We’ve all heard about female menopause and hormonal changes in women. A lesser known condition, however,  is that of male menopause, also referred to as TDS (testosterone deficiency syndrome).

Guys blame ‘midlife crises’ for their urge to buy a motorbike and change jobs or for getting a bigger boep. In fact, all this can be due to genuine physical and psychological changes.
Dr Pradaruth Ramlachan, deputy president of the Southern African Sexual Health Association of South Africa and executive member of the Africa Gulf Society for Sexual Medicine, gives us the low-down.

WHAT IS IT?
As with menopause in women, you won’t be feeling quite yourself anymore with TDS. Symptoms of low testosterone are:

• Irritability
• Lowered aggressiveness
• Loss of libido
• Erectile dysfunction (ED)
• Weight gain (a large boep should act as a warning sign that a man’s testosterone levels are low)
• Depression
• Anaemia
• Dry skin
• Osteoporosis

HOW DOES IT AFFECT ME?
Suffering from TDS can have a profound impact on your quality of life. Here are some of the changes you’ll experience:

• Increased visceral fat (especially around the waist area)
• Diminished sexual desire
• Mood swings
• Sleep disturbances
• Decreased lean body mass and muscle strength
• Decreased body hair and skin alterations
• Decreased bone mineral density

WHAT SHOULD I DO?

• Have your testosterone level checked by a doctor and ask him/her whether testosterone therapy would be suitable for you.
• Lose that boep. A testosterone treatment will help you achieve fat loss around the waist – but it’s essential to adopt a healthy lifestyle.
• Go for a full medical check-up – TDS predisposes men to heart disease, diabetes, abnormal cholesterol and other medical conditions that could threaten your health.
• ED could be a sign of low testosterone and/or existing heart disease. If you have ED, ask your doctor to prescribe one of the ED medications (such as Levitra, Cialis or Viagra). You’ll have one less symptom to worry about – and a healthy sex life can work wonders for your self-esteem.

APPROACH
So how do you fight it off, or at least manage the midlife crisis?

• Find a men’s health specialist (for example an endocrinologist, urologist, sexologist or a GP specialised in this area). Ask him/her whether testosterone therapy is appropriate for you.
• If you embark on testosterone treatment, keep the following in mind: while testosterone treatment won’t cause prostate cancer, it can ‘feed’ an existing prostate cancer – so it is important that you have a digital rectal exam and a special blood test (called a PSA test) to make sure your prostate is healthy before you embark on testosterone treatment.
• Your doctor should monitor your testosterone levels to ensure that you are getting just the right amount of testosterone to ‘normalise’ your levels. Under-dosing won’t bring you any health benefits and overdosing will cause side-effects and threaten your health.
• In South Africa, testosterone can be administered orally or by injection. Make sure you get the best quality testosterone treatment you can afford.
• Overcome your sense of embarrassment and get all the info you need on treatment for ED or TDS.
• Move more – exercise at least 30 minutes a day. It increases the production of your body’s feel-good substance, dopamine, which in turn helps fight off depression.

FAST FACTS

• Testosterone levels peak at around age 20, so it’s a good idea to go for a blood test to establish you personal testosterone level as you can refer to this later in life.
• Testosterone starts declining from age 35. While the decline is slow, symptoms can be insidious and hard to recognise unless you are forewarned as to what to look out for.
• ED often accompanies TDS – but it can be a sign of an underlying cardiovascular or metabolic condition and can predate a heart attack by 25 months.
• You are not alone – 16% of men worldwide aged 20–75 have erectile difficulties.