Dr James Le Fanu: 15 February
The notion of being able to capture the essence of masculinity in a pill has an obvious appeal – as the German chemist Adolf Butenandt, who first synthesised the male sex hormone testosterone, anticipated. When receiving the Nobel Prize in 1939 he reputedly remarked to the prize committee, ‘This is dynamite, gentlemen, pure dynamite.’
But more than 60 years on, its purported value in boosting the libido and general wellbeing of the ageing male remains as contentious as ever. There is no dispute that the amount of the hormone tends to fall with every passing decade, being for those aged 75 about half that when they were 20.
This decline is held to be responsible for a variety of symptoms, including reduced potency, loss of muscle bulk, fatigue and osteoporosis – warranting, it is claimed by some, testosterone replacement therapy. But others do not agree. This, at times, acrimonious debate has resurfaced recently, prompted by the escalating number of prescriptions issued for the popular testosterone gel – that has increased fivefold in a decade at an annual cost to the NHS of £11m. ‘We believe many men in the UK are receiving unnecessary treatment,’ observed Simon Pearce, professor of Endocrinology at Newcastle’s Royal Victoria Infirmary in the British Medical Journal.
Not so, responds cardiologist Graham Jackson of the British Society for Sexual Medicine. The rise in the number of prescriptions, he says, is due to previous underdiagnosis and undertreatment of this curable condition that does not (as previously claimed) increase the risk of prostate cancer. There is no reconciling these contrary views but it can be useful to know what is going on and simple enough for men whose libido may be a bit under par to have their testosterone levels checked out.
THIS WEEK’S MEDICAL QUERY comes courtesy of a lady from Sussex recently troubled by a frozen shoulder, now gratifyingly recovering. She does, however, also have a strong underarm odour confined to the affected side. Could, she wonders, the two symptoms be related?
The ‘whiffiness’ of the frozen shoulder is due to the excess sweat induced by its lack of mobility. It is possible the improvement may not be due to ‘unfreezing’ of the shoulder, but rather increased mobility of the scapula. This can be demonstrated by standing with the back against the wall, thus immobilising the scapula, and trying to lift both arms sideways like a bird. The still-limited range of the shoulder joint will then become apparent. Hence the persistence of the sweatiness (and smelliness) of the affected armpit.
drjames@lady.co.uk
Dr Jog speculated that chewing gum might improve this by stimulating the reflex, so although it would generate a greater amount of saliva, this would be more readily swallowed. And so it proved, as he reports in the journal Neurology, concluding that chewing gum is a ‘cost-effective, self-managed approach’ to reducing excess saliva.
But more than 60 years on, its purported value in boosting the libido and general wellbeing of the ageing male remains as contentious as ever. There is no dispute that the amount of the hormone tends to fall with every passing decade, being for those aged 75 about half that when they were 20.
This decline is held to be responsible for a variety of symptoms, including reduced potency, loss of muscle bulk, fatigue and osteoporosis – warranting, it is claimed by some, testosterone replacement therapy. But others do not agree. This, at times, acrimonious debate has resurfaced recently, prompted by the escalating number of prescriptions issued for the popular testosterone gel – that has increased fivefold in a decade at an annual cost to the NHS of £11m. ‘We believe many men in the UK are receiving unnecessary treatment,’ observed Simon Pearce, professor of Endocrinology at Newcastle’s Royal Victoria Infirmary in the British Medical Journal.
Not so, responds cardiologist Graham Jackson of the British Society for Sexual Medicine. The rise in the number of prescriptions, he says, is due to previous underdiagnosis and undertreatment of this curable condition that does not (as previously claimed) increase the risk of prostate cancer. There is no reconciling these contrary views but it can be useful to know what is going on and simple enough for men whose libido may be a bit under par to have their testosterone levels checked out.
THIS WEEK’S MEDICAL QUERY comes courtesy of a lady from Sussex recently troubled by a frozen shoulder, now gratifyingly recovering. She does, however, also have a strong underarm odour confined to the affected side. Could, she wonders, the two symptoms be related?
The ‘whiffiness’ of the frozen shoulder is due to the excess sweat induced by its lack of mobility. It is possible the improvement may not be due to ‘unfreezing’ of the shoulder, but rather increased mobility of the scapula. This can be demonstrated by standing with the back against the wall, thus immobilising the scapula, and trying to lift both arms sideways like a bird. The still-limited range of the shoulder joint will then become apparent. Hence the persistence of the sweatiness (and smelliness) of the affected armpit.
drjames@lady.co.uk
A STICKY SOLUTION
Chewing gum is useful for those troubled by a dry mouth as it stimulates the salivary glands. Recently, Canadian neurologist Dr Mandar Jog has shown it also has the reverse effect of reducing the excess saliva (that can result in drooling) associated with Parkinson’s disease. The functional disturbances of this condition include poor coordination of the swallowing reflex, so saliva ‘overflows’.Dr Jog speculated that chewing gum might improve this by stimulating the reflex, so although it would generate a greater amount of saliva, this would be more readily swallowed. And so it proved, as he reports in the journal Neurology, concluding that chewing gum is a ‘cost-effective, self-managed approach’ to reducing excess saliva.