Skip to comments.Goodbye, testosterone
Posted on 01/28/2003 5:15:28 PM PST by NYpeanut
Feeling anxious? Irritable, too? Has the stamina that used to fuel days and burn up the nights hit the road - along with a sex drive that has long been stuck in neutral?
Check your engines, gentlemen. There are thousands of males out there in the same sorry state, but now - thanks to a research scientist in Scotland - the condition has a name.
"Irritable Male Syndrome," that state of hypersensitivity, frustration and anger is now used to describe men who suffer from testosterone deficiency. And while the condition may have been around for ages, the diagnosis suggests that men may be just as vulnerable to the complexities of biology as women.
"This is very common," said Dr. Philip Aliotta. "Low levels of testosterone manifest in irritability, depression, weak muscles, loss of self-esteem. Men have no interest in the joys of life. Their libido has dropped. Their interest in intimacy is declining. Sexual function diminishes. Work performance suffers. Oftentimes they are misdiagnosed as being depressed.
"It's called a lot of names," added the Amherst urologist who has treated scores of men with testosterone replacement therapy. "It's the aging process. It's andropause. But Irritable Male Syndrome? I find that offensive. It implies we are walking around ready to beat up people."
At age 41, Nick Constantino knew something was wrong. The even-tempered insurance broker found himself getting more and more grouchy, chalking up his snarly demeanor to lack of sleep. After all, he was still adapting to his new lifestyle. Just a few years into his first marriage, the former bachelor in one swoop had become husband and father of three. No wonder his energy level was down, he rationalized. But one night last December as he was watching television, a commercial cried out to him.
"You could have knocked me off the couch," Constantino recalled during a phone interview from his home in Middletown. "Everything was me: tired, irritable, reduced sexual desire. I had been attributing a lot of it to just getting older. I called my doctor the next day and went in for a blood test."
The testing determined that Constantino was testosterone deficient, operating on levels that were two-thirds below normal. Hormone replacement therapy was suggested, and now - 45 days into the treatment - Constantino believes the patch that adorns his arm is working.
For years, menopausal women have taken hormone replacement therapy, using patches that secrete estrogen into their bodies. Now men are seeking the same hormonal elixir to revive their lagging sex lives and boost their energy.
"A lot of it is age-related," said urologist Aliotta. "But women can go through menopause at an early age, and men in their 30s and 40s can have testes that fail them. There's not a whole heck of a lot that makes the sexes different. The same physiology flows through men and women.
"Generally, they start in their 40s, complaining of sexual dysfunction," Aliotta said. "They tell you they have no interest in sex and they don't understand why. Their significant other may be relieved or upset. If the significant other doesn't understand, they tend to personalize it and all hell breaks loose in a relationship."
Testosterone is a hormone made in the testes under the guidance of signals from the pituitary gland. It surges through the body controlling male sexuality. Without it, puberty in boys would not take place. Neither would sexual performance. It is in fact erectile dysfunction that brings many men to their doctors' offices.
"I am a firm believer that when you have a problem, you go to the doctor," said John, a former railroad brakeman from Amherst, who asked his last name not be used in this story. "I was irritable. Small things were bothering me that I normally would not be concerned about."
At age 61, John is a diabetic with a heart condition and was advised against Viagra by his doctor, yet he simply could not perform sexually. After consulting with his urologist, John began receiving monthly injections of testosterone.
"It's worked fine," he said. "And I tell my friends about it, too. It's a thing that men don't like talking about, but they like hearing it. I'm not going back to where I was in my 20s, but I do have more desire."
This so-called testosterone revolution is not without drawbacks, doctors caution. Just as hormone therapy for women has been linked to increased risk of breast cancer, stroke and heart disease, testosterone therapy could trigger prostate cancer, as well as increase the danger of blood clotting. Also, as Aliotta pointed out, since testosterone is directly linked to prostate growth, men with prostate cancer are unlikely candidates for hormone replacement therapy. In addition, younger men - in their 30s and 40s - who are testosterone deficient may be at risk for developing osteoporosis.
Aliotta offers testosterone replacement in one of three forms:
gel, colorless and most often applied daily to the abdomen or chest
injections, monthly or biweekly
Carol Conklin, a clinical social worker with City Gate Counseling Center, specializes in relationships in crisis. Many of her clients who report incidents of erectile dysfunction are hesitant to speak out, she said.
"I see men whose testosterone seems to be waning, who may get into addictive behavior such as Internet pornography and sexual addiction," Conklin said. "But when you think about irritability, anger is its bigger piece, the only valid emotion men grow up with."
The term "Irritable Male Syndrome" was first coined in spring 2002 by a scientist in Edinburgh, Scotland. An expert on human reproductive science, Gerald Lincoln of the Medical Research Council came up with the term after studying the mating cycle of Soay sheep. In autumn, Lincoln found that the rams' testosterone levels soared and they mated. In the winter testosterone levels fell, and the rams became nervous, withdrawn and disinterested in sex. Lincoln has also observed similar behavioral changes in red deer, reindeer and Indian elephants.
Author Jed Diamond is writing a book on men who suffer from Irritable Male Syndrome. Men, he states, express their symptoms in two ways.
"It can be "acted out' or "acted in,' " Diamond writes. "Sometimes men express these feelings outwardly, becoming angry, blaming, defensive or demanding. At other times the irritability is turned within and they feel anxious, tense, sad or troubled. Many times men go back and forth and their relationship becomes an emotional roller coaster."
