What is it about the male psyche that causes men to often become grumpy as they age? We all know a once perfectly nice man whose inner Victor Meldrew emerged as soon as he turned 50. The grumpy old man isn’t a well-recognized trope for anything.
But could something else be going on? Could it really be that they have a medical problem?
For years we have assumed that old misanthropes were just a fact of life. We attribute their mood to losing their purpose in life or thinking the world is moving too fast for their liking. But there is a growing opinion that they could be suffering from a hormonal imbalance called andropause.
This controversial condition, also known as “manopause,” is the result of low testosterone levels and has inevitably generated many derisive debates. Some even say it’s a condition created by men trying to take advantage of all the attention women receive during menopause.
However, scientists have also estimated that one in five men over the age of 65 could be experiencing symptoms. And yes, these are similar to those of female menopause, including low libido, irritability, tiredness, sweating, and general aches and pains. One study puts the figure at 840,000 men in the UK currently suffering from symptomatic andropause, with only 19,000 currently receiving treatment in the form of testosterone replacement therapy, most commonly a gel applied daily to the skin.
In fact, the “manopause” is increasingly gaining traction as a legitimate condition. Last week it was revealed that NHS bosses are offering middle-aged male workers special uniforms, tailored desk space and up to a year of paid leave to help them cope.
“There is a growing view that older men may suffer from a hormonal imbalance called andropause,” writes Dr. Max Pemberton.
“While they recognize that a genuine change occurs as men age, some experts maintain that it has a psychological, rather than hormonal, basis.”
So is it something real? In women, menopause is triggered by the sudden drop in sex hormones (estrogen and progesterone) that occurs when the ovaries close. In men, however, there is no similarly dramatic decline in testosterone, but rather a natural, gradual reduction with age: a drop of about 0.5 percent a year.
Proponents of testosterone replacement therapy (TRT) say the fact that it offers men a new lease on life, eradicating symptoms while improving mood and libido, is proof that manopause exists.
However, many doctors are skeptical. While they acknowledge that genuine change occurs as men age, experts maintain that it has a psychological, rather than hormonal, basis. Marital problems, changes in social status, job dissatisfaction, lack of exercise, and the long-term effects of alcohol and smoking can cause symptoms similar to those attributed to andropause. They also suggest that some of the symptoms may be the result of other underlying medical conditions, such as thyroid problems, anemia or depression.
Professor John McKinlay of the New England Research Institute has argued that “there is no empirical research to support the syndrome” and advises people with lower testosterone levels to increase physical activity and go on a diet, as Obesity itself reduces testosterone levels.
“We are medicalizing lifestyle issues and the natural aging process,” he says.
And the fact is that testosterone treatment is not without risks. Side effects include possible breast growth, acne, sleeping problems, and an enlarged prostate. Some studies have even linked testosterone therapy to prostate cancer.
Critics also point to the fact that men may complain of symptoms while their blood tests show normal testosterone levels. In contrast, men whose blood tests show low levels do not necessarily experience problems.
My opinion is that there is a version of menopause in men, but far from all of them. Over the years, I have certainly seen “grumpy old men” whose lives have been transformed by TRT. Men who have been diagnosed with “depression” have suddenly seen their mood improve and no longer need antidepressants.
It has happened enough that I now test the testosterone levels of middle-aged patients who come to me with changes in their mood but no history of depression and no clear explanation for the deterioration in their personal lives.
Their wives often say that something is not quite right; that their husbands have lost their va-va-voom and look like a miserable, grumpy version of themselves and, ta da, when their testosterone is checked, it is in fact too low.
I can’t help but feel that this is similar to the number of menopausal women who have had their low mood misdiagnosed as “depression”, only to improve when they start HRT.
Another thing is whether men really need major adjustments in their work environment. But certainly the resistance to the idea that men would benefit from hormone treatment seems to smack of the resistance that women faced for years regarding HRT.
The drug Champix has been relaunched on the NHS to help smokers quit. Concerns have been raised about side effects. But smoking kills half of all smokers, so quitting (using any method) can save your life. Talk to your doctor!
Davina’s tumor shock
Davina McCall revealed last week that she underwent emergency surgery after a benign tumor called a colloid cyst was found on her brain.
Davina McCall revealed last week that she would undergo emergency surgery after a benign tumor called a colloid cyst was found on her brain. Although the results are generally very good for this type of operation, being told that you need it must be a huge shock.
What I’ve noticed in people when something like this happens is that they go into “survival mode.” They barely have time to process their diagnosis before scheduling surgery. People care about them and there are many offers of help.
Often it is not until long after the operation, when the anxiety and drama has subsided, that it really hits them and they suddenly realize the severity and enormity of what they have been through.
I have seen many people who have this delayed reaction and subsequently need a lot of support. However, at this point, many people assume that they are fine and have moved their attention elsewhere, or have even forgotten about it.
It’s always good to talk to someone a few months after something big like this to let them know that, even though the initial panic has passed, you’re still thinking about them and that you’re there for them if they need a hand or a shoulder. to continue crying.
Faced with a medical condition that promises only steady, grim deterioration, I think most doctors would choose the quick way out. But should assisted dying be legalized, as currently proposed?
Dr. Max Prescribes: The Anxious Generation
Social psychologist Johnathan Haidt’s excellent book offers a sobering look at the anxiety epidemic in children who grew up online, their childhood diminished and impoverished by smartphone addiction. It’s a call to arms to make fundamental changes to the way we allow children to grow up in the technological age, and it’s worth reading.
My biggest concern is the potential for such legislation to be abused or alter the way people with severe disabilities or terminal illnesses are perceived and treated. For those reasons, I am wary of fully supporting physician-assisted suicide.
The only solution I see is that each case would have to be argued in a court of law, so that this becomes a legal decision, not a medical one.
What I seriously disagree with is the idea put forward by critics of assisted dying that the debate itself is not necessary because modern medicine means we can all live long, pain-free lives.
Control of physical pain is not the determining factor in a person’s quality of life. It is the emotional pain, for which there is no analgesia, that is often the deciding factor in people wanting to die in such cases.
Antidepressants will not make you walk again. Talking therapies can help change attitudes towards an illness or disability, but they cannot give you back your old life. There is no analgesia that can dull the persistent feeling of loss, of helplessness and impotence, of frustration and unworthiness.
Certainly, many people with debilitating and terminal illnesses lead full and meaningful lives, but there are also those who do not.
While I am tormented by indecision about whether I would like to live in a country that helps people die, I am equally uncomfortable with vocal groups of people – from self-proclaimed ethicists to religious enthusiasts – who feel obligated to make judgments about another person’s existence.
Of course, it is argued that assisted suicide is open to abuse. But don’t set out to know what it feels like to lie in bed, staring at the ceiling day after day, being turned around by caregivers while they wash you and change your sheets, longing for the life you had but that now no longer exists. of scope. Don’t tell me that doesn’t hurt. Don’t tell me that doctors can control thatIt’s not some kind of pain.