Male Testosterone Therapy?
Testosterone therapy may be given to treat medical conditions, including female (but not male) breast cancer hypogonadism (low gonadal function) in the male, cryptorchism (nondescent of the testis into the scrotum), and menorrhagia (irregular periods).

Testosterone is the primary androgenic hormone and is responsible for normal growth and development of male sex organs and maintenance of secondary sex characteristics. Pre-pubertal hypogonadism is generally characterized by infantile genitalia and lack of virilization, while the development of hypogonadism after puberty frequently results in complaints such as diminished libido, erectile dysfunction, infertility, gynecomastia, impaired masculinization, changes in body composition, reductions in body and facial hair, and osteoporosis. Hypogonadal men also report levels of anger, confusion, depression, and fatigue that are significantly higher than those reported in eugonadal men.

Evaluation of potential candidates for testosterone replacement therapy should include a complete medical history and hormonal screening. Total serum testosterone should be measured in the morning. When the serum testosterone level is low and LH is elevated, testosterone replacement therapy is warranted. Patients with low serum LH and testosterone levels need an imaging study of their pituitary and may need endocrinologic consultation.

Is all this because of the maturation (maturity) process? Is it because by middle age man has had enough sex so as not to be unnaturally preoccupied with it any longer? Is this because his wife has aged a bit and is no longer as attractive/interested as before? Or is it because of the pressures at the work-place, the demands of parenthood, or pre-occupation with the lives of grown-up children and aging parents?

Is there really something called a middle-age crisis?
If so, how is it different from male menopause?

Yes, there is something known as a mid-life crisis. This is often a time in life when stability has been achieved and the struggles that were once a large part of life are now at an end. This new awareness that a life change has taken place can sometimes trigger a crisis. For some men, new-found stability may signify an end to vitality or youth. Many men find that after spending a lifetime working towards the goals of family and peers, the end result is unfulfilling. This is also often a time of change. Major shifts in career, marriage and parenting often occur during this time period. And, along with the physical signs of aging comes a realization of impending old age, retirement and eventually death. This time of life will only become a crisis if the changes become too difficult to cope with.

Mid-life crisis, thus, is essentially a problem of psycho-social adjustment. It need not necessarily have a bearing on a man's sex life. It is thus not synonymous with the male menopause although there is frequently a superimposition of male menopausal factors in middle-aged men going through crises and this makes the picture hazy.

Male menopause, on the other hand, is a distinct physiological phenomenon that is in many ways akin to, yet in some ways quite different from the female menopause.

Menopause is a condition most often associated with women. It occurs in a woman when she ceases to menstruate and can no longer become pregnant (usually). Men experience a different type of `menopause' or life change. It usually occurs between the ages of 45 and 60 - but sometimes as early as age 30. Unlike women, men can continue to father children, but the production of the male sex hormone (testosterone) diminishes gradually after age 40.

Testosterone is the hormone that stimulates sexual development in the male infant, bone and muscle growth in adult males, and is responsible for sexual drive. It has been found that even in healthy men, by the age of 55, the amount of testosterone secreted into the bloodstream is significantly lower than it is just ten years earlier. In fact, by age 80, most male hormone levels decrease to pre-puberty levels.

One hundred and fifty years ago, a German Professor called Berthold showed that transplant of a cock's testis prevented atrophy of the comb after castration. In 1944, what we now describe as the male menopause was reported in a key article by two American doctors, Carl Heller and Gordon Myers. They compared the symptoms with those of the female menopause, and did a blind controlled trial showing the effectiveness of testosterone treatment. Unfortunately, like many pioneering efforts, these went unnoticed. Men were unwilling to accept that they could attain `menopause' and such research was often hurriedly brushed under the carpet. Men with genuine symptoms were told that `this is just a mid-life crisis' - just like men with erectile dysfunction were told that `it's all in the mind'. Besides, testosterone therapy had come into disrepute because of its abuse by athletes and the concept of testosterone replacement therapy for male menopausal symptoms was not received very well. Further, there was much hype about the side effects of testosterone, especially prostate cancer.

It was only after HRT (Hormone Replacement Therapy) with estrogens produced tangible symptomatic improvement and `aging reversal' in post-menopausal women that men sat up and, not wanting to get left behind their women folk, began to take notice.