It was January 1988 when my world changed. Both my testicles went missing as Cancer appeared simultaneously. To say it completely floored me is an understatement. Soon nothing mattered except the hitherto unknown feature of my body, my hormones.
---This is article #57 in our series of #100Voices4Men and boys
Little did I know hormones are as important to men as they are to women, but I soon found out when doctors left me without any replacement Testosterone, a loss that created a different Nick. Gone was energy, confidence, humour, swift and good decision making, but most importantly control of my mind. I didn’t know myself. I was scared, confused and angry and tried unsuccessfully to end my life that April.
Once recovered and on therapy, I became motivated to make a noise about my discovery. It seemed nobody else knew Testosterone was important either. Doctors appeared scared that it caused aggression and Prostate Cancer. A psychologist had even suggested men would live longer and happier without it!
I began in earnest during 1996 when I joined the Testicular Cancer Resource Center’s TCNET email group. I’d rant away about male hormones and their importance. My bleating fell on deaf ears in some quarters, but held ground in others. I had no training, had never been to university so failed to understand the need to back up my words with solid scientific evidence. Today, I have that education and a referenced website.
I witnessed the USA embracing the notion of Testosterone deficiency since proper guidelines appeared in 2002. I am not impressed. Neither am I impressed with the poor uptake of the UK guidelines published in 2011, though for a different reason.
The problem I see in the States is what I call the Formula 1 approach, where “optimisation” appears to be the word. Multiple drugs driving Testosterone levels towards the top of the range, with other drugs taken to moderate the side effects like Oestrogen production. A niggle inside tells me something unexpected is going to break. This in my opinion is a reasonable facsimile of steroid abuse.
'2 million men need help'
There has been poor uptake of UK guidelines despite it being accepted that low Testosterone is a real health problem for men, perhaps because of the hype. Many doctors are oblivious to them, ignorant of the sea change and how seriously the matter ought to be taken.
The Internet forums I maintain are revealing. Slowly but surely doctors are becoming acquainted with the new guidelines as patients present them. Some are hostile, others receptive, but in the main people who come to the forums get the help they need eventually. The numbers of patients finding those forums is small, whereas the UK men estimated to need help is in the order of 2 million, according to at least one expert and my own calculations.
The one question on my mind is, will this 62-year-old live to see this real health problem dealt with properly and therapeutically? I can’t say I am optimistic, but remain determined to right a wrong, where the answer is not always Testosterone therapy.
By Nick O'Hara Smith
-- Picture credit: Dr Farouk
You can find all of the #100Voices4Men articles that will be published in the run up to International Men's Day 2014 by clicking on this link---#100Voices4Men---and follow the discussion on twitter by searching for #100Voices4Men.
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