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October 5, 2020 by BHP Leave a Comment

What is Andropause and what happens to men when their testosterone levels decline?

Schools will soon have menopause on the curriculum. Largely due to the efforts of psychotherapist Diane Danzebrink and her #MakeMenopauseMatter campaign. In 2019 Education Secretary Damian Hinds confirmed menopause will
become part of the Sex and Relationships curriculum for teenagers in the UK in Autumn 2020 alongside periods and pregnancy.

With the recognition that menopause needs to be better understood in the broader context of sex and relationships perhaps now we can begin to talk about men’s experience of changes in their hormones. Testosterone is the main sex
hormone (androgen) in men and the symptoms that men can experience as a result of reduced testosterone are called andropause. The hormone testosterone plays a role in the production of sperm, in the drive to have sex, in building muscle and bone mass, in the way fat is deposited around the body, in the facial and body hair patterns found in males and their deeper voices.

Men will experience hormonal changes as they age, levels of testosterone will start to decline from around 30 at approximately 10% every decade. It is important to note that testosterone reduction can also be affected by other
factors such as injury, cancer treatments, medication and chronic conditions including diabetes, obesity, kidney and liver disease. Symptoms include a lower sex drive, loss of body muscle and an increase in body fat, decrease in bone
density, fatigue, insomnia and difficulty attaining and maintaining erections*.

From research by the Centre for Men’s Health Clinic in Manchester, looking at men over 50 in the UK, Dr Malcolm Carruthers says: “Of the ten thousand men surveyed actually 80 per cent had moderate or high levels of symptoms suggesting they had testosterone deficiency. This shows that its not the rare condition that some doctors claim but actually its very common and almost totally untreated.”

Symptoms described by two patients attending the clinic and suffering from low testosterone, defined as Testosterone Deficiency Syndrome, share features with women’s accounts of menopause.

“Well I was 55 or there abouts and I was getting perspiration in my shirt and was getting really wet, I’m talking serious perspiration, tiredness and I had a lot of muscle aches particularly in my legs”.

“I was a fishing skipper for 23 years and was the type of person that woke up in the morning and rolled out of bed and was on the job, something to do” …  Then when I reached the age of 55 I began to feel that I was flagging and I got all sorts of strange to me symptoms, aches, pains, horrendous sweats and uncontrollable temper.”

What about the mental and emotional aspects of andropause? We need to acknowledge and better understand andropause and the impact on men and their lives and relationships. Symptoms of andropause include mood swings,
irritability, low-self esteem, memory and concentration problems and depression. These are familiar menopausal symptoms for women, however it may be harder for men to acknowledge these symptoms and to ask for help
because they are associated with female menopause.

 

Angela Rogers is an Integrative Psychotherapeutic counsellor working with individuals and couples in Hove.

 

Further reading by Angela Rogers –

Viagra for women? Medical treatment for women’s sexual problems focuses on the brain rather than the genitals

New Year’s Resolutions – Why change might be so difficult?

Viagra: Some ups and downs of the little blue pill

The Menopause – Women of a Certain Age

 

References –
Diane Danzebrink
https://twitter.com/hashtag/makemenopause

Centre for Men’s Health Clinic
Associated Press Television 11.3.2011
https://youtu.be/33aCzR4U9l4

*See an earlier blog about men’s use of Viagra here.

Face to Face and Online Therapy Help Available Now

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Filed Under: Ageing, Angela Rogers, Relationships, Sexuality Tagged With: men's issues, Menopause, sexuality

September 14, 2020 by BHP Leave a Comment

Am I cracking up or is it my hormones? Pre-menstrual Dysphoric Disorder and the importance of tracking symptoms

It is not comfortable being told that you are feeling the way you do because of your hormones. This kind of biological reductionism is not helpful to any gender but the extremely severe symptoms of Pre-menstrual Dysphoric Disorder are completely aligned to the menstrual cycle. They manifest during the week before menstruation and end when or shortly after the start of menstruation. Like a switch going on and off.

There are a wide range of physical symptoms some not usually recognised as linked to pre-menstruation – changes in vision, heart palpitations, numbness and easy bruising – along with those that are familiar. In this post, I am concerned with the psychological symptoms.

The ones we might expect like irritability, confusion and weeping to excessive anxiety, deep depression and suicidal thoughts and feelings. It is the severity of these psychological symptoms, far more severe than normal pre-menstrual symptoms that make PMDD so disturbing and destructive.

Women suffering with PMDD can find themselves unable to cope with everyday life in the week or so leading up to their period. Ordinary tasks at home or at work can be insurmountable. Getting out of bed to dress and wash is impossible. The ‘personality changes’ put relationships under enormous duress. The sudden change in symptoms at the onset of a period is a relief but much of the next three weeks will be spent in repairing and picking up the pieces. It is not surprising that women can feel they are cracking up.

Unfortunately, many women are undiagnosed, incorrectly diagnosed and they can feel as if they are regularly in torment for a long time until their PMDD is recognised and treated. An example of misdiagnosis is a diagnosis of bipolar disorder. This is because the cyclical nature of mood swings is a feature of both conditions but it fails to recognise the correlation between emotional lability and the menstrual cycle. The predictability of the changes in thoughts and feelings is a key feature of PMDD and this raises the importance of tracking symptoms. Tracking symptoms provide information over time that may reveal a pattern, in this case, the menstrual cycle. Informed diagnosis leads to appropriate treatment, this means a woman will be treated for a severe problem with her endocrine system rather than a psychiatric illness. Sometimes it is your hormones.

 

Angela Rogers is an Integrative Psychotherapeutic counsellor working with individuals and couples in Hove.

 

Further reading by Angela Rogers –

Viagra for women? Medical treatment for women’s sexual problems focuses on the brain rather than the genitals

New Year’s Resolutions – Why change might be so difficult?

