“My mood is low, I feel anxious, I have unexplained fatigue, I lack drive & determination, I have ‘brain fog’, I don’t enjoy anything anymore, something isn’t right.”
“I think you are depressed and/or anxious. Take these antidepressants”
“I don’t feel any better”
“Let’s increase your dose.”
“Still no better, I’m having some side effects”
“Let’s try a different antidepressant”
“I’m still no better.”
“Let’s increase your dose.”
“I still feel the same.”
“I’ll refer you to a Psychiatrist.”
This is an all too common scenario in the UK at present. Often the potential cure – Testosterone Replacement Therapy – is never even considered, despite there being a clear link between low testosterone and depression. Medical research backs this up.
Testosterone Deficiency Syndrome is a medical condition. There are British Society for Sexual Medicine Guidelines for its treatment which doctors in the UK are simply not adhering to. Whilst guidelines exist, it is up to the doctor to implement them. However due to a lack of education and understanding of the impact of low testosterone on men’s physical and psychological health, it is not high priority.
Statistics already show that men are at particular risk of mental health issues. Low testosterone is a risk factor for mental illness. Most men who end up on Testosterone Replacement Therapy have already been to their GP or an Endocrinologist and have either been denied treatment or offered ineffective treatments. This has led to many men self-administering testosterone from underground steroid labs because they already know that their levels are low and know that testosterone improves their mental well-being, but they can’t get the help they need from the NHS.
How many men have committed suicide with a confirmed diagnosis of low testosterone but had not been offered the treatment that they need? How many more high-profile male suicides need to happen before affirmative action is taken? How many of these suicides were preventable?
Patients with a confirmed diagnosis of Testosterone Deficiency Syndrome, who were previously on anti-depressants, often no longer need them once on TRT. Antidepressants will not cure symptoms caused by a testosterone deficiency, only dampen them, often making them worse. Low testosterone is reversible, depression due to low testosterone is reversible.
The Healthy Body, Healthy Mind #ChooseTRT campaign was recently launched following two young suicidal patients, both in their 20s, saying that TRT saved their lives. We need to raise awareness and improve understanding surrounding the link between mental health and testosterone deficiency. We need affirmative action. Men have been keen to tell their story and share their experiences for the campaign in order to help others. I have included a few examples below.
Until a national screening programme is implemented, or doctors in the UK wake up to the fact that hormone levels need to be tested in ALL men presenting with symptoms of depression, men are going to continue to suffer. This is stark contrast to the US where they have a far more progressive attitude towards preventative health and wellbeing. High profile celebrities such as Joe Rogan, Jeff Bezos, Robbie Williams, Dorian Yates, Sylvester Stallone, Mel Gibson and Dan Bilzerian all openly admit to needing TRT. There is no shame to needing TRT. Testosterone Deficiency is simply a hormonal deficiency, much like any other.
Dr Robert Stevens MBChB MRCGP Dip.FIPT