8/18/15

Adding Fuel To The Furnace



I am a huge Al Pacino fan and could probably recite almost all of his movie monologues by heart, especially those that came out during my college years. Out of all of his dramatic expositions, there is a line from Devil’s Advocate that just stayed with me for years.

Love? Overrated. Biochemically no different than eating large quantities of chocolate.
John Milton (Al Pacino)
This simple quote made me realize how our emotions and mental state isn’t just based on how we feel, but can actually be a result of our body’s chemistry, lesson I never quite seemed to pick up from any Bio or Chem class. In the usual philosophical debates that followed any cool movie, my friends and I began to discuss how our body’s biochemical balance can directly affect our moods, thoughts, and emotions just as much as our moods, thoughts, and emotions affect our biochemical balance. You see, chocolate’s phenethylamine causes the same endorphin based euphoria that falling in love does, proving that our emotional state isn’t as subjective as we would like to believe. After an extensive amount of nonsensical philosophizing to the extent of this realization, we proceeded to unbalance our bio-chemistry with cheap beer. These where my college years, what did you expect?

That was close to 20 years ago; a time when hormonal imbalance was something women had during PMS and clinical depression was still extremely stigmatized with countless damaging stereotypes. Back then, men apparently didn’t have any hormones regulating their body and the only chemical imbalances you had to deal with was alcohol, motor oil, and some kind of unending supply of methane gas.

As hard to believe as it might be, today we live in a more scientifically literate world. We now understand how depression isn’t someone who’s simply “sad” or “has an off day,” and recent tragedies serve as a reminder of how dangerous it can be when left untreated. We now accept how a simple chemical imbalance within our body can lead to catastrophic results. Unfortunately, even with all of this is knowledge, men still refuse to go to a doctor unless they can no longer avoid it. The funny thing is that if their car has even the most minor change or unusual noise in its engine, they’ll spend endless hours trying to figure out what’s wrong. That’s a bigger problem than what most men realize or want to openly admit, as we will work to maintain anything other than ourselves. Before you criticize this mentality, consider how we constantly tell men not to show signs of weakness or how we make fun of men when they are sick. This has turned going to a doctor into an open admission of weakness and unmanliness.

As we get older, the fire that would burn within our soul’s furnace starts to dwindle. We will resign ourselves to accept that we are now a pale comparison to the warrior we were in our youth or refuse to acknowledge just how much our bodies change with the years as we desperately fear growing old, of losing the man we were in our twenties.  We start blaming “life” as we become “too old for this shit” as we wonder what happened to us as we reach middle age. To mediate this feeling, men will usually take the “never read the instructions” route, as we bottle up our issues and ignore the problem and expect it to magically go away, only to have those problems grow unchecked within ourselves. With that mentality, no wonder why out of the top 10 leading causes of death in the US, men outnumber women in 6 of them, with one being equal between the genders, and women outnumbering men in only 3.

We tend to think that most of these problems are a result of inevitably getting old, yet in many cases they start to show themselves long before we can technically call ourselves old. With the average life expectancy for men being 79 years, why would we consider our late 30’s and early 40’s as growing old? Middle age is just when you finished the break-in period of your body, yet this is precisely when we start seeing most men’s health issues. What if it isn’t that we are growing old that’s causing our health problems? When you take into account the fact that the group with the highest suicide risk is men between 45 and 65 years old, you have to start considering that the answer might lay elsewhere. What if the problem isn’t we’ve grown old, but rather the fact that we often ignore what happens to our body as we grow older?

As women hit middle age, they understand the need to go to the doctor for a full checkup. They are fully aware that their bodies’ chemistry will drastically change due to menopause and, as these changes happen, there are plenty of other health complications that happen due to the domino effect brought about by these changes. Women understand there is no shame in taking care of themselves as it’s the smart thing to do. But men don’t really have to worry about things like menopause and body chemistry changes, right?

Not really. A large number of men start suffering from “male menopause” as soon as they get past their twenties. Before you shut down mentally or close the tab thinking I’m going to turn this into some preachy monologue defending wimpy guys who excuse themselves with words like “hormonal,” understand that male menopause, or Andropause as its clinically known, is a real thing. It just isn’t the kind of “menopause” women deal with.

