From the age of 50, most men’s testosterone levels begin to fall. The once-rampant stag who raged around the parties and clubs of his youth starts to prefer a comfortable chair near the radiator, a glass of whisky and a newspaper to the pursuit of the pleasures of the flesh.

As male testosterone levels fall, so does any aggressive tendency and business drive. At the same time the tiredness induced by long hours spent in an office and commuting increases. Women also have testosterone. As they grow older and pass the menopause, their oestrogen level falls. As a result their testosterone oestrogen balance changes and they may become increasingly commanding.

Recent research from the University of California San Diego School of Medicine has shown that low levels of testosterone could be detrimental to the long-term health of men over 50. In the study, which has continued for 18 years, men with a low level of testosterone had a 33 per cent greater chance of death than did men with higher testosterone blood levels. The differences in the death rates made suitable allowances for smoking, drinking, physical activity and any diseases that the subject may have had before the study began.

If the testosterone level in a man is low, and therefore his oestrogen testosterone balance is closer to that of a woman, he has a larger waist girth and other signs and symptoms of the metabolic disorder that gives rise to arterial, heart and diabetic troubles. The metabolic syndrome is often a prelude to diabetes type 2, high blood pressure, coronary arterial disease, heart failure and raised cholesterol levels.

For many years the association between low testosterone levels and a lack of sexual enthusiasm and prowess has been accepted. Dr Richard Petty, a London physician who has made a special study of men’s problems in relation to testosterone levels, welcomed more evidence confirming the importance of testosterone to the maintenance of male health. He pointed out that the present study clearly illustrated the disadvantages of low testosterone.

More randomised placebo-controlled clinical trials were needed to define the relationship between testosterone supplements, if one exists, and increased life expectancy. One such trial is planned at the University of California, San Diego School of Medicine. Care is needed when testosterone supplements are prescribed because there is theoretically a possible association between high testosterone levels and prostatic troubles.

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