The damage that low testosterone causes

Rachel came to the sexology clinic and declared that she was pregnant with her third child. I sat back and smiled. We had literally gone a full circle. Memories of a year ago when I first met her zoomed back to my mind as if it was just the other day.

Back then, Rachel had come to the clinic to find out if she could have a tubal ligation. I asked her to confirm if she already had her desired number of children. Instead, she broke down and cried uncontrollably.

“Sorry, I did not mean to offend you,” I apologised, unsure of why she was crying. She was a 34 years old then and working as a secretary in a government office. She had been married for seven years. Her husband Erick was 45 years old and also a civil servant. “I have to choose between having a husband and having children,” Rachel said, trying to control her emotions.

The couple had not been intimate for close to a year. Rachel believed that her husband was no longer interested in her. She had tried to excite him but he brushed her off. Her attempts to discuss her concerns with him were futile, as he would simply remain quiet. Rachel’s conclusion was that childbirth had deformed her body, causing Erick to keep off her. She made a decision to do tubal ligation since, in her analysis, child bearing had brought misery to her life.

“I would have wanted three children but see what these two have done,” she explained. “If I have the tubal ligation my body will shape up with time. But if I conceive again it will be the last straw on a camel’s back and divorce will be inevitable.”

I was convinced that Rachel’s analysis needed further investigation. I was sure Rachel was suffering from a defective body image. My immediate recommendation was that she needed therapy to appreciate her beauty but beyond that, I also needed to talk to her husband to establish if he also had a problem.

Rachel brought Erick to the clinic on her next appointment. I interviewed and examined him. I also ordered for some laboratory tests. Surprisingly, Erick appreciated Rachel’s beauty. He said that in spite of the two deliveries, his wife had taken good care of herself. He sometimes felt jealous when men repeatedly admired his wife. He was sorry that he never told Rachel about these feelings.

“But why then are you not having sex with your wife?” I asked.

“I have no interest doctor, nothing to do with Rachel,” he replied. He said that he had also noted that he never got morning erections, a sign of normal functioning in men.  “And the last time we had sex it was a mess, a weak erection which died off,” he said, staring into space.

The test results showed that Erick had low testosterone, a male hormone that is critical to the functioning of a man sexually. Erick was among many men who walk around with low testosterone. Such men have low libido, erection problems and sometimes delay in ejaculation during sex. They may also feel fatigued most of the time, may be depressed and if not treated for long, may develop weak bones and suffer fractures easily. It is estimated that up to 8 per cent of men have testosterone deficiency and are mostly unaware of it.

“So are you able to help my husband to be normal again?” Rachel asked, her voice shaky and her eyes welling with tears. I nodded.

I put Erick on testosterone hormone treatment. This treatment requires close monitoring to ensure that the hormone levels are raised to physiological levels and not beyond. Side effects are also monitored, especially to ensure that the prostate and the blood system remain healthy. The hormone can have adverse effects on these two systems.

Rachel also underwent therapy to appreciate her beauty and she regained her confidence and self-esteem.

“Thank you for helping me realise my dream of a third pregnancy, I am happy and my husband is too,” Rachel said, interrupting my thoughts of what we had gone through for a year and bringing me back to today. I nodded again and smiled. Yes, the circle was complete.