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Has your get up and go got up and gone?

Written by: Centre for Men's Health

For a great many men over the age of 45 many changes in health are overlooked simply because they assume it is an inevitable part of getting older. These can include the onset of middle aged ‘spread’, not having as much energy as they are used to, feeling tired, perhaps not being as happy within themselves, being more irritable, depressed and not being as sexually active or indeed able to ‘rise to the occasion’, especially first thing in the morning. Often these changes are overlooked either because the man feels so pressurised by the rest of their life, or because their sexual partner has lost interest as well. Besides lack of sex drive, there is often loss of drive in professional or business life. Physically there is frequently stiffness and pain in the muscles and joints, symptoms of gout, episodes of night sweats and a rapidly deteriorating level of fitness. There may also be signs of the accelerated ageing of the heart and circulation. When men suffer a combination of these symptoms, there is strong scientific evidence to show that this may not be the natural process of ageing but is actually a distinct medical condition – testosterone deficiency syndrome.

In fact, testosterone deficiency among some groups of men is quite common. Research by the Centre for Men’s Health (1) indicates that as many as 20 per cent of men over the age of 50 live with either moderate or severe symptoms of this syndrome. Among men with type 2 diabetes the figure is as high as 50 per cent, according to the charity Diabetes UK. Yet despite this being a widespread problem, studies show that three quarters of men are unaware that their symptoms may be due to a deficiency in their levels of testosterone.

Dr Malcolm Carruthers, who is an expert in testosterone deficiency syndrome and lead clinician at the Centre For Men’s Health in London, Manchester and Edinburgh said, “Over the age of thirty, men’s testosterone levels fall naturally but what can make these levels fall further, and the reason it occurs in the over 45s and over 50s particularly, is mainly a whole variety of life events; particularly stress. Anything that puts a man down – if he loses his job or if he loses his partner – these types of stresses can cause it. Too much alcohol might just be a possible cause and a whole variety of disorders generally.”

Despite the prevalence of testosterone deficiency, research by the Centre for Men’s Health (1) shows that only 1 per cent of the men that could be helped have been diagnosed and are on testosterone replacement therapy, which can reverse the symptoms.

Dr Malcolm Carruthers said, “It is astonishing that this most common hormonal disturbance in men, which can wreck their lives, loves and health, is the least commonly treated. While there is increasing recognition among doctors that testosterone deficiency syndrome is a common and important condition, there is still some resistance. The condition can be difficult to diagnose other than from the very characteristic symptoms, because the overall level of testosterone in the blood is often within so-called normal limits. In my experience this makes many doctors reluctant to accept the idea that the patient may have the condition, and is one of the main reasons why the condition is so rarely recognised and treated.”

He concluded, “A further obstacle has been the inability of men to take a more active role in their health and wellbeing. I know from my 20 years of work in this area of medicine how difficult it is for men to talk openly about difficulties with the most intimate aspects of their health. A great many of the Centre for Men’s Health patients have found us via the internet, which is why we have placed the best available symptom questionnaire, the AMS scale, on our website.

This provides men with the opportunity to see if they are living with testosterone deficiency and, if they are, they can then approach their own doctor for help or they can of course book a consultation with one of our consultants.”


1: Trinick T.R.,Feneley M.R. Welford H, Carruthers M. The Aging Male 2010 1-6 *International web survey shows high prevalence of symptomatic testosterone deficiency in men. A 10,000 Department of Chemical Pathology The Ulster Hospital Belfast, Institute of Urology & Nephrology University College Hospital London, Centre for Mens Health, July 2010 Informa healthcare

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