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Psychosexual
problems for men and women
Low sexual
desire in men - hormones and the andropause
Up until a
few years ago I would have agreed 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.
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
the 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 the 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:
For many men
in this situation, Viagra and
testosterone replacement therapy is the
dream combination.
Finally I
should add that there is also an
awareness growing 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!
