The ageing process in men is accompanied by a significant decrease in available androgen (male hormone) levels, probably as a result of decreased activity of androgen producing cells in the testes and a reduced blood supply in the testes. Androgen deficiency in men may lead to loss of strength and energy, a decrease in muscle mass, osteoporosis, a decrease in sexual activity, and, in some cases, changes in mood and cognitive function, This combination of factors often results in impaired quality of life in these men.
While the female menopause usually happens in the limited age range of about 45-55, the symptoms in men can start any time from 30 onwards, though they too tend to peak at 50. And unlike women who are willing to discuss their menopause with each other and with their medical advisers, men are remarkably reluctant to turn to either unless desperate.
“What is the mystery of the male menopause? It is the mystery of why the vitality and virility of millions of men go missing in middle age or later”. So, said Andrologist Dr. Malcolm Carruthers, ‘The typical story is of a man in middle age who gradually loses his drive, strength, energy and enthusiasm for life and love. An all-enveloping mental and physical tiredness descends on him, often for no apparent reason. He changes from being a positive, outgoing person who it is good to be around, to a negative, pessimistic, depressed bear with a sore head and it is increasingly difficult to live or work with him’.
The classic symptoms and signs of this deficiency include:
- Low motivation
- Decreased sex drive
- Decreased muscle mass and strength
- Bone weakness
- Increased body fat in men up to 70 years
- Memory dysfunction
- Decreased appetite
- Decreased hair growth
The hormone deficiency most commonly associated with the above symptoms is the male hormone Testosterone. It is a hormone produced by the testes and is responsible for:
1. Development of male secondary sex characteristics
- Body hair growth (eg. Beard, chest, pubic hair)
- Genitals- penile growth
- Deepening of the voice
2. Sexual behaviour
- Sex drive (libido)
- Erections sufficient to achieve successful penetration
3. Possibly for well-being and energy Reasons for Testosterone Replacement:
Low levels of testosterone in the blood may indicate the need for testosterone replacement, especially if there is decreased libido, or impotence. Replacement may also improve general sense of well-being and physical stamina.
The testosterone level is low if the testes fail to produce sufficient testosterone (hypogonadism). The underproduction by the testes may be due to poor functioning of the testes or due to disease of the pituitary gland (hypopituitarism) which ceases to stimulate the testes to produce testosterone. If testosterone levels in the blood remain low for many years, osteoporosis (brittle bones) may develop. Testosterone replacement can help prevent this from occurring.
How do you go about receiving Testosterone Replacement Therapy (TRT)?
Treatment with TRT is undertaken when men present with clinical symptoms of reduced testosterone, in conjunction with evidence that testosterone production is decreased or that is a result of reduced activity of the cells in the testes.
Before we will start you on therapy, a baseline assessment of your clinical and biochemical status is undertaken. This is done as a means to pick up irregularities as well as a baseline against which future comparisons can be made. A blood test may also be needed to test your PSA levels to rule our possible prostate issues.
No patient is too old to start testosterone therapy.
What should you expect to experience?
- Improved feeling of well being
- More energy
- Increased strength
- Better sleeping pattern
- Improved libido
- Possible increased bone mineralisation and bone strength
The Men’s Clinic can provide you with an effective andropause treatment plan incorporating bio-identical hormones.
The current formulation is the most effective in the world. The treatment combines a range of vaso-dilating in various combinations. This has been the most popular and effective medical treatment for many years now, and helps more than 95% of patients achieve erections through a virtually painless procedure thanks to the automatic applicator: it administers the medicine instantly at the press of a button, making sex spontaneous and enjoyable. Direct application into either rod (the “corpus cavernosa”) causes relaxation of the penile arteries and of the erectile tissue, allowing a rigid erection to occur almost immediately.
Self-injection therapy can be very successful with all causes of erectile dysfunction or premature ejaculation. This type of treatment represents the gold standard against which other treatments must be compared: it is also the safest – with no significant side effects in the rest of the body. International experience shows this type of treatment has the highest cure rate, improving erections and confidence for many patients. If this is the preferred treatment option the Medical Professional will give you a Dosing Protocol and written instructions before mixing the treatment specifically for you.
To treat this, your therapy involves intensive treatment of six to eighteen months’ duration, once or twice per week by self-application to help open and stretch muscles of penile arteries and erectile tissue. This is not just to give you an erection but also to improve the elasticity needed for future erections: it can not only prevent deterioration but also improve spontaneous erectile function.
Reducing risk by quitting smoking, losing weight and increasing exercise can also be important.
Self-application of medication helps improve the elasticity or expandability of the erectile tissue allowing trapping and hence maintaining an erection. Having a good erection up to twice per week for six to eighteen months as an intensive treatment can improve this flexibility significantly. In severe cases a penile ring can be useful as well.
The vicious cycle can be broken once you are sure that you will perform: a positive reinforcement will occur and your level of confidence and self-esteem will improve, meaning a lesser chance that adrenaline will be released, reducing blood-flow to your penis.
The Men’s Clinic wishes you all the very best with your improved sex life. We will endeavour to keep our patients informed of any new treatments as they become available.
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Premature ejaculation (or PE) means that you ejaculate before you and/or your partner want. Over 30% of men suffer from premature ejaculation at some stage in their lives. On average, men ejaculate within 5-10 minutes after entering the vagina (“penetration”). Virtually all men will lose their erection after ejaculating and it can take between several minutes and several hours before the next erection.
Effectively the nerve supply in the penis is overly sensitive, i.e. the “thermostat” or “neurostat” for the penile nerves is set too high. The aim of treatment is to reduce this over-sensitivity immediately with medication, and in the long-term by exercises with you and your partner.
YOU ARE NOT ALONE! Almost all men will occasionally ejaculate very quickly, and if you don’t often have sex, the more likely you are to ejaculate quickly when you do. Sometimes a new partner can bring on PE after years of living without it, or it can be relationship difficulties or psychological problem that brings it back. If necessary, we can refer you on to a counsellor as well as using this treatment.
Is medication necessary?
Medication combined with exercises has success rates better than 95%. With the injectable medication you can carry on and have fun after ejaculation, doing whatever you and your partner desire as your erection is still maintained.