I just found out that I suffer from male PMS, or as it’s also known, Irritable Male Syndrome (“IMS”).
Stick with me.
The concept of IMS has been around since the late 1990s, but you won’t find it in any medical journal or textbook. You will, however, find it in publications such as Cosmo. Still, just because something isn’t recognized by the medical community, that doesn’t necessarily mean it’s fair to disregard it altogether: After all, the concept has stuck around for about 20 years now, and many men — if not most — will identify with at least some of the syndrome’s symptoms, which include anxiety, frustration, anger, self-doubt and hypersensitivity.
It was just such symptoms, in fact, that first led me down a Google-hole to the discovery of “Irritable Male Syndrome.” I soon found out that diagnosing myself was as simple as taking an online quiz at the delightfully-named irritablemale.com, a website overseen by Dr. Jed Diamond (more on him later). The quiz is fairly simplistic: It asks if you suffer from a laundry list of negative feelings — anger, frustration, hostility, loneliness, etc. — then asks you to specify the frequency with which you feel each emotion by choosing from “Most of the time,” “Frequently,” “Sometimes” and “Not at all.”
Having a background in data gathering, as well as knowledge of what a proper Likert Scale is, I was a bit perturbed by the lack of the choice “Rarely,” but I gamely took the test and answered the questions as best I could.
I scored a “50.” Which… I think is bad? I don’t really know, as there was no scale given with my results. 50 out of what? A hundred? A thousand? The results page simply informed me that, “You scored a 50,” then proceeded to tell me what types of IMS I suffer from.
Within IMS, the site says, there are seven or eight types (I couldn’t find a consistent number), which feature faintly seven dwarf-ish names like “anxious type,” “fearful type,” etc. Mostly, the test reveals, I’m “grumpy type,” meaning that I’m easily upset or hypersensitive. And, okay, yeah, it’s true: I do tend to lose my cool a bit too quickly, like when I try making an omelet and the fucking thing won’t flip, despite the fact that I’ve been making omelets for almost 20 years now, how can I still be fucking them up 70 percent of the time, and why the fuck can’t my wife just make do with scrambled eggs, anyway?
Being the grumpy type also means that I can be “moody” (check), “impatient” (check) and “angry” (check). But it also says that I blame everyone else for my problems and feel that my loved ones are purposefully slapping my “emotional sunburn,” which is definitely not me. I may be an irritable man, but I’m at least man enough to know that it’s my shit that causes me to lose my temper with my wife, my toddler, the person on the other end of the phone at my credit card company and that Goddamned non-stick frying pan.
Along with my results, I received recommendations for treatment, including “getting help immediately,” and more notably, buying the books of Dr. Jed Diamond at menalive.com. Diamond — who has been in practice for more than 40 years and possesses a master’s in social work and a PhD in international health — has written a variety of self-help books focusing on IMS, andropause (i.e., “male menopause”) and helping men with the effects of aging and low testosterone. It was in the late 1990s, while writing about about male menopause, that Diamond first noticed there were men of all ages and life stages suffering from the symptoms of what he would eventually dub “Irritable Male Syndrome.”
Now, maybe it’s just another symptom of being a “grumpy type,” but I’m aware that sometimes I can tend to be a little bit cynical. But despite feeling like someone was just trying to sell me a book, I refused to let these tendencies get the better of me, deciding instead to press on and give IMS the benefit of the doubt. After all, as I mentioned, Diamond has a master’s degree and a PhD: My own qualifications include a Bachelor’s in Liberal Arts and a vast knowledge of obscure 1990s cartoons, so frankly, I’m not in much of a position to argue.
In an effort to gain some objectivity, I reached out to Joshua Gonzalez, a urologist and sexual health doctor who specializes in, among other things, hormones and the effects of aging. I wanted to find out if I was just suffering from the normal life stresses that affect everyone else in the world, or if I should be concerned about a “syndrome” that might require greater attention.
To my cynical vindication, when I first mentioned IMS, Gonzalez said he’d only heard of it in places like Cosmo. But as he continued talking, it soon became clear that both the disagreeable behaviors some men display — and their causes — sound exactly like what’s being described by IMS. Life stress, lack of sleep, poor diet and lack of sufficient exercise all made a showing as contributors, as did the biggest issue of all (and the one with the most medical concern): Low testosterone. Because while the cliche has it that an excess of testosterone leads to assholeish, aggressive behavior, it’s actually a deficit in the hormone that’s more likely to cause moodiness and irritability.
It’s the low testosterone angle that’s caused IMS to be referred to as male PMS (or a “manperiod”) and other such overly simplistic ideas, because, like menstruation, low testosterone does involve hormonal fluctuation. However, they’re so dramatically different in nature that trying to compare them only complicates the issue.
“A decrease in testosterone happens naturally as a man ages,” Gonzalez notes, saying that men over 40 especially have to deal with this. It may get so bad that it can result in something called “late-onset hypogonadism,” or for the layman, andropause or “male menopause.” For someone my age (32), low testosterone can occur due to life stress, lack of sleep, etc. In turn, having low T may result in even more stressed-out behavior — it’s a sort of vicious (or rather, irritable) circle.
Gonzalez notes, too, that men’s hormones do fluctuate throughout the day, “with testosterone peaking in the morning,” and that there may be some seasonal effects, much like seasonal affective disorder. But he also points out that men don’t have regular “cycles” like a period. Nor are there dramatic changes in hormones in a short period of time, which is what results in PMS. Even with aging, as a man over 40 gradually loses testosterone, there’s nothing comparable to the dramatic drop a woman experiences with estrogen during menstruation.
Still, Gonzalez stresses that low testosterone is a very real problem, and treating it is important. “I’m a big proponent of hormone replacement therapy if it’s for the right person,” says Gonzalez, sharing that he deals with this problem regularly. Due to the side effects of hormone replacement — including dependency and sterility — he strongly recommends trying more natural means of boosting your testosterone first, things like eating better, getting more sleep, exercising more and just trying to find ways to de-stress your life in general. All of which, funny enough, lined up exactly with the recommendations suggested for treating Irritable Male syndrome (although with the notable exception of buying a book).
So what to make of “male PMS”?
After speaking with Gonzalez, I came to the conclusion that it’s basically a more catchy way of saying low testosterone, since the symptoms and the treatments are nearly identical (a rose by any other name, as it were). And while it’s both unhealthy and unfair to compare male mood swings to the more extreme, regular burden of PMS (women have a tough enough time convincing doctors of their pain, without dudes co-opting and trivializing their situation), there’s certainly merit in considering what might be causing you to feel bad. The “syndrome” might not be real, but the methods out there for getting you through the times you feel like a lunatic are. It’s important, now more than ever, to get some perspective on just how much stress and exhaustion are impacting your life.
But you know what?
I’m still not buying that book.