DR MAX: I believe that ‘manopause’ DOES exist – and that men suffering from it should get HRT

What is it about the male psyche that causes men to often become miserly as they get older? We all know a once very nice man, whose inner Victor Meldrew came out as soon as he turned fifty. The grumpy old man is a well-known trope for good reason.

But could there be something else going on? Could it be that they have a medical problem?

For years we assumed that misanthropic old men were just a fact of life. We attribute their mood to missing their purpose in life or thinking that the world is moving too fast for their liking. But there is a growing belief that they could be suffering from a hormonal imbalance, andropause.

This controversial condition – also known as ‘manopause’ – is the result of low testosterone levels and has inevitably led to many laughable discussions. Some even say it’s a condition made up by men trying to focus on all the attention women get during menopause.

Yet scientists also estimate that as many as one in five men over the age of 65 could experience symptoms. And yes, these are similar to female menopause, including low libido, irritability, fatigue, sweating, and general aches and pains. One study put the figure at 840,000 men in Britain currently in the grip of symptomatic andropause, with only 19,000 currently receiving treatment in the form of testosterone replacement therapy – usually a gel applied to the skin daily.

‘Manopause’ is gaining ground as a legitimate condition. Last week it was revealed that NHS bosses are offering middle-aged male workers special uniforms, tailor-made desk space and up to a year of paid leave to help them cope.

‘There is a growing view that older men may suffer from a hormonal imbalance called andropause,’ writes Dr Max Pemberton.

‘While recognizing that there is a real change as men age, some experts argue that this has a psychological rather than a hormonal basis.’

So is it real? In women, menopause is caused by the sudden drop in sex hormones – estrogen and progesterone – that occurs when the ovaries shut down. In men, however, there is no similar, dramatic decline in testosterone, but rather a natural, gradual decline with age – a decline of about 0.5 percent per year.

Proponents of testosterone replacement therapy (TRT) say the fact that it revitalizes men, eradicating symptoms while improving mood and libido is proof that manopause exists.

Yet many doctors are skeptical. While they acknowledge that there is a real change that occurs as men age, experts argue that this has a psychological rather than a hormonal basis. Marital problems, changes in social status, job dissatisfaction, lack of exercise, and the long-term effects of alcohol and smoking can all result in similar symptoms to those attributed to andropause. They also suggest that some of the symptoms may be the result of other, underlying medical conditions such as thyroid problems, anemia, or depression.

Professor John McKinlay of the New England Research Institute has argued that there is ‘no empirical research to support the syndrome’ and advises people with lower testosterone levels to increase physical activity and diet, as obesity itself lowers testosterone levels.

“We are medicalizing lifestyle issues and the natural aging process,” he says.

And the fact is that treatment with testosterone is not without risks. Side effects include possible breast growth, acne, sleep problems, and prostate enlargement. Some studies have even linked testosterone therapy to prostate cancer.

Critics also point to the fact that men may complain of symptoms even though their blood tests show normal testosterone levels. Conversely, men whose blood tests show low levels do not necessarily experience problems.

My opinion is that there is a version of menopause in men, but not all. Over the years, I have undoubtedly seen “grumpy old men” whose lives have been transformed by TRT. Men who have been diagnosed as ‘depressed’ suddenly see their mood improve and no longer need antidepressants.

It’s happened enough that I now test the testosterone levels of middle-aged patients who come to me with changes in their mood, but no history of depression and no clear explanation for the deterioration of their personal lives.

Their wives often say that something is not quite right; that their husbands have lost their va-vavoom and seem like miserable, moody versions of their old selves, and – ta da – when their testosterone is checked, it is indeed too low.

I can’t help but think that this is similar to the number of post-menopausal women whose low mood was misdiagnosed as ‘depression’, but which improved when they started HRT.

Whether men really need major adjustments to their work environment is another matter. But the resistance to the idea that men would benefit from hormone treatment certainly seems to resemble the resistance women have faced for years regarding HRT.

The drug Champix has been relaunched on the NHS to help smokers quit. Concerns have been raised about side effects. But smoking kills half of all smokers, so quitting – in any way – can be life-saving. Talk to your doctor!

Davina’s tumor shock

Davina McCall revealed last week that she underwent emergency surgery after a benign tumor, a colloidal cyst, was found in her brain

Davina McCall revealed last week that she underwent emergency surgery after a benign tumor, a colloidal cyst, was found in her brain. Even though the results of this type of surgery are generally very good, it must still be a huge shock when you are told that you need it.

What I’ve noticed in people when something like this happens is that they go into ‘survival mode’. They barely have time to process their diagnosis before the surgery is scheduled. People are fussing around them and there are many offers of help.

It is often only long after the operation, when the fear and drama has subsided, that it really hits them and they suddenly realize the severity and enormity of what they have experienced.

I’ve seen a lot of people who have this delayed reaction and then need a lot of support. However, at this point many people assume that they are doing fine and have shifted their attention elsewhere, or even forgotten about it.

It’s good to always check in with someone a few months after something so big to let them know that even though the initial panic has passed, you are still thinking about them and are there for them if he or she needs a hand or shoulder. to continue crying.

Faced with a medical condition that promises only steady, grim deterioration, I think most doctors would take the quick way out. But should assisted death be made legal, as currently proposed?

Dr. Max prescribes: the anxious generation

Social psychologist Johnathan Haidt’s excellent book takes a sobering look at the anxiety epidemic among children who grew up online and had their childhoods diminished and impoverished by an addiction to smartphones. It’s a call to make fundamental changes in the way we raise children in the technological age – and well worth reading.

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My biggest concern is the potential for such legislation to be abused or to change the way people with severe disabilities or terminal illnesses are seen and treated. For these reasons, I am wary of fully supporting physician-assisted suicide.

The only solution I can think of is that every case should be discussed in a court of law – that this becomes a legal decision, and not a medical decision.

What I have serious problems with is the idea put forward by critics of assisted dying, namely that the debate itself is unnecessary because modern medicine ensures that we can all live long, pain-free lives.

Controlling physical pain is not the determining factor in a person’s quality of life. It is the emotional pain, for which there is no pain relief, that in such cases is often the decisive factor in people wanting to die.

Antidepressants make you unable to walk. Talking therapies can help change attitudes towards an illness or disability, but they cannot bring back your old life. There is no painkiller that can numb the gnawing feeling of loss, of powerlessness and helplessness, of frustration and humiliation.

Certainly, many people with debilitating and terminal conditions live fulfilling and meaningful lives, but there are also those who do not.

While I’m haunted by indecision about whether I want to live in a country that helps people die, I’m equally uncomfortable with the vocal groups of people—from self-styled ethicists to religious enthusiasts—who feel obligated to pass judgment. sheets about someone else’s existence.

In any case, argue that assisted suicide is open to abuse. But don’t you imagine knowing what it feels like to lie in a bed, staring at the ceiling day after day, being turned over by caregivers as they wash you and change your sheets, longing for the life you had, but that is now over. of range. Don’t tell me it doesn’t hurt. Don’t tell me doctors can control it thatt kind of pain.