• HRT and Low Testosterone in Men

The HRT journey: what happens when your man is left behind?

There is no doubt that Hormone Replacement Therapy (HRT), given for the treatment of menopausal symptoms in women, has improved the quality and health outcomes for millions of women worldwide, but it is only recently that through the efforts of several dedicated doctors and patient advocates, that we have started to see the benefits of HRT become more widely accepted and better understood by many patients and doctors alike.

Even just 10 years ago, for a lot of women, menopause was just still seen as a natural stage in life that should not be medicalised or interfered with and therefore, the symptoms and changes in body and mind that accompanied the drop in oestrogen production were simply dismissed as being part of nature, and therefore not warranting medical intervention.

Thankfully, now times are changing, and many more women and health professionals are aware and understand the enormous benefits HRT can have when given to the right person.

Dr Jeff Foster
Dr Jeff FosterMedical Director & Male Health Lead

Dr Jeff Foster is a Men’s Health specialist and one of the founders of H3Health.

You can find out more about Dr Foster by viewing his latest articles and biography .

But could changes in hormone deficiency awareness bring help to men too?

But what happens to the partners, husbands, and boyfriends of those women who are embarking on this positive change in lifestyle and health?  This may seem an odd , even misogynistic question; a question posed by a Men’s Health, male doctor, perhaps just looking to jump on the bandwagon of female hormone deficiency?  Of course, this is not the case, and the problem is that not only do many men not understand how menopause affects women, but they often fail to realise they might also be travelling along their own similar, but more insidious path of hormone deficiency.

Replace a women’s lost oestrogen with HRT and most women will dramatically improve how they feel; this can also make the symptoms of hormone deficiency many men experience become even more obvious. For most couples, life is about being on a journey together; if you both feel rubbish, have no energy, and don’t want sex, then it’s tough, but it’s tough for both parties.

When one person suddenly feels better through taking HRT, has lots of energy, feels motivated, mood improves and wants to have sex while the other person still feels apathetic, the pathway goes off in different directions, and suddenly that journey together becomes a much more difficult one to navigate.

Why understanding menopause better could help men as well as women.

From a male perspective, we have all heard of menopause, and most men understand this is a loss of a women’s ability to bear children, but other than that, its impact on health and wellbeing is not commonly discussed or recognised.

This is for several reasons: when we are trying to increase awareness of a medical condition, the idea is we target education at the patient so they can recognise their symptoms and hopefully seek medical advice.  A voluntary educational session for men on menopause, a condition they will never suffer with, is unlikely to have a great turnout.  In a similar way, my uptake of women attending my erectile dysfunction talks has tended to be very low indeed.  Secondly, there is a cultural trivialisation of menopause for both sexes that often follows: “my wife’s 50, we’ve been married 20 yrs anyway, so we don’t want to have sex, we don’t really get on that well, she’s always throwing the sheets off at night, but she’ll get through it, after all, it’s just menopause”.

Until we appreciate how menopause affects women differently, in particular how devastating it can be for some women, we cannot expect men to know how to support their partners during this time.

But ironically, there is actually an easy way for many men to understand menopause better.  And this is to just look at themselves.

There is a cultural narrative that says if you’re a guy 40+ you should not want to have sex as much as you used to, your job is busy, you have kids and a family, time is tight, so you don’t eat as well, you don’t exercise, and you spend your time in the car travelling or sitting at a desk.  Life pressures stop you doing those things you used to enjoy and kept you healthy.  The result is your body changes, you get fatter, you lose any interest in sex, you’re tired all the time, work is harder and you don’t seem as happy with life.  You’re told you’re a classic “grumpy middle-aged man”.   This is just a normal part of getting older.

But is it?  These symptoms are remarkably similar to the way many women present during menopause, and just as women who lose oestrogen, men lose their primary sex hormone, testosterone, as they get older.  The difficulty is that for men, this loss in hormone production tends to be a much more gradual and progressive condition that starts at the age of 30 and drops by about 1% a year.  Other medical problems, even mild ones such as asthma or high blood pressure can affect testosterone production, and while some people are lucky enough produce sufficient levels that they never feel a drop in hormone production, other men may become symptomatic even in their 30s.

So, are men and women really all that different when it comes to hormones?

Nearly 1 million men the UK suffer with testosterone deficiency, but there are probably thousands more who have just been told there symptoms are “normal for age”.  Many of these men feel rubbish but they laugh it off or ignore their symptoms because their wife is suffering much worse with menopause or because they simply believe this is a normal part of getting older.

I see many patients who have come to clinic because their wives have started the HRT journey and feel great, it is at this point that the man suddenly says “I need to do something”.  Not all men know if the problem is testosterone related, but they know something isn’t right.

I have always argued that men and women are not really that different, and when it comes to hormones there is a lot we can learn from each other.  If we are going to help men understand menopause better, maybe the best way to approach this is to first look at ourselves.

As men, sometimes that self-reflection can help us to realise that we are more like are partners than perhaps we first thought.

You can book now if you’d like to discuss your concerns with one of our doctors.

We have a team of doctors who specialise in men’s and women’s health. If you’d like to speak to a doctor about low testosterone, menopause, or any of the topics we’ve touched on you can make a booking here or speak to one of our helpful team on 03309 120769 – to make it easy we offer consultations online or face to face, whichever you prefer.

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