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Testosterone Replacement Therapy (TRT)

Some men develop depression, loss of sex drive, erectile dysfunction and other physical and emotional symptoms when they reach their late 40s to early 50s.

Other symptoms common in men this age are:

  • hot flushes
  • mood swings
  • loss of muscle mass
  • fat redistribution, such as developing a large belly or “man boobs” (gynaecomastia)
  • tiredness and a general lack of enthusiasm or energy
  • increased sweating
  • poor concentration and short-term memory
  • irritability

These symptoms can interfere with everyday life and happiness, so it’s important to find the underlying cause and work out what can be done to resolve it.

Is there such a thing as a ‘male menopause’?

The “male menopause” (sometimes called the “andropause”) is a term sometimes used in the media to explain the above symptoms.

This label is misleading because it suggests the symptoms are the result of a sudden drop in testosterone in middle age, similar to what occurs in the female menopause. This is not true. Although testosterone levels fall as men age, the decline is steady – less than 2% a year from around the age of 30-40 – and this is unlikely to cause any problems in itself.

A testosterone deficiency that develops later in life (also known as late-onset hypogonadism) can sometimes be responsible for these symptoms, but in many cases the symptoms are nothing to do with hormones.

Personal or lifestyle issues

Lifestyle factors or psychological problems are often responsible for many of the symptoms described above. For example, erectile dysfunction, loss of libido and mood swings are often the result of stress, depression or anxiety. These psychological problems are typically brought on by work or relationship issues, divorce, money problems or worrying about ageing parents.

A “midlife crisis” can also be responsible. This can happen when men think they’ve reached life’s halfway stage. Anxieties over what they’ve accomplished so far, either in their job or personal life, can lead to a period of depression. In men, this usually happens between the ages of 35 and 50, and can last up to 10 years.

Other possible causes of the above symptoms include:

  • lack of sleep
  • poor diet
  • lack of exercise
  • drinking too much alcohol
  • smoking
  • low self-esteem
  • diabetes

What to do

If you are experiencing any of the above symptoms, see us at Select Medical. `we will ask about your work and personal life, to see if your symptoms may be caused by a mental health issue, such as stress or anxiety.

If stress or anxiety are affecting you, you may benefit from medication or a talking therapy. Exercise and relaxation can also help.

Do I need HRT?

We may also order a blood test to measure your testosterone levels. If the results suggest you have a testosterone deficiency, you may be offered testosterone replacement treatment in the form of tablets, patches, gels, implants or injections to correct the hormone deficiency, which should relieve your symptoms. If so you will need to have blood tests to measure you testosterone levels and your prostate (PSA) levels.

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