NHS spends £20million a year on testosterone prescriptions despite evidence it could do patients more harm than good
Tiredness and low sex drive don't mean you're entering the 'manopause' or that you need testosterone supplements, say our experts
IF you ask a group of middle-aged men if they feel tired and lack a zest for life or sex, many will say yes.
Stress and other lifestyle factors — such as lack of or interrupted sleep, too much booze, bad diet and being overweight — are often to blame.
But a growing number of men are heading to the doctors claiming they are going through the “manopause” — or male menopause — and being given prescriptions for testosterone.
The sex hormone prescriptions, such as jabs and gels, have increased by 20 per cent since 2012 and now cost the NHS £20MILLION a year.
Two different drugs, testosterone and testosterone undecanoate, are now among the ten most prescribed controlled drugs for the first time, according to Pulse magazine.
Singer Robbie Williams injects himself twice weekly with the hormone after his GP revealed he has the “testosterone levels of a 100-year-old man”.
But a study published in the journal PLOS One last week argued that there is no benefit to treating ageing men with it.
Researchers from Georgetown University in Washington DC analysed more than 200 studies, dating back to the Fifties, and found supplementation with the hormone for low mood, energy boosts, sexual function and cognitive ability made no difference at all.
In fact, previous studies have shown that testosterone therapy could actually CAUSE health problems.
Research from the University of California found that men over 65, who used testosterone gels or patches and have a history of heart disease, were three times more likely to have a heart attack shortly after treatment began.
Professor Sander Greenland, who authored the study, urged patients and doctors to assess the risk of heart attacks when considering it.
And studies from University of Pennsylvania School of Medicine discovered that men taking the sex hormone have a 29 per cent greater risk of death and stroke.
There have also been concerns about a possible link between the therapy and prostate cancer.
Yet GPs last year wrote 374,457 prescriptions for testosterone.
So do men really need hormone replacement therapy?
Sun doctor, Carol Cooper, says: “Men can, and do, get testosterone deficiency. Obesity and various conditions such as sarcoid and pituitary gland disease can cause it. So can surgery or severe injury to both testicles.
“But those are very different scenarios to diagnosing a ‘male menopause’.
“As anyone over 50 knows, life brings its challenges — relationship worries, loss of youth, trouble at work and concerns about children or ageing relatives.
“It might be nice to imagine the fall-out could be fixed with just a hormone prescription.
“But the notion of ‘a pill for every ill’ risks over-medicalising problems.
“Doctors should not prescribe a drug unless the patient is likely to benefit from it. That’s a good rule for any medic to live by, especially since every drug has potential side-effects.
“In the case of testosterone, the most worrying aspect is a slightly increased risk of blood clots and stroke.
“Levels of testosterone do drop slowly with age. But there isn’t the nosedive that menopausal women get with oestrogen.”
So what could cause the symptoms men are describing?
Dr Cooper says: “Fatigue, low mood and loss of sex drive happen to a greater or lesser extent in many conditions.
“It is vital you look at your lifestyle but the symptoms could also be a sign of something serious, including heart disease, diabetes, thyroid problems or even some types of blood cancer.”
Nutritionist Amanda Ursell believes men with flagging libido and energy or low mood should take a close look at their diet rather than turning to hormone gels, pills or injections.
She says: “Eating regular meals consisting of a good balance of starchy carbohydrates, lean protein and vegetables and fruits is a great place to start.
“It helps to control blood sugar and thus energy levels, as well as delivering a good range of essential nutrients.
“Low selenium levels can contribute to low mood and energy levels.
“So can folate, one of the B vitamins.
“It is crucial to remain well hydrated. Even small levels of dehydration can make you feel stressed, fatigued and lacking in endurance and motivation.
“Again, all are reversed when hydration is restored.”
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Fitness expert Lucy Wyndham-Read says: “Low mood and low energy levels can all be caused by not doing enough exercise. Just a walk to the shops every day at a brisk pace could change this.
“Men should look at their lifestyles before taking pills. Making sure you are of a healthy weight and have a balanced diet without too much booze will also help.”
But there are those who do not necessarily agree that lifestyle tweaks are the answer.
Professor Malcolm Carruthers, of the Centre for Men’s Health clinic, Harley Street, has spent 30 years researching testosterone therapy.
He says: “HRT is beneficial to women and there is no reason why men can’t benefit from it too.
“Just as women stop having periods and have symptoms as they age, men can also suffer with erectile, mood and energy problems.
“Testosterone prescriptions won’t suit every man with symptoms.
“But it can be of considerable benefit to many.
“Often, men don’t have a deficiency of testosterone but have built up a resistance to it.
“Changing that can reverse symptoms in as little as two weeks.
“Research I have been involved in shows that supplementing with the hormone could aid patients with Type 2 diabetes and could help prevent or treat conditions such as Alzheimer’s.
“Those with depression could also benefit from it.”
'It masked my bipolar symptoms'
PAUL SCATES, 38, is an event planner from Bournemouth. He says:
"I was suffering with feelings of depression and anxiety and convinced myself my problems were linked to low testosterone.
"I tried to persuade my GP to give me testosterone patches or gel. At my lowest ebb I tried to kill myself.
"I was later diagnosed with bipolar disorder. Looking back, I had all the symptoms but had just convinced myself I had problems with low testosterone levels.
"Many symptoms of the “manopause” are the same – I lacked a zest for life, felt tired all the time and was depressed. But I am now receiving the right treatment for my condition. I had therapy and self-medicate with diet and exercise.
"If I hadn’t finally had the right diagnosis I might not even be here now.
"It shows people need to be wary of testosterone supplementation.
"Not only can it be bad for your health, it might not be treating the real reason for your symptoms.
"Finally getting the right treatment has literally saved my life."
'I can exercise and enjoy sex again'
ALAN TAYLOR is a 64-year-old retired engineer from Gourock, Inverclyde. He says:
"I lost a zest for life after my wife died.
"My GP told me it was normal to feel this way and it was all part of getting older. But I thought something else was wrong.
"I had a private blood test which revealed my testosterone levels were low. I was prescribed a testosterone-containing gel, which I apply to my thighs twice weekly.
"In a few months, my energy levels had increased and I had enough to start exercising regularly. I also found a new partner and could finally enjoy my sex life once again.
"Men who feel they have a testosterone deficiency need to get properly tested – it has really changed my life. I know there are real risks involved in oversupplying your body with testosterone and my health is a priority.
"That is why I get tested every nine months to make sure that my levels are OK and my general health is good."