Menopause, in simplified terms for those who didn’t pay attention during Sex Ed or Biology, is when the woman’s reproductive system quits and she no longer menstruates as she reaches her midlife. As a result, the body shuts down the production of certain hormones (estrogen and progesterone) it did back in its youth. Although the effects between women dealing with menopause vary, hot flashes, mood swings, trouble sleeping, and weight gain are typical during this time. They also have to deal with the social expectations to keep up with society’s beauty standards of women half their age, leading to self-consciousness about their body’s changes. To compensate for the resulting changes in their body, some women undergo medical and hormone treatment.

So, if men don’t have a menstrual cycle to shut down, how the hell can they have menopause? The reality is we don’t. Andropause is something else. What happens to many men is their hormone (testosterone) production gradually drops as they go past their twenties, sometimes even earlier. If this drop becomes below acceptable levels, or if you didn’t produce enough testosterone to begin with, you end up with what is called Testosterone Deficiency Syndrome. Since this isn’t as drastic a change as in women’s menopause or because of the social stigma of not being “man enough,” men tend to ignore or dismiss the results of having Low Testosterone (Low T) levels. Only when they become a major problem do some men start taking action, but by then the damage is already done.

At this time, they will try to Band-Aid every single individual symptom by popping pills as if they were breath mints; one to be able to deal with anxiety, another to deal with depression, another for stress, another for sleep disorders, another for high blood pressure, yet another to get it up, etc. Sound familiar?

Remember the fuel that kept your soul’s furnace burning during your youth that I mentioned earlier? What do you think was that fuel? Gasoline? It’s Testosterone and, without your consent or prior knowledge, your body just decided to offer as tribute the one hormone that gave you a warrior’s edge to deal with life’s challenges. Suddenly, the all too common defeatist attitude men in their 40’s start having starts to make sense.

The biggest challenge we face when talking about these topics is the social stigma and stereotypes used to dismiss some very real issues about men’s health. Whenever there is  mention of Testosterone, Low T levels, or Testosterone Treatments, most people react with visions of insecure men being self-conscious about their penis, douchebags wanting to ramp up their game in the sack, or muscle-head jocks wanting to find alternative option to juicing with steroids. The fact that most online  information about Testosterone Treatment start off by focusing on an improved sex drive or muscle development doesn’t help much either.

The reality of Low T, or any hormonal or chemical imbalance within the body for that matter, can be pretty serious when left untreated. Remember how men already top 6 out of the top 10 causes of death? Men with Low T have an even higher mortality rate than men with regular testosterone levels already have. There is already enough clinical evidence correlating testosterone levels in men with severity of depression. This has promoted companies like BioTe Medical to treat Post-Traumatic Stress Disorder (PSTD) with hormone balancing strategies.

Not to sound like Mr. Miyagi, but the secret to your health and well-being IS balancing your body, mind, and spirit. So when your body’s hormones get off balance, the effects might cause multiple chain reactions that when looked individually might seem unrelated. Do you feel like you’re old before your time and don’t really ‘feel’ like dealing with it? It’s hard to take action when your fuel for the furnace is running low. If you catch yourself dozing off right after a meal or too stressed to get a good night sleep, have you considered that it might not be the meal or work pressures that is causing this? That comfort zone you have chosen to make camp in or lack of interest in keeping up the good fight might just be your body trying to tell you something. Listen to it. More importantly though, act on it.

I’m not saying that whatever emotional or physical problem you have is testosterone related. What I am saying is that you should go to your doctor regularly, sit down with them and actually talk to them. Stop assuming that you know what’s important or relevant to your visit. That’s what they trained for. You’re already paying them, so it might be a good idea to let them do their job. Let them make the call on what’s important or not. We need to understand that most medical conditions can be handled before they become critical when dealt within a timely manner. Just because you’ve avoided a doctor’s diagnosis doesn’t mean you don’t have something that needs diagnosing.

As men, we need to stop viewing self-care as narcissism, vanity, an admission of weakness, or even as something that makes us “less of a man.” As a society we need to stop shaming and making fun of men taking care of their health. Being supportive might actually mean that men don’t have to risk their well-being just to prove themselves as men. Gentlemen, just remember how you won’t be there for others if you’re not there for yourself first.

(I want to thank the team behind Advanced Institute for Woman’s Health, BioTe Medical and a couple friends and acquaintances for providing me with a better understanding of this issue.)