Dear Dr Ren:
I’m a gentleman of a certain age who has been diligent about keeping fit financially, socially and physically. My boyfriend and I have been together since forever. He’s a dozen years younger and recently I’m finding myself struggling to keep up with him in the bedroom. Sometimes I’d really rather watch Oprah than romp with him.
The truth is, I’m faking it more and more. We used to wake in the middle of the night to make love; now the only reason I’m up before sunrise is to pee. Though nothing has been said aloud, I expect to see a little eye-rolling any day now.
I’ve heard taking testosterone might turn all this around. True?
Dear Silver Daddy:
Starting at about age 40, men’s bodies produce about one percent less testosterone (T) each year. You are correct that this powerful hormone boosts libido. It has some other benefits, too. T is responsible for maintaining muscle and bone mass and strength, regulating fat distribution and sperm production, and sustaining the ability to attain and maintain erections.
The slow and gradual decrease in T levels does not bother most men — many people claim that a little less T makes older men far sweeter — but about 20 percent suffer from deficiencies below normal range. Especially for this population, adding extra T to your system can seem to have the effect of reclaiming lost youth.
Boosting your T levels can also improve your energy levels, your cognitive performance and the appearance of your hair and skin. Many men also report a decrease in irritability and depression while taking T.
Why would anyone refuse such an attractive cocktail? It’s a good question and there are some good answers.
The risks associated with T therapy include: sleep problems (T can cause or aggravate sleep apnea), increased blood production or polycythemia (The extra blood doesn’t make better erections boys; it increases your risk of stroke), gynecomastia (growing breast tissue), decreased sperm production, acne, and prostate problems.
T stimulates growth of the prostate. An enlarged prostate may account for the frequent nighttime urination you mentioned. T is a bad idea if cancer is present because it may fuel the growth of the cancer cells.
These are all serious health considerations and must be evaluated by your doctor before taking T.
Still, let’s assume that your healthcare provider gives you a green light for T therapy. You will have to choose the delivery system that is right for you. You can swallow or inject T. You can rub it into your skin as a cream or gel, apply it as a patch, pop it between your lips and gums, or have it inserted in rod form under your skin.
T that is swallowed or injected, for example, is metabolized by the liver readily available and very economical, but it tends to be less consistent in dose delivery than some other methods.
If you opt for either oral or injectable T, insist on regular testing. Consult your healthcare provider for specific suggestions, but you’ll probably need to be tested for haemoglobin and hematocrit levels (to detect polycythemia), liver function, and total T levels.
I realize you are also concerned about coping with transitions in your age-disparate relationship.
Your boyfriend has always been younger than you are. You knew that the age difference would eventually affect your pace. Watching the bloom fade from our own rose is never pleasant and few of us accept it gracefully.
What you may be discounting, though, is that your lover expects you to age. He may be more tolerant of it than you are. This is a good time for some honest communication about your mutual fears, disappointments and expectations.
Give him a chance to reassure you of his commitment to your bond. Negotiate how your relationship will change as your energy levels become less aligned personally, socially and sexually.
This may be an appropriate time to seek professional counselling to help you create a safe environment in which to discuss these sensitive issues. This is a transition. You’ve been through them before and you have others yet to face. Keep some perspective on this. Chances are your boyfriend will hear your news graciously, and that he loves you enough to accommodate whatever changes need to be made, just as you would if he needed your understanding.
There are no guarantees that because he is younger, your boyfriend will never get sick or injured and need your compassion and understanding. Why are you holding yourself to such a rigid standard? Relax! Growing old can be scary, but you are doing it with a loving partner by your side. Assume success, and reward him richly when he responds to you as you would to him, with love, understanding and compassion.