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Psychosexual problems for men

Low sexual desire in men - hormones and the andropause

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Up until a few years ago I would have agreed with most experts that the concept of a male equivalent to the female menopause was a far-fetched idea. Then I began to meet men in mid-life, usually between forty and fifty years of age, all with the same symptoms. Working with them convinced me of the reality of the "andropause".

Here is a summary of how it makes itself known to the unsuspecting man whose hormone levels are, unknown to him, beginning to decline.

The man whose hormones have dropped below a level which has sustained him in his masculinity for most of his adult life may suddenly (or indeed gradually) find himself:

  • feeling tired every morning, with aches and pains all over his body

  • feeling depressed and demotivated, lacking a purpose in life

  • inclined to throw over his existing life for something else, often meaning an affair with a younger woman or a change of job

  • experiencing a low level of libido

  • masturbating much more than before, or much less than before

  • waking up at night with hot flashes

  • having hot flashes during the day

  • with a dry skin

  • and very moody, irritable or angry

Every one of these changes can be attributed to a decrease in a man's testosterone levels as he ages. The above symptoms could of course also be due to other physical or psychological issues, however, once you have really investigated all other possibilities please also consider the possibility that you may be experiencing the andropause.

A man who starts to act in this way needs to have his hormones checked. But he needs to have them checked by a competent doctor. I've lost count of the number of times a man has told me that he's been to see his doctor, who's (usually reluctantly) ordered hormone tests, then told the man that his testosterone levels are fine, and basically to go away and see a therapist because he's depressed.

It's such a contemptuous attitude, though happily there are signs that things are changing. Much of the credit for this goes to a few doctors and authors on the andropause, most notably Jed Diamond, Malcolm Carruthers and Eugene Shippen.

The fact is this: measuring a man's total testosterone levels is not a way to assess how much active testosterone there is in his blood. To represent things simply, much of the testosterone in a man's bloodstream is bound up with a protein called sex hormone binding globulin and is not available to his body tissues. The level of this protein increases with age. In addition, a man's liver, which destroys estradiol (a form of estrogen) naturally present in his body, becomes less efficient at this process with age, so the effective level of female hormone in a man's body as he ages can actually increase. Taken together with the increase in sex hormone binding globulin, the amount of free testosterone available to a man's body may be very low indeed. Only a competent andrologist or endocrinologist who is fully informed about male sexuality can assess these factors correctly. You can read much more on the science of male hormones in Eugene Shippen's book The Testosterone Syndrome and Malcolm Carruthers' book The Testosterone Revolution: Rediscover your Energy and Overcome the Symptoms of Male Menopause.

If you're a man going through the mid life changes I've described, I strongly recommend both these books to you. They may not only save your relationship, they may save your sex life.

 

As a man, you will hear it said, if you set out on a quest to get hormone replacement therapy, that any or all of these things will or won't happen:

  • it's not safe and you may develop prostate problems

  • it's not safe and you may develop liver problems

  • it doesn't work, and anyway there's no male andropause in any case

  • you're just depressed

  • it won't increase your libido

  • if you have erectile dysfunction, it won't give you your erections back

  • your hormones are normal, there's nothing wrong with you

I know this because I've witnessed men who've gone through the process. I've debated with doctors who've held fast to their beliefs that there could not possibly be a male andropause (though they often undermine this by adding, "...and if there was it wouldn't need treating anyway!")

Rather than recap the excellent account of the male mid-life crisis recorded on The-penis.com, I'd just like to refer you there if you want to read more about it. See:

The Andropause, what it is and what to do about it, including the low sexual desire that results from low testosterone levels.

For many men in this situation, Viagra and testosterone replacement therapy is the dream combination.

Finally I should add that there is also a growing awareness  that some men start life genetically resistant to testosterone - in other words, their body can't assimilate it quite as efficiently as it should. For men in this situation, the effects of the mid-life drop in testosterone are much more marked, but these men can still be helped by testosterone replacement therapy. There are many different forms of safe and effective hormone therapy available now, so do not be discouraged if you meet a doctor whose knowledge is out of date or inadequate - find another one!

 

Written by Rod 20.07.07, last updated 1.8.09

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