MAN AND SUPERMAN

Brain fog, mood swings and low libido can often affect men over 40. Could testosterone replacement therapy help, or can it actually be harmful?

- Delia Von Neuschatz

Whether it is Davina McCall talking about losing “something of herself”, Zoe Ball describing bouts of “meno-madness”, or Halle Berry declaring her menopausal status from the steps of the

Capitol in Washington, the conversation around menopause has become loud and proud. And this in turn has resulted in important debates about legislation to protect the employment rights of women experiencing the debilitating effects of menopause, and treatments such as hormone replacement therapy (HRT) that can help to alleviate them.

However, absent from this discussion has been the issue of how a midlife hormone shift can affect men, too – and what can be done to relieve its symptoms, which can be equally distressing.

While the medical community is still divided as to whether the age-related drop in testosterone experienced by some men should be described as male menopause, it is sometimes referred to as the andropause, and it can manifest in men in their late forties and early fifties. Symptoms include depression, low libido, erectile dysfunction, insomnia, and a loss of muscle mass, and increasingly men are turning to TRT – testosterone replacement therapy – to help restore virility, strength and energy.

While maintaining a healthy weight and lifestyle is the best way to preserve testosterone levels, the demand for testosterone therapy has soared over the last two decades among men who believe they have “low T”.

There has been a proliferation of standalone “men’s health” clinics and online “low T” services, meaning that TRT is fast becoming a billion-dollar business, with the peak demand for prescriptions coming from men aged 50 to 60 years old, according to Dr Channa Jayasena, a consultant in reproductive endocrinology at Imperial College London.