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Andropause
Bernard Collom doesn’t do road rage. He doesn't get irritated at supermarket checkouts, or snarl at his family. He used to - but not because he had too much testosterone, as you might expect. Collom's own experience, increasingly backed up by clinical evidence, suggests that such grumpyold- man behaviour is a giveaway sign of someone with dangerously low levels of male hormones. Sex Drive In ParkBack in 1989, Collom, then 43, was surly to his wife and stepson, anxious, depressed, and lacking in energy and sex drive. Well on the way to a collapsed marriage and a failing career, he had "the great good fortune", as he says, to consult a specialist in what was then called the male menopause, now known as the andropause.  A simple blood test revealed him to be in urgent need of extra testosterone, at an earlier age than normal (50-plus), probably because he had mumps in his 20s. Ever since then, he has taken daily testosterone supplements, in the form of capsules, implants, testostosterone patches and, most recently and successfully, a testosterone gel he rubs into the skin of his scrotum. Almost from day one, he says, he’s been a new man: nicer to be with, more relaxed, more energetic and both healthier and sexier.
His story is one to which doctors should pay urgent attention, according to Dr Malcolm Carruthers, chairman of the Andropause Society and author of Androgen Deficiency in the Adult Male, with which he aims to "equip the medical profession with the information needed to diagnose and treat androgen deficiency". About one in 10 men between the ages of 40 and 60 are thought to have subnormal or low testosterone levels as a result of normal ageing, physical illnesses such as mumps, or other problems including stress, too much alcohol and even tight jeans. Typical symptoms are irritability and hostility - "often, literally, an impotent rage," says Dr Carruthers. Until now, the medical consensus has been that hormonal changes in men are a myth and that taking testosterone - available therapeutically since it was first isolated in 1935 - simply turns on aggression, promiscuous sexuality and big muscles. Abuse by athletes of testosterone- based anabolic steroids at up to 20 times the therapeutic dose hasn't helped its reputation. But a series of recent studies, including one of 1500 men by members of the Andropause Society, suggests not only that low testosterone is a problem in up to 80 per cent of men, but that treating the deficiency is good for their hearts, boosts libido, strengthens bones and helps to prevent depression and Alzheimer's disease. It was believed that, because women suffer fewer heart attacks than men before menopause, testosterone encourages cardiovascular disease. Yet researchers have now shown that low testosterone levels raise the risk of heart disease - and that testosterone replacement therapy appears to lessen thickening of the arteries, thereby helping to prevent stroke, angina, heart disease and high blood pressure. In March, researchers from the Hormone and Vascular Biology Group at Sheffield University, writing in the journal Clinical Science, predicted the development of a male HRT for heart disease within years.
A similar pattern is emerging with regard to Alzheimer’s disease. In the last year, a series of studies from Italy, Baltimore and the Oxford Project to Investigate Memory and Ageing (Optima) has shown that men with Alzheimer’s have lower testosterone levels than is normal for their age - and that these low levels predate the development of their disease. Researchers are so far cautious about promoting androgen therapy in middle age. "At the moment, we don’t know whether this would help all men with low testosterone levels or whether it would be more effective in men who are genetically at risk or who have low initial levels of testosterone," says Dr Eva Hogervorst, a research fellow at Optima. "We need to find that out."
Drew Voight
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