Magical thinking: Testosterone

This week's BBC article titled Death of the sex drive — and the great debate over whether testosterone can help get it back (https://www.bbc.co.uk/news/articles/ckg8r28d3lgo) triggered a number of reactions in me.

The answers presented hold true in multiple ways, and also don't, yet none provide the ultimate answer to the role of this hormone, its use, its abuse, or its impact.

First and foremost, before we reach for the glass of water and gulp down the magic pill that will resolve all our sexual, physical and emotional woes — let's pause and think.

Our human experience is made of an intricate interconnection of physiological, emotional and physical responses that work in the background in ways we are mostly unaware of. If we could visualise it, it would probably look like the infrastructure beneath London — pipes, cables, signals and systems pushing and pulling information in every direction, keeping everything alive and kicking without a single person on the street knowing it's there or how it works but ready to complain nonetheless when it fails.

In short, we are a sophisticated bunch. And yet, like any complex system, we are also prone to errors, endless upgrades, incidents and tangles.

Why does this matter?

Because we tend to forget that the origin of our problems is rarely down to a single, easily identifiable cause. Being human, and understandably focused on removing symptoms quickly, we look for the immediate solution — we ask for it, and we are given it, because powerful social and financial forces are more than happy to facilitate exactly that.

So, is taking a testosterone supplement a good thing? It.... depends.

It depends on a significant number of factors, and before you head to your GP you owe it to yourself to explore those factors properly. There are serious consequences to your health when you don't take your health seriously.

There is also a genuine risk in extrapolating so-called truths from scientific research, because sensationalism sells. Drama at every corner keeps people clicking.

Take libido as an example. It is true that testosterone is associated with libido, and that supplements can help where there is an organic hormone deficiency.

What is equally true is that testosterone is not the only factor at play. Emotional dysregulation, for instance, will dampen your desire for intimacy — meaning that even a cartload of pills will not resolve the underlying issues, and may well make things worse.

Stress has a significant impact on the body's natural testosterone release. So when it comes to even thinking about intimacy with a partner, you can find yourself hit by a double whammy: stress-induced anxiety on one side, and reduced testosterone on the other.

Bringing in a supplement at this point is like signing a £50 million striker when what the team actually needs is a decent manager. That striker will make little difference to a squad that is exhausted and now even more demoralised. The very same player, in a healthy and balanced team, could win you the Champions League.

Testosterone is like the striker, powerful yes, and in the right circumstances, incredibly effective but the striker alone will not win the Cup

Our bodies, minds and brains are beautifully — if at times frustratingly — complex. Coming in with the equivalent of a bulldozer tends to be counterproductive, even dangerous.

The better approach is to do the work first. Identify what is genuinely causing disruption in your life: work, finances, relationships, sleep, patterns of behaviour. Keep a diary of your physical and emotional responses. Look for trends. Take ownership of your health. Then visit your GP, and share your findings clearly, one at a time and do not leave until you get an answer to each one. Barging through the door with "my libido is on the floor and I need testosterone" is not the way forward — and any clinician worth their salt will tell you the same. If they do not.... change clinician