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REPRINTED FROM THE DAILY MAIL 4TH JULY 2000

CAN HRT BEAT THE MALEMENOPAUSE?

When people tell Reg Eagle there is no such thing as the male meno-pause,
he get extremely angry. Many doctors still doubt its existence and challenge the need for men to be on hormone replacement therapy like women.

But a growing body of opinion believes that hormone therapy for men should be as easily available as it is for women.

Reg has been on HRT for five years and is convinced he was a victim of plummeting testosterone levels, which were ruining his life. He says: ‘I was in my late 40s and life started to pass me by.

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I lost interest in my business and my relationship and just didn't want to do anything. I’ve been an inveterate reader all my life and I couldn't even summon up the energy to read a book.

I became a couch potato and started to hibernate away and hate contact with people. I
would be irritable at home and would behave like a stag with a sore head.'

Some doctors believe men who lose interest in work and their social life are experiencing nothing more than a mid life crisis.

But Reg says it was the weariness and complete apathy which made it clear this was something more serious. I wasn’t looking for a new direction,’ he says, 'I just didn’t want to do anything.

I was also having symptoms such as terrible night sweats and insomnia.'
Reg believed he was suffering from a major illness and thought it might be ME. But tests proved negative.

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'I really was at my wits' end about what was wrong with me. I had so little interest in my business that I wanted to close up and retire before the age of 50.'

One blow was that Reg's relationship with his partner of 30 years, Anita, started to go downhill. 'A lot of people confuse male menopause with impotence. For me it was a loss of libido,’ he says. 'I just wasn’t interested in women.'

He realised what was wrong with him while listening to the radio. 'I heard Dr Malcolm Carruthers describe perfectly the sort of experience I was going through.'
When he went to see Dr Carruthers, who specialises in treating the male menopause, Reg discovered why he had been feeling so dreadful.

'I was incredibly low on testosterone, the male hormone - so low that I only had half what you'd expect to find in a man of 70.'

Reg was placed on the hormone implant Restanadol. 'After a couple of days I started to feel better and some of my symptoms began to
disappear,’ he says. 'Within a couple of weeks I was feeling really well - better than I had for years.'

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The implant is placed under the skin in a buttock and slowly releases the hormone into the body. It is considered more effective than taking oral HRT.

Reg, 55, is now leading a full and active life. 'I feel like I'm 30 again,' he says. 'I gave up any idea of retiring, ditched my old business and started up a new one working in television post-production.'

Dr Carruthers, who works at the Gold Cross Medical Group in London, has seen more than 1,000 patients with the male menopause. He says the battle for the acceptance of male HRTis slowly being won .
 
There was some concern about its safety in relation to prostate cancer, but all the evidence is now showing that it might actually help prevent the cancer developing. The big battle that has yet to be won is for GPs to recognise this condition in men in the same way as it has now become a routine diagnosis for women.

Part of the problem is cost, and also the fact that men don't go through quite the same changes as a woman at the menopause.'

Dr Paul Gard, a senior lecturer at the school of pharmacy at the University of Brighton, says many conditions which affect men in older age could be alleviated if testosterone replacement therapy were more widely available.

'There is good evidence that testosterone secretion decreases with age and that many men over the age of 60 have lower levels than normal,' he says.

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This can lead to a number of symptoms, including osteoporosis, loss of weight and strength, plus mood disorders and loss of memory and cognitive ability, Dr Gard says.

'It is generally recognised that testosterone replacement therapy may be of value in the alleviation of some of the symptoms associated with aging males,' he adds.

However, the delivery of HRT for men is not as advanced as the treatments available to women.

While women can obtain HRT in a wide range of ways, including injections, tablets, creams and implants, the options for men are limited mainly to implants or tablets.

But Howard Jacobs, professor of reproductive endocrinology at the Royal Free and University College School of Medicine, say the merits of hormone replacement for men are far from proven.

'It is easy to see the attraction of hormone treatment. But there is, I am afraid, a long way to go.'

He claims testosterone treatment given to elderly men has failed to increase bone mineral density, and that men losing the ability to achieve erection would be better taking Viagra.

W GOLD Cross Medical Group 020 7636-8283.

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