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DR MICHAEL MOSLEY: Being married and self-employed can help prevent manopause

Do you feel tired and irritable, sleep poorly, have low sex drive, breast discomfort, and occasional hot flashes or sweats?

These symptoms are typical of women going through menopause, when female hormone levels drop. But they are also symptoms that middle-aged men may experience when their levels of the male hormone testosterone begin to drop.

Recently, menopause has rightly received a lot of attention, especially due to the current shortage of hormone replacement therapy (HRT), which is affecting the lives of many women.

But the male equivalent, andropause, also known as penopause, low T, androgen deficiency in the aging man (ADAM), or simply “irritable male syndrome,” is much less talked about.

That’s partly because, unlike women, there isn’t a dramatic period in a man’s life when his testosterone levels fall off the cliff; it’s more like a slow descent.

The male equivalent, andropause, also known as penopause, low T, androgen deficiency in the aging man (ADAM), or simply

The male equivalent, andropause, also known as penopause, low T, androgen deficiency in the aging man (ADAM), or simply “irritable male syndrome,” is much less talked about

Because of this, the claim that men go through a ‘menopause’ is controversial.

But there is no question that many men have low testosterone levels and this is grossly under-diagnosed; a 2020 study, conducted by the Yale School of Medicine in the US, suggests that up to 40 percent of men have low testosterone levels and this has become much more common, particularly among younger men , in the last decades.

Low testosterone is linked not only to all of the symptoms I described above, but also to depression, memory problems, loss of body hair, reduced bone density, and an increased risk of type 2 diabetes, essentially because Testosterone plays a role in so many bodily functions.

The big debate is when and if Low T should be treated with testosterone replacement therapy. Few men will admit to having increased testosterone, although there are plenty of private clinics that will give you a shot.

But treatment is quite expensive, and unless your testosterone levels are shockingly low, injections are unlikely to give you much benefit.

Low testosterone is linked not only to all of the symptoms I described above, but also to depression, memory problems, loss of body hair, reduced bone density, and an increased risk of type 2 diabetes, essentially because Testosterone plays a role in so many bodily functions

Low testosterone is linked not only to all of the symptoms I described above, but also to depression, memory problems, loss of body hair, reduced bone density, and an increased risk of type 2 diabetes, essentially because Testosterone plays a role in so many bodily functions

A few years ago I participated in an experiment where, under medical supervision, I regularly injected myself with testosterone to see if it improved my mood and libido, as advocates promise.

In theory, even though my testosterone levels were normal (and I had no symptoms), an extra dose of this hormone should have had a profound impact on my body.

But it wasn’t like that, so after a few months I gave up.

The advice from the NHS is that if you experience the kind of symptoms outlined above, talk to your GP. You may be offered a blood test, which may then lead to a visit to an endocrinologist (hormone specialist) who can give you testosterone replacement therapy in the form of tablets, patches, gels, or injections.

Not many men follow this path, and in fact their levels have to be very low to be treated on the NHS.

But the good news is that while big drops in testosterone can happen, they are not inevitable and there are many things you can do to maintain or increase your levels without medication.

Maintaining a healthy weight helps. In a 2012 study of nearly 1,400 middle-aged men, researchers at the University of Adelaide in Australia found that over a five-year period, testosterone levels fell by an average of 1 percent per year.

But there were wide variations, with the biggest drops in men who put on a lot of weight and those who remained single. The problem with weight gain is that fat cells contain an enzyme, called aromatase, that converts testosterone to estrogen. So carrying a lot of fat means less testosterone.

And the reverse is also true: Losing some of that fat should boost your testosterone levels.

In a 2011 trial, researchers at Massachusetts General Hospital in Boston found that men with prediabetes who lost 17 pounds (8 kg) of weight lowered their blood sugar levels, and the proportion of men with low testosterone was cut in half (from 24% to 11%). ).

There was no change in the men who had received blood sugar medications.

But why would being single affect your testosterone levels? Gary Wittert, a professor of medicine who led the Australian study, thinks this is probably because married men tend to be healthier and happier. Also, married men tend to have more regular sex; a safe way to increase testosterone levels.

More surprisingly, in another study, Professor Wittert found that men who are self-employed tend to have higher levels of testosterone than those who work for others or who are unemployed, although it is not clear why.

I’m happily married, reasonably slim, and self-employed, so I wasn’t surprised, but certainly relieved, to discover that my testosterone levels are in the upper end of the normal range for my age when I recently took a test for a tv show .

But I still take steps to prevent low testosterone: I do regular resistance exercises (push-ups and squats), which have been shown to increase testosterone, and I try to get a good night’s sleep (another well-proven testosterone booster). There are also certain foods that can help:

■ Eating oily fish will increase your intake of zinc, a nutrient you need to keep your testosterone levels in a healthy range

■ Leafy green vegetables, such as spinach and kale, are a good source of magnesium, another nutrient that helps maintain testosterone levels.

■ I also regularly snack on Brazil nuts, which are a great way to boost selenium levels, which tend to be lower in men with low testosterone levels.

And finally, try to get out in the sun, without burning yourself. A short burst of sunshine will increase vitamin D levels, which is also linked to libido in men and women.

Unless we act quickly, we will lose more talented doctors

Another friend from medical school, a GP in his early 60s, has announced his retirement.

She’s had enough, aside from increased bureaucracy, she told me that the fear of being accused of malpractice and the rising levels of complaints from frustrated patients have finally worn her down.

It used to be so different. My family doctor father-in-law didn’t retire until his mid-60s (other doctors of his generation were often still going into their 70s).

But, as he said, in his day drug regimens were less complicated, patients less litigious and doctors felt better supported.

There has also been a recent fiasco around NHS pension reforms, which meant that doctors who wanted to continue working were penalized financially for doing so.

All of this is on top of the current workforce crisis in the NHS, with the number of GPs declining just as demand is rising. There has been a belated attempt to persuade doctors to come out of retirement, but it feels too late.

Unless more is done to improve working conditions for GPs, I fear many recent graduates will choose to work part-time or leave the country once qualified.

Having said all this, when my mother, who is 93 years old, recently fell, a lovely GP made a house call within a few hours.

There are still many wonderful things about general practice, but the government really needs to stick the finger out to fix the current mess.

Fasting can add years to your life

As you may know, I’m a fan of intermittent fasting: cutting calories for a couple of days a week (the 5:2 diet) or reducing the times you devour them, known as time-restricted eating (TRE). .

Studies have suggested that TRE may lead to modest weight loss and improvements in blood pressure and blood sugar levels.

So I was disappointed by the recent headlines claiming that TRE is a waste of time.

A study in China, where people were asked to eat between 8 a.m. and 4 p.m., found that this led to an average weight loss of 8 kg (nearly 18 lb) after one year; those who simply cut calories lost 6.3 kg (nearly 14 pounds).

But as the trial was quite small, these differences were not considered ‘significant’. However, the volunteers were healthy from the start, so it was not surprising that they didn’t get noticeably healthier.

By contrast, a more recent study, in the journal Science, found that combining ERT with calorie restriction extended the lifespan of mice by an impressive 35 percent. So I won’t give up!

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