SEX life? What sex life?
When men hit their forties, they often feel exhausted, irritable and are the butt of grumpy old man jokes.
GettyWhen men hit their forties, they often feel exhausted, irritable and are the butt of grumpy old man jokes[/caption]
They are always tired, suffer broken sleep and even night sweats or a bulging waistline.
Most men simply put it down to ageing but The Sun on Sunday’s resident GP, Dr Jeff Foster, says it could well be the manopause — a serious medical issue where testosterone levels drop.
Dr Jeff said: “It is comparable to but more subtle than menopause, where oestrogen levels drop suddenly. Once men hit 30, they naturally lose around one per cent of their testosterone every year. It’s very gradual.
“It happens to everyone, though it may occur at different ages. You slowly grind down to become a grumpy, fat old man who doesn’t want as much sex as when they were 20.
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“Society tells men what is happening to them is normal for their age, but it’s not normal. It’s a medical problem and there is something you can do about it.”
Here, Dr Jeff reveals all you need to know if you or your partner are going through the manopause . . .
THE SYMPTOMS
Similar to menopause, where dropping oestrogen levels affect women, testosterone reduction affects men.
The most common symptoms are feeling run down and more tired, with less get-up-and-go.
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Some men aren’t as motivated to get a job done, have a lack of interest and are less sharp. You will find they can’t remember things, such as people’s names. We call it “brain fog” for women.
Partners often complain their man is more grumpy and irritable, with less sex drive.
A classic sign is the loss of the morning erection, which is caused by a surge in testosterone. If it goes, something is wrong and in the long term may lead to erectile dysfunction.
You might suffer hot flushes or be working really hard at the gym but getting fatter.
Low testosterone can cause changes to blood pressure and cholesterol, an increased risk of type 2 diabetes, heart disease, osteoporosis and depression.
WHEN DOES IT HAPPEN?
Women typically hit menopause in their forties or early fifties – and that is most common age for men too.
But there is no specific age. If you had high testosterone levels in puberty, exercised and ate well, your testosterone might not drop until you are 90.
If you were born with a lower level or had a medical problem, you might notice it in your 20s.
I have one patient in his 70s who was told he had dementia, but forgetfulness and memory problems were because he had low testosterone.
After treatment, his memory has returned. A lot of our patients have been referred by their partner and want to know if there is a medical issue or if he just no longer loves them. It can destroy relationships.
DO I NEED A PRESCRIPTION?
Not everyone needs drugs. There are ways to improve testosterone.
Start by keeping a healthy BMI. Being overweight drives oestrogen, which suppresses testosterone.
If you are too thin, your body suppresses sex hormone production to conserve energy.
Diets high in protein and lower in carbs (but not taken out completely) tend to produce better testosterone levels.
Regular exercise is vital. Aim for three or four intense sessions a week that get your heart racing and tire you out, for 40-45 minutes.
You need at least six to seven hours’ sleep a night. Deep sleep triggers the testosterone surge in the morning.
Having sex may also help. Some studies show that if a man is abstinent for four weeks, testosterone levels rise, but after 12 weeks will drop.
DO OVER-THE-COUNTER PRODUCTS HELP?
No. Nor will supplements. There are no studies on humans which show these products work.
If they are claiming “evidence” it was probably tested on rats for a few hours. It’s a con.
WHEN SHOULD I SEE A DOCTOR?
If lifestyle changes don’t help, a simple blood test from your GP will show if your levels are low.
If your GP can’t help or you are just told everything is “normal”, find a men’s health specialist.
Low testosterone could also be caused by thyroid disease, type 2 diabetes or anaemia, so you need to rule those out.
Then you need testosterone therapy. It can be hard to get an NHS diagnosis. In medical school we get little training on testosterone.
WHAT TREATMENTS ARE THERE?
One that best suits you, fits your lifestyle and your blood test results.
Usually a gel, cream or injection. Tablets — that can be toxic to the liver — should no longer be offered in the UK.
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WHAT NEEDS TO CHANGE?
Davina McCall made a brilliant menopause documentary that has helped millions of women and doctors, some of whom felt they didn’t know enough and read up on it.
The same thing now has to happen for men.