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Sex talk: Laugh not, sir; there is the manopause

Men and hormone replacement therapy (HRT) don’t usually sound right in the same sentence.

The therapy is most-associated with women above 35 years, who start on their peri-menopause journey, sometimes with debilitating effects. Their medicine cabinets usually have a concoction of food supplements, women wellness pills and other HRT remedies if they want to maintain a normal sex life and sanity at home.

Well, if a Daily Mail article backed by scientists from last week is to be believed, men’s so-called midlife crisis is more than just a phase; they too lose great levels of the all-important male hormone, testosterone, which affects their libido, weight and temperament, among others.

Doesn’t that sound like menopause, ladies? Well, that is because this andropause, as scientists call it, is the ‘man’opause. And Dr Cherry Armstrong, the physician quoted in the article, says if your not-so-young husband has a flagging libido, is tired all the time and his potbelly is getting out of control, “then yes, he has hit the manopause”.

Consider putting him on testosterone replacement therapy (TRT) to bring back his mane and roar, and put a stop to you having to beg and trick him into making love to you.

Some men notice the declining libido and difficulties in getting an erection before their wives do, and this can be hair-raising and scary.

The denial can push some into infidelity, thinking their wives are the problem – that she no longer knows how to flip his ignition on; so, he tries his keys in other ports first. After the initial, new-relationship ‘success’, he soon suffers a dip in libido again, and the cycle continues.

The quick fix has been Viagra, but for about 10 years now, men, where health systems actually work, are getting TRT for more sustainable solutions.

Daily Mail’s Nick Curtis writes: “Increasingly, health and diet-conscious men, particularly in recent years, are encroaching on what has been the largely female preserve of hormone replacement. It seems the andropause is the new menopause and TRT is the new HRT for men.”

The testosterone is administered through weekly injections, although there are also creams, “which are applied to the upper or inner arms, buttocks, upper or inner thigh.”

Like HRT can have adverse side-effects in some women, the testosterone replacement can pose the risk of growing breasts and infertility in men. However Dr Armstrong is quick to reassure that these side effects can be countered with inhibitors.

Now, just imagine the quagmire in the average Ugandan marriage where couples are the other side of 40 and none of them has heard about HRT or TRT.

There they sit, grumpily in their once-happy home, in a now sexless marriage that, however, has its share of mood swings, lethargic feelings and depression caused by declining levels of oestrogen and testosterone – unknown to the stakeholders.

While in the West the options are many and qualified doctors with help are a block away, here even the right diagnosis would be a miracle; that is if the ‘sufferers’ have the courage to seek help for a sex-related problem.

Sex in Africa still has many strange ribbons and chains attached to it; a man will not admit to sexual inadequacy and would sooner start a string of extra-marital affairs to convince himself and the community that his virility is very much intact – even as that machismo now has more to do with his money and power, and less to do with sexual prowess.

A wife in many African communities would rather fake it from here to eternity than speak up or find help and ‘make her husband feel sexually inadequate’.

But if you have shaken off some of those chains and can acknowledge there is a problem as you have grown older, talk to your doctor about it. If the doctor is competent, s/he should be able to point you in the right direction.

Manopause or menopause, the sex can still be regular and great once you pull your heads out of the sand.


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