a

contradiction in terms Menopause literally translated means

“stop-ping of the menstruation cycle.” But men do not have a cycle to

stop Only women do And having experienced a monthly menstrual

cycle most of our lives, it is only fair that we claim “menopause” for

ourselves

What happens to men at midlife—hormonally, psychologically, socially, culturally, and physically—was an area that needed to be

more deeply explored, clearly defi ned, and brought into the open

We knew we were the ones to do it

So we called our literary agent and told her what we were ing She wasn’t at all surprised The same sort of uneasiness seemed

think-to be drifting in the wind around her and the women in her world

That’s when she suggested the term manopause Hearing it, we

smiled Men pause; they change It made such sense It was a way to

give them their own term, one that had not already been used and

confused, one that would be all-inclusive, appropriate, and easy to

understand When we talked it up with our professional associates

and personal friends, they not only smiled, they let out a “been there,

experienced that” laugh And so, our journey began Over several

years, massive research; interviews with medical, psychological, and

cultural experts; dialogues with men about their personal stories; and

hours of woman-to-woman sharing brought Manopause to life The

result is a book that can help to guide you through the most

challeng-ing transition in your man’s life

Manopause is divided into two parts Part One is the launchpad

for your understanding of why men are the way they are In this

sec-tion, you will discover the power our culture has exerted over our

men, the many ways its infl uence has shaped their feelings about

how they must behave in order to “be a man,” and the ways in which

women are equally vulnerable to our culture’s preconceptions of what

“a man” should be This section also highlights the ways men can be

negatively impacted when change occurs that prevents them from

fulfi lling their perceived manhood requirements And it clarifi es what

lies behind the behavioral challenges that may crop up when

unre-lenting cultural pressures collide with a man’s physical decline Finally,

it explores the biological differences between men’s and women’s

brains, and how these differences can complicate the

already-complex relationship dance during manopause

Part Two becomes more specifi c, exploring a variety of areas and

situations that are impacted by manopause on an everyday basis

Here you will fi nd chapters that delve into men’s hormones and

emo-tions, and others that discuss the impact of manopause on sex, family,

work, and on a man’s interaction with the world around him In this

section you will also read about the many admirable and redeeming

masculine traits that you should welcome, enjoy, cherish, and

encour-age in your man Throughout these chapters, we have provided fi

rst-person stories that will help you to better understand what your man

is going through, and tip boxes that offer suggestions and guidelines

that will resonate with your desire to make life-affi rming changes in

every challenging situation

Before you jump in, we invite you to take the Manopause Quiz

This series of questions will fi rst clue you in on where you stand in

your knowledge of men in general, and then, on manopause men

in particular The quiz will then ask you to test yourself on ways your

introduction

personal attitude plays into, and potentially complicates, your

mano-pause man’s issues Truly knowing yourself and understanding where

you stand will be a precious tool in your efforts to move through this

time of life, toward a more fulfi lling tomorrow

The insight you gain by reading Manopause will allow you to feel more empathy and patience toward your manopause man and his

behavior Sharing what you have learned with your man will help him

to become better adjusted to his own changes and more emotionally

aware of what he is going through, plus what you are going through

alongside him This new insight will help to lessen his struggles and

release him from the cultural pressures he is laboring under He will be

more at peace in his home, with his family, at work, with his friends,

and, most important, with you You will enjoy improved

communi-cation and a more intimate relationship You will be freed from the

constraints that have kept you both from exploring avenues of life

that have always been intriguing but seemingly unobtainable Now

is your chance to absorb the message of Manopause With men living

longer today than ever before, it’s time to take the steps to ensure

that you share your future with a man who is happy, well-adjusted,

and fulfilled

pa R T

I

understAnding your

Manopause mAn

chApter one

the Manopause Quiz

Men we can’t live without them They make up almost 50 percent of our planet We are raised by them We work with them

We live with them We share our lives with them And best of all, we

make love to them They are our fathers, our friends, our husbands,

our co-workers, and every so often, our bosses They are our teachers,

our mailmen, our doctors, our taxi drivers, our attorneys, our

super-market clerks, our shoe salesmen, and our neighbors

But while it’s true we can’t live without them, let’s admit that sometimes it’s hard to live with them, especially during the unset-

tled years between 40 and 65 These are the years when noticeable

changes in our men can begin to turn them into people we aren’t

sure we recognize Why does this happen? And why has there been

so little focus placed on this? Why does society as a whole find men’s

changes frightening and difficult to talk about? It’s because our

cul-ture has pronounced that this change eats away at the very core of

what it means to “be a man.”

There are certain ways men must behave, and certain ways they are expected to perform And most of them conform to these stan-

dards, at least for a while But when they reach midlife, with

hor-mones possibly ebbing, the struggle gets harder For some men,

midlife can be a transition that is relatively smooth, with just a few

bumps in the road For others, it may be disquieting But for many,

it can be earth-shattering, as their declining hormones collide,

head-on, with our culture’s manhood demands It is this crash that triggers

uncharacteristic feelings and actions in our men This is the period we

call manopause—one word that says it all Manopause encompasses

every aspect of the inevitable change in a man’s life

But don’t despair Your relationship with a manopause man can

thrive, as this period of time can also offer a satisfying, rewarding,

and fulfi lling new stage in life Manopause will turn on the lights for

you, expose how important it is to understand how men tick at this

precarious time of life, and guide you both to savor a happier shared

future

The Quiz

Maybe you sense that your man is in the midst of this change

Perhaps you don’t But then again, do you really know and

under-stand your man and the ways he is different from you? To help make

the process of change more comfortable, you need to appreciate and

empathize with what he is going through You must also begin to

analyze how you may be contributing to his stress The following quiz

will help you take a more honest and forthright look at your

knowl-edge of the differences between men and women, and it will help

you to recognize the inner cultural programming that affects both of

your expectations In addition, it will shed light on how both of your

behaviors individually infl uence and color this confusing, sometimes

tumultuous, but potentially fulfi lling time of transformation

part one:

How well do you know and understand men? How different

are they from us? The following short quiz will help you determine

your depth of knowledge about some all-important male and female

traits—traits that could impact your relationship and your ability to

the manopause Quiz

communicate as you navigate through manopause Your score on this

quiz will show you just how much you know about men, and their

changes at midlife After all, knowledge is power

Q UESTIONS

1 A man who has sex at least twice a week can boost his

infection-fi ghting cells by:

c They are equal

3 Generally, as a man ages, the semen he ejaculates:

a Decreases by up to half

b Decreases slightly

c Becomes thicker

d Increases slightly

4 Studies show women recognize signs of sadness in a

face 90 percent of the time, whereas men recognize them:

a 40 percent of the time

b 60 percent of the time

c 75 percent of the time

5 On average, a man begins losing testosterone at the

a A woman’s brain activates faster than a man’s

b A man’s brain activates faster than a woman’s

c Both brains activate at approximately the same rate

7 Whose brain can better analyze a dangerous situation

before acting on it?

a Women’s

b Men’s

c They do it equally well