Having problems getting your man to the doctor for a check-up? Especially if he's been constantly tired, unmotivated and irritable lately?
Women might want to bring up their husbands or partners' sexual performance as an excuse to get them to see a doctor - and halt testosterone depletion in its tracks.
'Manly' problems such as erectile dysfunction (ED) and premature ejaculation, possibly having accompanying testosterone deficiency, have been getting men through clinic doors recently, for their own good, says urologists.
Testosterone deficiency is linked to more health issues than just ED, and it's a sign of men's overall health in general.
But first, the growing awareness of sexual problems.
'There's been more awareness and openness about male sexual problems in the last two years - and more are getting medical help for it,' says Colin Teo, consultant urologist at Khoo Teck Puat Hospital and vice-president of the Society of Men's Health, Singapore.
Symptoms of testosterone deficiency syndrome (TDS) include lethargy and a lack of motivation, irritability and so on.
'The rough estimate of men suffering from TDS in Singapore is about 26 per cent, and they're usually be in their 40s and above,' Dr Teo points out.
It is understood that men's testosterone levels drop by 1-2 per cent every year, after the age of 40.
Also, men are more inclined to seek treatment because there is a range of safe solutions for them.
'The latest is Levitra, which can be taken orally for ED, and then there's the Nebido injection to raise testosterone levels, done only once every three months,' says Dr Teo.
Also, problems such as premature ejaculation can also be treated - with a newly FDA-approved drug.
And as men get their libido issues addressed, this affects their social interactions and overall health.
Their relationships with their female partners improve, says Dr Teo, adding that he has seen couples on the brink of a break-up get back together.
In fact, they regain their drive in their careers, being more energised and positive, and their colleagues actually comment on their change after they have been on testosterone replacement therapy. Most actually restart their fitness regime and start losing weight.
But the even more important issue is that by going to see doctors about their ED and being treated for TDS, other medical problems are also being addressed.
'That's because having a problem like ED isn't just about ED itself. ED is usually a symptom or sign of other health issues like obesity, diabetes, ischaemic heart disease and Metabolic Syndrome,' Dr Teo points out.
Shorter life expectancy
Shorter life expectancy
Visceral fat (which is the internal fat that wraps around the organs) breaks down testosterone and lowers the male hormone.
'Men who are obese might even start to have 'male breasts' as testosterone gets broken down by the visceral fat and is converted into estrogen,' he adds.
Studies have shown that severe TDS is associated with a shorter life expectancy.
Doctors will usually do a thorough medical check on the men who come to see them for their sexual health - checking for diabetes, cholesterol, blood pressure, and so on.
'Vascular problems lead to nerve degeneration, which will present as ED as the male organ has a smaller artery feeding it,' he explains.
Dr Teo clarifies that not all who come in complaining of ED have a low result on their testosterone levels when they are tested.
'If levels are low and they exhibit symptoms of TDS, we will then recommend treatment. There have to be symptoms like tiredness, decreased libido, poor sleep, decreased memory, mental sharpness or irritability. And the end result that we're always looking for is the improvement of these symptoms, besides just focusing on a higher testosterone count,' he says.
'TDS isn't necessarily related to aging. While we do expect older men to have a lower level of testosterone, one does not have to live with TDS and can still enjoy the vigours of manhood as one ages. It can also affect men below 40 years, though this is less common, when risk factors such as obesity are present.'
Asking a man to go for a health check for his medical condition might be like pulling teeth. But if they have a problem with their libidos and know that there are now treatment for them, they'd be more open to seeing a doctor.