What About My Libido, Doc?
Bill, 53 years old, salesman
Bill is sitting opposite me. He looks very tired and unhappy. He seems apathetic, as if it"s an effort to get his words out.
"Bill", I ask. "I see from your notes that you are 53 years old, you"ve been married for 27 years and you have three grown-up kids. Is your problem more getting and sustaining an erection or premature ejaculation?"
"Doc", he says, 1 have a problem getting it up when I want it, but that"s not the problem. The problem is that I don"t want it. I haven"t had the urge for it now for four years."
Is there a relationship problem at home?"
"Absolutely not I love my wife and she loves me. And that"s it I feel like I owe her more. I"m always tired. I"ve lost my drive in life and in the bedroom. She"s a wonderful woman. I don"t know how she puts up with me."
"And this problem, how long has it been coming on?"
It"s been there for about five years. Come to think of it, it"s been longer than that I reckon I started this downturn when I was in my mid-40s. I"m just not motivated. I wake up in the morning with aches and pains, my energy level is down, I"m a grump at home, always flying off the handle. Sex doesn"t interest me/
"Have you been to see your general practitioner about it?"
"Well there haven"t been any specific symptoms. He"s checked me out once or twice, did a few blood tests, but found nothing abnormal. He told me that I was going through a midlife crisis and it will pass."
Greg, 48 years old, electrician
Greg had responded to the following advertisement in a newspaper:
Do you suffer with any of the following:
• Low energy levels • A low sex drive
* Erectile difficulties
• Short temper, poor memory
• and poor sleeping patterns AND ARE YOU OVER THE AGE OF 40?
If you do, you could be suffering from a condition called Male Menopause.
Greg"s first statement after I asked what seems to be his problem was. That"s me in a nutshell. All those symptoms are me and my family will vouch for that"
Greg is 48 years old and married with two teenage kids. He describes how, over the last two years, these symptoms and others have been creeping into his life.
1 go off the handle for nothing and I just don"t have any energy or desire to do anything."
I then went through a checklist of questions:
• Are you experiencing fatigue, tiredness or loss of energy? "Yes."
• Would you describe yourself as irritable and bad tempered? "Yes"
• How is your concentration and memory? "Poor."
• How is your sex drive? Very low"
• Are you experiencing erection problems? "Yes, they"re getting worse"
• Are you experiencing anxiety and nervousness? Yes, more than I used to be."
• How is your mood? 7 generally feel depressed and low"
• Do you have any aches and pains? Yes, especially in the morning"
• Loss of fitness? Yes"
• Stress level? "Feeling over stressed"
• Do you sweat? Yes, uncomfortably much."
• What about your skin? "Constantly feels dry." "Greg"I asked, "You"re 48 years old. How old do you really feel?"
"l definitely feel older than that"
Why does a man"s vitality and virility deteriorate in middle age? Why does the typical man in middle age gradually lose his drive, strength, energy and enthusiasm for life and love? He often changes from being the positive, bullish, outgoing person who is good to be around, to a negative, pessimistic bunch of sour grapes who is increasingly difficult to be around.
Apart from the above symptoms, it has been postulated that there is an association of this symptomatic deterioration with testicular or prostate damage. It has been shown that a number of patients with these symptoms have, in the past, undergone a vasectomy operation as a sterilisation procedure. Other operations or conditions that are thought to interfere with testosterone production and possibly contribute to these symptoms include prostate operations, a history of adult mumps with testicular inflammation (a side effect of adult mumps), or a urinary tract infection. These hypotheses, however, are not conclusive.
*50\4*
