Middle age

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For other uses, see Middle Ages (disambiguation). Middle age is the period of age beyond young adulthood but before the onset of old age. Various attempts have been made to define this age, which is around the third quarter of the average life spanof human beings. According to Collins Dictionary, this is "... usually considered to occur approximately between the ages of 40 and 60". The Oxford English Dictionary gives a similar definition but with a later start point "... the period between early adulthood and old age, usually considered as the years from about 45 to 65". The US Census lists middle age as including both the age categories 35 to 44 and 45 to 50, while prominent social scientist, Erik Erikson, sees it ending a little later and defines middle adulthood as between 40 and 65.

Middle-aged adults often show visible signs of aging such as loss of skin elasticity and graying of the hair. Physical fitness usually wanes, with a 5±10 kg (10-20 lb) accumulation of body fat, reduction in aerobic performance and a decrease in maximal heart rate. Strength and flexibility also decrease throughout middle age. However, people age at different rates and there can be significant differences between individuals of the same age.[1] Both male and female fertility declines with advancing age.[2][3] Advanced maternal age increases the risk of a child being born with some disorders such as Down syndrome. Advanced paternal agesharply increases the risk of miscarriage and many birth defects, including Down syndrome, schizophrenia, autism, decreased intellectual [4][5][6][7] capacity, and bipolar disorder. Most women will experience menopause, which ends natural fertility, in their late [8][9] 40s or early 50s. In developed countries, yearly mortality begins to increase more noticeably from age 40 onwards, mainly due to agerelated health problems such as heart disease and cancer.[10][11] However, the majority of middle-age people in industrialized nations can expect to live into old age. Life expectancy in developing countries is much lower and the risk [10] of death at all ages is higher. However, well-being involves more than merely physical factors, and middle age is not experienced as a 'time of decline' for healthy people. Middle-aged people benefit from greater life experience than they had when young, which contributes to happiness and makes emotional responses to stress less volatile.

Mid-life crisis
What is it?
A controversial condition or syndrome which some doctors and psychologists thinks affects many men in their 30s, 40s and 50s. Some believe it has mainly psychological causes while others argue that it's related to hormonal changes. Other health professionals argue that there's no such condition, however, and that the symptoms often associated with mid-life crisis have other causes.

What are the main symptoms?
From Reggie Perrin to American Beauty, we're all familiar with the stereotype of the man who reaches 50 and trades his wife in for a younger model or chucks in his job to go off and travel the world. The term "mid-life crisis" conjures up images of a dissatisfied man in middle age who suddenly goes through a series of sudden and violent changes of behaviour. Those doctors and psychologists who believe the mid-life crisis is a genuine condition have identified a wide range of symptoms. Frequently reported problems include: y Irritability y Loss of libido (sex drive) y Erectile dysfunction (impotence) y Fatigue y Depression, charactised by low moods and (often apparently unaccountable) feelings of sadness and lethargy. At least one study has suggested that those undergoing mid-life difficulties may be distinguished from other men affected by depression by their sense of urgency. Such men are driven to keep on being active, sometimes even more active than they were before the crisis. Some men may also be affected by: y Stiffness in the muscles and joints y Night sweats y Dry skin y Hair loss y Weight gain y A loss of ability to recover quickly from injuries Several of these symptoms, occurring together, might understandably provoke a sense of crisis in a man.

