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London - A simple jab that restores a flabby and depressed middle-aged man into a virile Adonis with a washboard stomach may sound unlikely.
In fact, thanks to a new medical study, injections of the male hormone testosterone are seriously being touted as a magical cure for the dismal ailments of midlife malehood.
In a German study, 115 men with low testosterone were regularly given the injections over a five-year period. The volunteers lost an average of 2½ st, while their waists shrank from an average of 107cm to 98cm.
The researchers, who presented their findings to the European Congress on Obesity in Lyon, France, claim testosterone increases lean muscle. This burns more calories than other forms of tissue, and thus raised the volunteers’ metabolic rates and boosted the amount of energy their bodies burned.
There were other benefits, said the lead researcher, endocrinologist Dr Farid Saad, including reduced body mass index, as well as cholesterol and blood sugar levels. He added: “Increased testosterone levels improve energy and motivation to do physical exercise.”
It all sounds great, but does the treatment live up to the promise?
Drug companies and supporters of testosterone therapy have been pushing for its widespread adoption since the late 1980s. They claim it not only shrinks stomachs but boosts sex drive.
In the process, they’ve invented the idea of the “male menopause”, claiming men go through a physical transformation, just as women do during the change of life, and so need testosterone supplements as a form of male HRT.
Britain’s leading exponent of testosterone therapy, Dr Malcolm Carruthers, claims one in five UK men over 50 should be taking testosterone - even if their blood levels appear normal.
Dr Carruthers, who is medical director of the Centre for Men’s Health in Harley Street, is campaigning for medical recognition of Testosterone Deficiency Syndrome. He says the syndrome makes many older men’s bodies resistant to testosterone, so even normal levels in the blood are insufficient.
Other experts now think testosterone could even be a lifesaver. Hugh Jones, an endocrinologist and professor at the University of Sheffield, says his studies show that 40 percent of men with Type 2 diabetes have low levels of the hormone
What’s behind the link isn’t clear, but last year a study by Professor Jones showed men with Type 2 diabetes and low levels of testosterone had a 20 percent greater risk of dying prematurely. But in those given hormone patches to remedy the shortfall, the risk fell to 9 percent.
And yet question marks remain, not least when it comes to the new German research.
As he acknowledges, Dr Saad was employed by the pharmaceutical giant Bayer Schering Pharma, which manufactures testosterone injections. On the whole, scientists are sceptical about the independence of trials conducted by researchers employed by drug companies.
Also, the Bayer team had originally set out to see if the injections could alleviate men’s problems with erectile dysfunction.
Scientists are always suspicious of “accidental” results, because the study will not have introduced safeguards to ensure the findings weren’t down to other causes - for instance, men in trials often behave more healthily, so may have improved their diets.
And the results are hardly new. Nine years ago, Russian doctors announced they’d cut a group of men’s obesity by more than 15 percent in six months - by doubling the level of testosterone.
People have long known about its muscle-building potential, too. Only last month, US boxer Lamont Peterson sparked controversy after it emerged he had used a surgically implanted testosterone pellet - reportedly for his abnormally low testosterone.
Testosterone has, of course, a bad reputation for causing fights, reckless driving and other troubles. But supplements are also being linked to a wide range of dangers, such as cancers and life-threatening blood clots.
Earlier this year, Professor Mirjam Christ-Crain, a hormone expert at University Hospital Basel, warned testosterone treatment can accelerate the spread of prostate cancer and has been found to cause an excessive red blood-cell count. This can cause a condition known as polycythemia - which increases the risk of stroke, heart abnormalities and blood clots.
Professor Christ-Crain’s analysis of 19 previous trials reveals that men given testosterone supplements are nearly four times as likely to suffer this problem.
Similar concerns have been raised in new British guidelines for testosterone therapy, published under the lead authorship of Professor Kevan Wylie, a consultant in Sexual Medicine at the University of Sheffield.
The guidelines stress that: “Men over 40 receiving testosterone replacement require regular medical review, including for prostate disease and polycythemia.”
There is also evidence of other side-effects, including male baldness, moobs (man boobs) and snoring - none of which is likely to boost their sex lives.
Proponents of testosterone-replacement dismiss such fears. Dr Carruthers says a study he conducted with Mark Feneley, a urological surgeon at University College London, of more than 1,500 men who’d received the treatment for up to 15 years found they were at no more risk of cancer than those not given it.
Yet there also remains the question of whether there is a male menopause, or Testosterone Deficiency Syndrome. Many experts are not convinced.
For example, a study of 3,000 European men, led by Manchester University researchers (and published in the New England Journal of Medicine) found only three percent of men ever experience physical symptoms as a direct result of having low testosterone.
And new research has revealed that smoking, obesity and depression can cause men’s testosterone levels to fall.
Professor Gary Wittert at the University of Adelaide - lead author of the study of 1,500 men aged 35 to 80 - said testosterone does not naturally plummet as men age, only in those who have unhealthy lifestyles. Just giving men testosterone supplements may not address these underlying problems.
As Fred Wu, a professor of medicine and endocrinology at the University of Manchester, explains: “The prevalent view is that low testosterone in older and middle-aged men is a reflection of their general health and is related to obesity and associated physical problems.
“It is a symptom, rather than a cause, of ill health - so rather than giving testosterone supplements, it looks more important to find out what the problems are behind the low testosterone.”
He added lifestyle changes such as losing weight and doing more exercise to improve health could reverse low testosterone levels. “There is no evidence that testosterone supplements alone will improve someone’s overall health status,” he added.
Raising morale can also do wonders. In a study published in the journal Psychological Science, 30 male students were asked to play the board game Mousetrap, or play with a replica gun. The Mousetrap men had normal levels of the hormone but it spiked in the gun players.
Ironically, it’s those things we associate with a “mid-life crisis” that may prove most helpful.
Canadian research shows driving a fast car boosts middle-aged men’s testosterone. A group of 39 men were given a Porsche for one hour, followed by an hour in a battered Toyota saloon. Their saliva samples showed a significant increase in testosterone after the Porsche drive, but a decline at the wheel of the old banger, reports the journal Organisational Behaviour and Human Decision Processes.
The same effect can be achieved by anything that boosts mid-life men’s pride - even showing off skills such as dancing the tango increased sex hormones.
A study in the journal Music and Medicine found participants felt calmer, sexier and more closely bonded. What’s more, there are no detrimental side-effects... bar the occasional squashed toe. - Daily Mail