The body ages. Slowly, often quietly, it changes. For women, menopause marks a clear transition. There’s a sudden drop, a loss of balance. Menopause affects nearly half the population, yet society speaks of it in whispers. Meanwhile, men grow older too, with hormones ebbing and flowing in the way of testosterone’s slow decline—less visible, perhaps, but noted. The difference between these experiences isn’t simply biological. It’s written into how healthcare treats them, how research funds them, how society values them.
This disparity is glaring when we compare the medical attention given to menopause and male hormonal decline. The imbalance in research, treatment, and cultural narratives tells a story of who we care for and who we silence.
Menopause: The Ignored Struggle
Menopause hits most women in their late 40s or early 50s. The symptoms are many—hot flashes, insomnia, mood swings, cognitive changes, and more. These effects are so common that about 75% of women experience significant symptoms, but only 20% to 30% seek medical help. This isn’t for lack of need. Many women hesitate because of stigma or fear about treatments. The 2002 Women’s Health Initiative (WHI) study, which linked hormone replacement therapy (HRT) to increased breast cancer risks, left scars. The study was later revealed to have been widely misinterpreted. But the damage was done. Women stopped trusting the few treatments available to them.
Compare this with the focus on male aging—specifically testosterone decline, often termed andropause. This change happens more slowly, but it’s no less impactful. Symptoms like low energy, mood changes, and reduced libido can begin in a man’s 40s or 50s. The difference? Men receive treatment. A 2014 study showed that testosterone therapy prescriptions tripled between 2001 and 2011. Even though testosterone levels decline naturally with age, men are often encouraged to restore what’s lost. Pharmaceutical companies seize on this, promoting testosterone replacement therapy as a path to reclaim youth and vitality.
Erectile Dysfunction: A Billion-Dollar Industry
Nowhere is the disparity more evident than in the treatment of erectile dysfunction (ED). This condition affects about 30 million men in the U.S. alone. ED medications like Viagra hit the market in 1998, and their success was immediate. Viagra quickly became a billion-dollar product, with peak annual sales exceeding $1.8 billion globally. The development of Viagra was a commercial and medical triumph, celebrated as a breakthrough for men’s health. ED, once a private issue, became a public conversation—encouraging men to seek treatment openly.
Meanwhile, women struggle in silence. There’s no equivalent billion-dollar investment for menopausal symptoms, despite their prevalence. The pharmaceutical industry hasn’t poured resources into developing new menopause treatments. HRT, which could help many women, is still viewed with caution, partly due to the aftershocks of the WHI study.
Testosterone vs. HRT: A Double Standard
Testosterone therapy is widely available for men, with the market for testosterone replacement therapy projected to grow to $1.3 billion by 2027. Yet the growth of HRT for women remains stunted. While men are encouraged to replace their lost testosterone, women are left to manage menopause on their own. Doctors too often tell women to “endure” it. Only 17% of NIH research funding goes to women’s health issues, leaving conditions like menopause underfunded and under-researched.
It begs the question: Why do men receive attention for a gradual, natural decline, while women are ignored when they experience a much more abrupt and disruptive transition?
Cultural Silence Around Menopause
Part of the answer lies in cultural norms. Aging in men is often associated with wisdom and experience. Declining testosterone is seen as a fixable problem, not a loss of vitality. Treatments like testosterone therapy or ED drugs reinforce the idea that men should maintain sexual function and strength as they age.
For women, aging is different. Menopause is framed as a decline—fertility fades, and so too, it seems, does value. This cultural silence feeds into the medical system. Women hesitate to ask for help, not wanting to appear weak or to admit their bodies are changing. Menopause is too often viewed as something shameful or embarrassing. The conversation stops before it even starts.
Menopause and the Workplace
The effects of menopause don’t end at home. They follow women into the workplace. Studies show that untreated menopausal symptoms can lower productivity and increase absenteeism. In the UK, where awareness is beginning to rise, some companies offer menopause-specific benefits, such as flexible working arrangements or access to specialists. The NHS also offers menopause clinics, where women can seek specialized care.
Yet, globally, most workplaces don’t address menopause at all. Women are left to navigate symptoms while balancing careers and family responsibilities. The economic impact is significant—not only for women but also for the companies they work for. If left untreated, menopausal symptoms cost women and employers in lost productivity, increased sick days, and higher healthcare costs.
Andropause: A More Comfortable Transition?
Testosterone declines more gradually in men, making andropause less dramatic. But the medical community steps in to help, nonetheless. Men receive testosterone replacement therapy, which is framed as a way to regain strength, libido, and energy. Even though TRT isn’t without risks—some studies link it to heart disease and prostate cancer—the treatment is embraced by doctors and patients alike. The message is clear: men’s symptoms deserve attention and treatment.
For women, even after two decades of re-analysis and new research showing HRT’s benefits, the cultural memory of the WHI study remains. Women are encouraged to “wait it out” or seek natural remedies, while men are offered medical solutions to their aging-related symptoms.
Why Does This Disparity Persist?
The discrepancy in how we treat male and female hormonal changes is deeply embedded in healthcare systems, medical research, and cultural narratives. Male health concerns like erectile dysfunction and low testosterone are commercialized and destigmatized, while women’s menopausal symptoms are medicalized only to be downplayed.
This difference raises important questions:
- Why is there so little investment in menopause research and treatment when it affects so many women?
- Why do men’s hormonal treatments receive more media attention and funding, despite the fact that menopause is often more disruptive to a woman’s health and well-being?
- How does this disparity reflect our society’s views on aging, gender, and value?
The Need for Change
Menopause needs more attention—from doctors, researchers, and society. As long as women remain underrepresented in medical research, their needs will go unmet. The pharmaceutical industry should invest in treatments that address menopausal symptoms in the same way it developed drugs for erectile dysfunction. Governments need to support research into menopause and offer public health initiatives to educate women and healthcare providers about the benefits and risks of HRT.
Women deserve more than silence and dismissal when it comes to their health. They deserve the same attention, treatment options, and medical advancements that men have received for their own age-related hormonal changes.
The question is: when will we start listening?
Share Your Voice
Join the conversation. How has your experience with menopause or hormonal health been shaped by the healthcare system? What changes do you think are needed to address this disparity?
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