Relationships 51 July 2006
 Every month Maggi Stamp, a qualified and experienced relationship counsellor for Relate and in private practice, writes about some of the emotional challenges we meet in later life.
For reasons of confidentiality Maggi never writes about a particular person's problems unless you have sent one in to be answered, but all her examples are based on problems raised by clients, family and friends over the years.
You can write to Maggi at maggi@laterlife.com for her to respond in the column.
IT COULD BE YOU….
Testosterone loss
K writes: As a result of my inability to have sex, my
marriage broke up.
Last year I read an article that indicated that I had 19 of the
20 symptoms of male testosterone loss. I had this confirmed by a
private physician, but as I live on a modest pension I sought
treatment on the NHS. I took the test results and various
articles on the condition to my own GP who said that no-one in
the surgery knew anything about testosterone loss. She treated
me for my depression, but not the underlying chemical imbalances
due to the low levels of hormone.
Like prostate cancer, this condition receives little publicity,
while HRT and breast cancer treatments for women have regular
media attention. Why is that? Is it because men are so much
worse at dealing with their health problems than women? Are men
more ignorant about their bodies? Why are GPs ignorant of
testosterone loss: surely they should know?
Maggi replies:
There are a whole range of symptoms and health problems that
men, especially middle-aged men, suffer from. However, men
are often reluctant to go to their surgeries, especially if
their GP is female; perhaps this leads to a few GPs remaining
ignorant of such issues. But it is important for all GPs to be
knowledgeable about the symptoms and effects of low testosterone
levels in men and of course the treatments.
Hardly anyone finds it easy to consult their doctor about
symptoms of a sexual nature. Women’s bodies are more complex
and many require regular examinations during and after
pregnancy, so that most women are more used to the procedure and
continue to have essential check-ups throughout life.
Men, on the other hand, are blessed with external ‘plumbing’
and therefore need fewer invasive examinations, except for
regular and essential ones, such as to check the health of the
prostate as middle age progresses - and I hope this is regular.
It is not surprising that men find it harder to take their
problems to the doctor. If they are lucky enough to have general
good health, there are few reasons to go to the surgery.
Dr James Kennedy, a GP in Hayes, Middlesex and chairman
of the Prescribing Committee of the Royal College of General
Practitioners, agrees that men in general consult less with
their doctor, are less attentive to their health and less
informed about their bodies.
“They tend to come later rather than earlier over any health
problems, so are more prone to present with greater health
problems in later years, such as vascular degeneration”, he
says.
He explains that one of the main
symptoms of vascular disease is erectile dysfunction, or ED.
Weakened blood vessels in the penis cannot maintain an erection,
or in some cases do not achieve one at all. Problems of this
kind cause a loss of confidence and, unless discussed with
partner and doctor, a man may suppress or lose desire and stop
sexual activity altogether. Relationship difficulties and
depression are then very much on the cards.
Testosterone is the hormone that maintains healthy tissue in
the male urinary and reproductive systems, promotes libido,
sexual desire, aggressiveness, assists protein to build muscle,
skin and bone, stimulates sperm production and regulates the
production of prostaglandin, which controls prostate growth.
Some of the symptoms which might indicate low
testosterone levels are:
-
ED
-
loss of libido and/or sexual
desire
-
lack of energy
-
tiredness
-
irritability
-
weight loss
-
joint aches and pains
-
dry skin
-
osteoporosis
-
loss of deeper vocal range
-
unexplained increase in
emotional upsets
-
loss of body strength and tone
-
softer body shape e.g. less
defined musculature
-
breast tissue increase
-
belly spread and body hair loss
Some of these symptoms, such as
hair loss and paunch, are experienced by many men even
though they maintain healthy levels of testosterone. Loss of
desire might be due to other problems in a relationship, while
lack of energy or tiredness could signal a variety of
conditions. It is therefore important that these symptoms are
assessed by a doctor so that other possibilities, serious or
mild, can be ruled out before an accurate diagnosis is made.
Diagnosis is complex, involving not only blood tests but taking
a long, detailed look at many other factors.
Sex is usually so personal and private that few people
are likely to discuss any difficulties with anyone other than
the most trusted friend. Some of my clients take a long time to
get round to talking about such matters. If your doctor is a
stranger to you, then the task is even more stressful.
I don’t know whether you are in a relationship now.
People in relationships should always tell their partners what
their thoughts or worries are and be sure to ask what their
partner’s worries are too. That is where you start. If you feel
your doctor hasn‘t been able to help, it’s essential you ask to
be referred to another, perhaps in the same practice.
You might consider seeing a Relate-trained sex therapist for
help in dealing with the emotional effects of having very low
sexual desire or libido, but you must take into account that
it might not be the whole picture.
Dr Kennedy emphasizes that symptoms likely to be brought to
the surgery can indicate other conditions, so care must be
taken to check those out. Having established that there is a low
testosterone level and that the symptoms could be alleviated by
hormonal treatment, further care is needed to ensure these
powerful agents are given safely.
It could be that lifestyle changes and dietary and emotional
improvements might help. These, in some cases, can
re-stimulate testosterone production to an age-appropriate level
where good health, good energy and good sex can be enjoyed.
“I see a significant number of middle-aged patients presenting
with ED, low libido and tiredness and will always look at what
might be influencing their general health as well as check more
for specific factors”, says Dr Kennedy.
You can write to Maggi at maggi@laterlife.com
for her to respond in the column.
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