Suddenly. especially when children leave the parental home. and. A few psychologists argue that almost all men go through a mid-life crisis to some degree ² they all have to deal with what is a time of transition and adjust to a new perspective on life. attributable perhaps to a heightened sense of our own mortality and/or feelings of dissatisfaction at the way life has turned out. and often. unlike oestrogen in women. This increase is believed to undermine the body's ability to make use of its own testosterone. . any man for whom work is his main source of personal identity. insecurity at work and the changing role of men add to the uncertainty many feel during this time of transition. Is this the start of the slippery slope? And where will it end? By middle age. leading them to grow fatter and more unfit because they cease to generate growth hormone. as well as sexual drive and the production of other hormones. and sidelines older people. is a strong candidate. it's difficult for many people to move smoothly into their middle years. y There is some evidence that men most affected by the mid-life crisis are those who have given little thought to such inevitable upheavals as ageing and retirement. it's also the case that many men seem to pass through this stage of life without any apparent difficulties at all. perhaps. it isn't difficult to see that in real-life cases such drastic behaviour may be motivated by deeper issues that are all too serious. it's harder to get an erection. Studies have shown that the condition is associated with a tendency to avoid problems and an uncertainty about the future.What's the risk? y Some experts argue that men are at risk of suffering the symptoms of mid-life crisis from the age of 30. healthier and likely to live longer when they enter mid-life than at any time in the past. Physical causes Some doctors argue that the crisis of confidence and the unpleasant mid-life symptoms some men experience are not primarily psychological in origin. While there may be common psychological problems arising as a reaction to life events and the consequences of getting older. it may be possible that some men have to go through both a psychological crisis AND a hormonal one! The very phrase "male menopause" is misleading. This can lead to a greater degree of reflection. or who starts to feel or show his age. they argue for the existence of a "male menopause" involving hormonal changes in the body. the experts have yet to agree on the name: the terms "andropause". on what has happened during the first part of life and what the future holds. so they are less able to absorb testosterone. According to a report in the Journal of the American Medical Association. in origin? Or hormonal?Or a bit of both? Psychological causes While the Reggie Perrin stereotype is richly comic. the cells in the body also tend to thicken with age. since menopause strictly refers to the cessation of menstruation. even sociological. Divorce. although the period from the late 30s to age 50 is generally nearer the mark for most. such as DHEA (dehydroepiandrosterone). measurable drop in testosterone in men in middle age. Men are better educated. If there is a male equivalent. physiological and chemical changes which occur in men between around 40 and 55. y Classically. men may have achieved most of their realistic goals and be unclear about their future direction. or a more trivial event like a milestone birthday. The male menopause has been defined by its proponents as the hormonal. and often the testosterone levels of men complaining of andropausal symptoms can still be measured as normal. y On the other hand. analogous to the female menopause. y The proportion of men who experience emotional difficulties during mid-life is unknown. In fact. there is no sudden. Men in their 30s and 40s sleep far more patchily and lightly than in younger years ² even when they sleep the same number of hours as before. What does appear to happen is that a carrier protein called sex hormone binding globulin (SHBG) increases in mid-life men. introspection. however. "viropause" or "endopause" have all been put forward. Relationships may also change. What causes it? Not only is the existence of the mid-life crisis questionable. Many men find the changes in sexual function which come with getting older unsettling. In a society which puts a particularly high value on youth. you can't do it three times a night any more. It's argued that the symptoms of the male menopause ² the main one being a loss of libido ² are caused in middleaged men by the decreasing level (and effect) of testosterone. However. Very often such gloomy insights are brought on by a specific trigger: a redundancy or divorce. Sleep may be another factor. mid-life crises may be linked with a growing inability to sleep deeply. Many of us are aware of feelings of disillusionment and irritability setting in in middle age. those who believe it exists also disagree about the causes. by the time a man reaches 80 they will be at pre-puberty levels. Is it psychological. few manage deep sleep at all. according to the report. By the age of 45. the hormone responsible for secondary sexual characteristics such as muscle strength and facial hair. In addition. and are often adversely affected. Testosterone levels gradually decrease from the late 20s. Men reaching mid-life may feel a loss of masculinity and confusion about their future role.