Many of these troubled men and their significant others seek counseling, according to an area psychotherapist.
"One of the manifestations is anger," said Andre Toth. "And people are characterized as being moody all of a sudden. It's not only related to sexuality, but the general aging process.
"Men have always been lousy at expressing sadness," Toth added. "We are much better at anger. When we don't know what to do, we get angry. It's our middle name."
Let's talk about two things, actually: "hope" and "interest". First, "hope". How many men my age and older (ok, even younger) find themselves in lives that they despise? They are in jobs they dislike intensely, dead-end or otherwise. They start to feel that the dreams they had as younger men just probably aren't going to come true. They get up......have some coffee, read a paper (scan FR?), shower/dress, and commute to a job they don't give a flying fiddler's damn about but pays the bills. They find themselves and their families in lifestyles that demand a certain income level, so they don't dare take what have become "unnecessary risks" any more. I consider this a form of "male neutering", harsh as that may sound. Too many of us become slaves to a "lifestyle" vs. working in a field that provides true satisfaction..............hope for a satisfying, fulfilling career.
As far as "interest" is concerned........and this one may be dicey, but I do NOT intend to insult either men OR women with this little theory / observation.
Maybe the men aren't as interested in sex because that woman they married 20+ years ago just doesn't interest them sexually any longer. Maybe she put on 30 pounds in the intervening years and doesn't take care of herself otherwise.........or JUST as likely, same thing happened to him. so her lack of interest in him is manifested, so he loses interest in her.
IOW, they stop giving a damn about how they look to each other........how attractive they are to each other.........how to be romantic. It's hard to be aroused by a woman who simply cannot arouse you. Take the guys in the article and plop them in front of a nubile 25-year-old and I guarantee that in the majority of cases, you won't see any sign of "sexual dysfunction". Both sexes are guilty of this. It takes work, it takes effort on behalf of both in a marriage.
Trouble is, too many are just too damned lazy to care enough to rectify the situation. That's a sad fact. Hit the gym? Can't be bothered; too time consuming. Diet? Forget it; never works. Get off the sofa and put away the remote control? Well gee, what else am I going to do on a Saturday evening?
People allow themselves to get "comfortable".....and they shouldn't.
I consider myself very, very fortunate in that area, for I've been married to a stunningly beautiful 6' blonde for 25 years (next month) and has given me 7 beautiful children. I want her every bit as much now as I did 25 years ago.......if not more. I try to do things to see to it that I'm worthy of her attention as well.
None of the above necessarily involves a lack of testosterone........but I'll add (as delicately as possible) that due to a cancer scare some years ago and resultant surgery, I'm now producing exactly half the testosterone I was before that surgery. Didn't change a thing. Oh......as for the first, I love what I do for a living and do all that I can to be damned good at it. I challenge myself far more than any "boss" ever could, and I love exceeding my own goals in that job.
Hope this helps somebody.
Hmmmmmmm . . . . . . . . . . .
Specialist in treating agoraphobia?
Actually, I think another way to sum up what you've described is to say that these people have become average -- just like any other middle aged person. It takes a strong desire to do something in life to keep yourself moving ahead.
" anger is ... the only valid emotion men grow up with"
If men are "lousy" at expressing sadness, only emoting anger, how does one account for the music, literature, architecture, engineering, and art that suggests that men are capable of a profound range of emotion, beyond angry/sad? And how do you account for the many 10's of millions of men that slide into middle age, make less testosterone, get laid less, and yet avoid becoming reactive emotional clods, and still manage to make their 40's and up the best years of their lives? Also, why is it supposed that men have to express emotions, particularly sadness, in a manner consistent with females for that emotion to be valid? Just because I am not over there whining on your shoulder doesn't mean I can't feel sad.
Damn, there I go, getting all emotional. Time to change my patch.
Well, in part it depends on what the original level was. Half of 700 is a lot better than half of 300. Then again, you may be one of those lucky souls who has a more efficient biochemistry, and need less to get the same effect.
Unfortuantely, for many people, the problem is very real, and in many cases, either undiagonosed or wrongly diagnosed. I've got the problem, and my level had dropped to less than 100 (normal range is 300-1000ug/dl), and in fact I had developed a "skipped pulse" heart rhythm. Fortunately, my physician recognized that "heart rhythm" tic as a potential symptom of low testosterone, and had a blood test done (after sending me to a cardiologist to be sure nothing else was going on). On seeing the results she gave me a testosterone shot, and the effect was magical. The heart rhythm problem disappeared IMMEDIATELY, and a lot of other nebulous irritations/physical complaints also vanished. Amazingly enough, I was NOT having signifcant problems with libido/sexuality at the time.
I suspect that many older males who develop these heart rhythm abnormalities and get put on medications to "regularize the heartbeat" (George Bush I, for instance) are actually suffering from a drop in testosterone.
The article doesn't mention the BEST method of supplementation, with is an under-the-skin timed release implant done every six months, but it is difficult to find a doctor who 1) knows about the procedure, and 2) is willing to do it.
I agree with you on the derivatized analogs of testosterone used in shots, but the testosterone used in the gel and time-release implants is the same as that produced by the body.
Your postulated "bad thing" only applies to weight-lifters and other steroid abusers who try to boost their testosterone to un-naturally high levels to build body mass. Bringing an un-naturally LOW testosterone level up to normal is another matter entirely. The reason you do that is your body no longer makes enough hormone. Those of us on hormone replacement therapy know we will be doing so indefinitely. Why would we stop??