Viagra: Some ups and downs of the little blue pill

The Menopause – Women of a Certain Age

Face to Face and Online Therapy Help Available Now

Click Here to Enquire

Filed Under: Ageing, Angela Rogers, Gender Tagged With: hormones, menstrual, Relationships

April 27, 2020 by Brighton and Hove Psychotherapy Leave a Comment

Coronavirus Lock-Down – Physical Health vs Mental Health

As I write this blog, we are entering into the fourth week of so-called ‘lock-down’ across the UK. Despite daily speculation, nobody has any idea how long the restrictions on life will last for. 

Everything has changed and this has been hard to cope with in a society where stability and the ordinary continuity of life has been severely disrupted and curtailed; the UK population is currently in limbo, isolated from the wider community and possibly in closer physical contact with family than ever before. 

We know why we are doing this – we are reminded multiple times per day – to ‘save lives’ and ‘protect the NHS’. 

There has been much talk of the compelling priorities of the health of the nation vs the health of the economy. Arguably initially it was the later that took precedent in this country meaning we are now facing large numbers of fatalities. However, beyond the obvious economic costs of ‘lock-down’ and social distancing, the mental health impact seems to have been largely overlooked. 

Why start now? 

Despite a strong history and legacy of psychoanalysis and psychotherapy in the UK, mental health provision has long-since slipped from the forefront of policy-makers minds. Gone is the aptitude to be curious and instead a culture of symptoms has emerged increasingly oblivious to the fact that symptoms are communicating emotional and psychic distress. Depression has ceased to be seen as an inability to mourn and is instead an illness to be medicalised – as if it can be caught from the air like Coronavirus. 

So, in the midst of the pandemic, it is not surprising that any meaningful discussion on the impacts of quarantine, lock-down and social distancing will have on mental health, not to mention the ongoing rhetoric of how the socially interactive parts of our lives will be ‘changed forever’; today the WHO suggested that wearing a face-mask in public must become the long-term norm without the being any consideration to what the psychological impacts on self and others would be from such a policy. For example, where healthy development of an infant is contingent on them constantly scanning their care-givers face for reassurance and validation, what will the effect be of masking these quite literally behind a surgical mask? 

Compelling needs 

Whilst some of us may remain in denial, there is no question that social distancing is the only real means available at present to combat this pandemic. It is the oldest method in the book for dealing with epidemics and remains all we have (at present). 

However, for relational beings (which is what humans are) the strategy is psychologically and emotionally challenging (and for many catastrophic). 

Humans understand themselves and gain a sense of meaning through relationships with others. This is not a luxury – it is essential both as we develop and throughout our lives. Not only do humans needs to be able to communicate verbally, but we also require contact that is ‘non-verbal’. 

The mortality of isolation 

Isolation may keep us safe from the Coronavirus, however isolation is linked is not the cause of many mental health problems such as depression and anxiety and is fatal, particularly for the elderly (who, it would seem, are also being most impacted by Covid-19). Indeed, some studies have shown that loneliness is, indirectly, the biggest killer of the elderly. 

Virtual connections 

We live in an age where we can make use of virtual connections and video conference software to stay in touch with each other – my profession – psychotherapy – has overnight shifted to online working to ensure the continuity of therapy sessions. This is a positive, however, it will not migrate the tsunami of mental health and relationship problems that will arrive in the wake of the health crisis. 

Meaning making propositions 

For many, our daily lives, often revolving around work, provide us with a profound and anchoring sense of meaning and purpose. Not only has the ‘treadmill’ stopped, but with it much of the sense of purpose and meaning that many of us have. These two combined can be difficult to manage contributing to anxiety and depression – a literal crisis of meaning. 

Anxiety 

In the absence of meaning and purpose, and with the distractions of ‘ordinary’ life removed, anxiety can bubble up. It can leave us with a profound sense of unease and discomfort in our own skin and the wider world. And at present, it is hard to escape from. Of course, in reality anxiety can never be escaped from – it is part of us. It can, however, be faced and used to ask difficult questions about how we live our lives. 

Depression 

We are faced with a narrative from the media and politicians that ‘things will never be the same again’. I am unsure really what this means other than that it sounds like a warning or premonition of some kind. Being alive means accepting that things cannot remain the same and that we adapt. Change is hard and it forces us to be confronted with difficult emotions that many of us would rather run from. In the current climate of Covid, running from emotions has simply become harder. 

Whilst there simply cannot be a national or state managed balance between physical and mental health needs at present, this does not mean that as individuals we cannot be staying with our discomfort and asking ourselves what we ultimately want from this precarious life. 

 

Mark Vahrmeyer, UKCP Registered, BHP Co-founder is an integrative psychotherapist with a wide range of clinical experience from both the public and private sectors. He currently sees both individuals and couples, primarily for ongoing psychotherapy.  Mark is available at the Lewes and Brighton & Hove Practices.

 

Further reading by Mark Vahrmeyer –

Why psychotherapy sessions should end on time

Coronavirus Induced Mental Health Issues

Coronavirus (Covid-19) Counselling

How being ordinary is increasingly extraordinary – On the role of narcissistic defences

Face to Face and Online Therapy Help Available Now

Click Here to Enquire

Filed Under: Ageing, Mark Vahrmeyer, Sleep, Society, Work Tagged With: anxiety, Covid-19, Relationships

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COVID-19 (CORONAVIRUS) Important Notice

We would like to reassure all our clients that Brighton and Hove Psychotherapy is operating as normal despite the current situation.

Our working practices have fully incorporated online therapy in addition to a re-opening of our Hove and Lewes practices for face-to-face psychotherapy in accordance with Government guidelines and advice on safe practice and social distancing.