meditation and other "mindful" techniques which help you to switch off can be useful too. pills or creams to those suffering male-menopausal symptoms. but sometimes it isn't possible to talk to your friends or partner. that those most vociferously in favour of TRT are often doctors in private practice who stand to make money from dispensing the treatment. agitation. diabetes or heart disease. A short course of antidepressants or tranquillisers may be prescribed to combat depression in those suffering from a mid-life crisis. however. extra testosterone may increase the sex drive. but it may not do anything for the ability to perform. but may not be easily available on the NHS.) Talk it over. injections. however. (It seems that while testosterone doesn't actually cause prostate cancer it does stimulate its growth when it's already there. there is the issue of whether the male menopause actually exists. massage and yoga. If it does not. one of the biggest killers of men in the UK. That leaves a great deal of time to broaden your interests. What they do say. y Third. How can I prevent it? If you believe that falling testosterone levels and rising SHBG levels are responsible for a male menopause then there's not much you can do about it. What are the main treatments? Advocates of the male menopause believe TRT (testosterone replacement therapy) is the answer. The effects of exercise in promoting positive moods and reducing mild depression are well-documented. such as aromatherapy. can all have a powerful relaxing effect. Should I see a doctor? Yes. If you feel you'd rather talk your problems over with a sympathetic stranger. These include: y increased vitality and well-being y less irritability and depression y more "drive" y increased sexual activity y increased hair growth y a general ability to cope better with life So why are some healthcare experts so opposed to it? y First. 34 men took extracts of the . Many complementary approaches. such as a counsellor. Don't be afraid to ask for help. disinterest and despair. you may save yourself a long wait. nicotine or other drugs to relieve it. but you can also see it as an opportunity to re-evaluate and perhaps change the direction of your life. y Second. you could still be only two-thirds of the way through your life. The journey from youth to middle age and on into old age may seem frightening and painful. Rather than believing that ageing is simply about having to give things up. leading to even greater frustration! y Fourth. Try to avoid the temptation to use alcohol. If you believe in a mid-life crisis that's primarily psychological in origin.) If you do decide to have TRT you should be checked for prostate cancer every six months. For example. y Accepting that you're no longer young and that you're not immortal. Psychotherapy can help with more deep-seated difficulties. Counselling can help for individuals. learn new work skills or take up new sports. try to think about what you'd like to start. then TRT can be seen as an attempt to provide a medical quick-fix for problems which are not primarily medical in origin.Opponents of the male menopause theory don't deny that testosterone levels fall steadily with age or that SHBG levels may rise. (If you can afford to see someone privately. Self-hypnosis tapes. return to education. If the debate on the existence of the male menopause is heated. This treatment involves administering doses of extra testosterone through patches. Many symptoms linked to the mid-life crisis need to be checked out for underlying physical causes. too. if need be. Giving hormones instead of looking at the root causes of these problems means they may remain unaddressed. erectile dysfunction (impotence) can be caused by depression. testosterone is associated with prostate cancer. there is a lack of long-term studies into the effects of testosterone supplementation. the herb ² available as a supplement in tincture or capsule form ² has been shown to alleviate feelings of anxiety. Also known as hypericum. try some de-stressing treatments and exercises. Alternatively. In a study carried out by the Berlin Depression Self-Help Group. and an intermediary can also be effective in dealing with problems in relationships. Contact your GP or Relate. There are also fears that the sideeffects of TRT may include heart and liver damage. then you could take steps to head it off by: y Finding better ways of tackling stress. According to its proponents. TRT has caused even more controversy. travel. Other treatments Talking about your problems is all very well. many men who have received TRT have reported almost miraculous results. When you reach 60. Sceptics point out. Instead. your GP can refer you. you could try a natural remedy such as St John's Wort. is that these changes aren't sufficient to produce any noticeable symptoms in the vast majority of men.

Ultimately. y Be positive. Vitamin B complex in particular is thought to be helpful for stress. Taking a daily multivitamin and mineral supplement will act as a "health insurance policy". saturated fats and cholesterol. and by succumbing to the pressures of an ever-accelerating workplace. It's easy just to slob out. especially when you're feeling lethargic and down. y Eat well. your friends. Britons work the longest hours in Europe. get used to it. Talking things over. Middle age is a time of great change. Make sure you eat regular meals throughout the day and avoid too many refined foods. After just five weeks three out of four showed a marked improvement. Yes. and explore the possibilities of real intimacy. and work out feelings of frustration. Doctors may also be able to treat any specific conditions such as erectile dysfunction (impotence) or skin problems. Never suffer in silence: always ask for help if you need it. Cut down on the hours and spend more time with your friends and family by: y Learning to delegate or even saying "No" to tasks where appropriate y Not claiming to be more available than you actually are y Developing better time-management skills y Treating arrangements with family and friends as seriously as you would work appointments What's the outlook? Potentially good. or ⼦ . y Vitamin and nutritional supplements can promote better health. A crisis can be used as an opportunity to change your life for the better. And remember: life can begin at 40. men of a similar age ² anyone you feel comfortable with. ensuring that you do not suffer from any dietary deficiencies which might affect mood and energy levels. y So your sex life may be changing ² don't fight it. and one in three became symptom-free. y Find a balance between work and home. For all-round benefits. can be a powerful remedy for anxiety and depression in itself. and that can mean beneficial changes too. yet report the lowest levels of job satisfaction. 50. and as millions of older men can testify. such as running. Go for quality rather than quantity. and explore every avenue. chances are. however. as you won't want to let the lads down.herb three times a day for six weeks. but keeping fit will help to relieve stress and mild depression. Too often we compromise our personal lives and relationships through fear of losing our jobs. which can be refreshing and even therapeutic. How can I help myself? y Men are famously reticent when it comes to sharing their feelings ² especially problematic ones. It's vital to get into a routine that you won't find difficult to stick to. try to combine aerobic exercise. Playing a team sport and/or joining a club is a powerful motivator. with some resistance work. y Take regular exercise.Attending to these simple needs may make a surprising amount of difference. It may well allow you to meet other men beyond the familiar circles of work and family. others will be experiencing similar problems. Also make sure you get enough rest and practise good sleep "hygiene". there lies a fresh perspective and new satisfactions on the other side of the transition. cycling or swimming. such as weight training. Try to talk to your partner. but that doesn't mean you have to be. the mid-life crisis is about managing change of one kind or another. our society is negative about ageing. You have a chance to review your life so far and to alter its direction in a positive way.

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