Dismissed. Treated as a joke. Told simply to get on with it. Until a few years ago, this was how menopausal women were treated. There’s still a long way to go, of course, but we’ve made huge strides forward.
For too long women were told their debilitating mood swings, hot flushes and insomnia – now known to be directly linked to plummeting hormone levels, and treatable with hormone replacement therapy (HRT) – were empty nest syndrome or depression.
But what if I told you that some men are enduring surprisingly similar issues now? And that many are suffering from a little-understood hormonal condition – this one linked directly to a decline in the male sex hormone testosterone, which can also cause life-changing symptoms – which is being dismissed and under-treated in the same way?
Let me first be really clear: what I’m not saying is that there is such a thing as the male menopause.
Before and after: How Stephen Webb responded to testosterone treatment
Despite loud claims to the contrary, often from muscled-up testosterone aficionados on TikTok and Instagram who like to insist most men would benefit from testosterone-based HRT, the male menopause doesn’t exist.
Only women who eventually stop having periods – the literal definition of menopause – will go through it as levels of their sex hormones, oestrogen and progesterone, fall at some point in mid-life.
Most men, by contrast, continue to produce sperm and testosterone all their lives.
But what does happen in men is that testosterone, which is produced in the testes, naturally declines with age. Levels fall by around one per cent every year after the age of 40. Most men won’t notice the difference, but for some, whose levels decline far more sharply, for myriad reasons, it can have a devastating impact.
The true numbers affected are unknown because it’s a condition which is understudied and, we think, vastly underdiagnosed. Some studies suggest it’s just two per cent of men – others estimate it could be ten times that, affecting as many as one in five.
Part of the reason it goes undetected is because the symptoms can mimic other problems.
The most common relate to sexual dysfunction – not surprising, given the leading role testosterone plays in the male libido. This might include problems getting or maintaining an erection, producing less semen, a low libido or delays reaching an orgasm.
There might be mood changes, such as irritability and anger, and difficulties with memory and
concentration. Other problems can include insomnia and fatigue, decreased body and facial hair, shrinking testes and even gynaecomastia (developing breasts). It’s also linked to serious chronic problems such as anaemia, type 2 diabetes and brittle bones.
All of these things can have an impact on work, relationships, sex lives and general wellbeing. Yet all too often it’s dismissed as depression, or stress, or treated using drugs such as Viagra and antidepressants without tackling the underlying cause.
Few doctors even consider the idea that low testosterone might be driving it all, let alone test for it. It isn’t part of standard blood tests, and one study of GP records found just 66,000 men – 0.2 per cent of the adult male UK population – had their testosterone levels checked over a ten-year period to 2011.
Yet for those men with a diagnosed testosterone deficiency, also known as late-onset hypogonadism, it can be easy to treat. Simply topping up testosterone levels with hormone replacement therapy, either in a gel or as a jab, 비닉스100mg복용법 can prove transformative.
Former Take That singer Robbie Williams and Happy Mondays star Shaun Ryder have both hailed the treatment for propping up their flagging libidos and restoring energy levels.
Former Gogglebox star Stephen Webb, 52, has said he felt ‘30 again’ after months of injecting himself with testosterone.
The TV personality revealed he had lost his sex drive and was told by a doctor that he was depressed. But after talking therapy failed, tests found his testosterone levels were those of a 75-year-old.
Mr Webb – who it was revealed last week had split from his husband Daniel Lustig – says testosterone therapy gave him the energy to begin exercising regularly, which meant he lost weight. ‘All the mood swings, anxiety, feeling lethargic, have gone,’ Mr Webb said last year. ‘It’s just unreal. My sex drive was on the floor, and that’s back. I’m telling anyone who will listen – have you had your testosterone checked? It’s life-changing.’
Stephen on Gogglebox with his then husband Daniel Lustig
I’ve seen similarly positive results in my own patients.
One 52-year-old man, Martin, came to see me only because his wife persuaded him.
Martin was exhausted and feeling sad and flat all the time. His sex drive had vanished, he struggled to get an erection and this affected his mood even further. Another doctor had performed some blood tests for fatigue – which don’t look for low testosterone – and, 센트립구매 when they failed to show anything, had suggested antidepressants. By the time I saw him, a few months down the line, his sexual dysfunction had worsened and he was developing what he thought were breasts.
The combination of symptoms made me consider testosterone deficiency. We did some tests – it involves taking blood in the morning, after fasting overnight, because testosterone levels are highest in the morning. These tests have to be taken again after four weeks to check what we’re seeing is persistent.
If a man has three or more sexual symptoms, plus levels of testosterone which are considered exceptionally low, I’d diagnose testosterone deficiency and refer to an endocrinologist.