8. Is there a “male menopause”?
9. Do men have hot flashes?
10. Mark McGwire took androstenedione pills the season he hit 70 home runs. They sell androstenedione pills in my local store. Should I start taking androstenedione to increase my own testosterone level?
11. My husband has a low testosterone level and the doctor’s are planning to start testosterone treatment. What precautions do I have to take? Will he turn into a sex maniac if his testosterone level is increased?
12. My wife and I have been trying to have a baby but cannot. The doctor told her that she is all right but that I have a low sperm count and that is why she doesn’t get pregnant. But I don’t understand how that can be. We have no trouble having sex and I ejaculate lots of semen out when I climax. How can our infertility be my fault?
13. I have heard that some men can get an erection on demand by injecting a chemical into their penis. It sounds creepy. Do men really do this? Doesn’t it hurt?

8. Is there a “male menopause”?

a. A woman’s menopause occurs because her ovaries abruptly stop making estrogens, and it is the lack of estrogens that is responsible for her hot flashes, vaginal dryness, and on occasion alteration in mood.

b. As man ages his testicles continue to churn out testosterone as well as sperm allowing him to maintain both sexual desire and fertility into his senior years. But man does not escape totally unchanged by the aging process. The number of testosterone producing cells decline so that the older man’s testosterone levels while normal are not quite as vigorous as they were when he was younger.

c. In Europe the ADAM (Androgen Deficiency of Aging Man) syndrome has gained popularity and spawned the development of “Andropause Clinics” where aging men are provided with testosterone supplements, but that trend has not yet caught on in this country.

9. Do men have hot flashes?

a. Have metastatic (spreading) prostate cancer and have had surgical removal of their testicles (castration) or medically castrated with every 3 month injections of leuprolide (Lupron) to obliterate their own testosterone production. Testosterone fuels the continued growth and spread of prostate cancer.Eliminating testosterone stifles prostate cancer spread.

b. Undergo surgery to remove both testicles as treatment for their testicular cancer. After surgery their testosterone levels plummet to zero.

c. Develop spontaneous failure of their testicles to produce testosterone-a condition called hypogonadism. Men with hypogonadism also have low testosterone levels and are prone to develop troublesome disconcerting hot flashes exactly like those experienced by menopausal women.

d. Testosterone treatment is safe only for men whose hot flashes are the result of spontaneous hypogonadism or have had surgery for testicular cancer. Testosterone is not safe and should not be used in men with metastatic prostate cancer.

10. Mark McGwire took androstenedione pills the season he hit 70 home runs. They sell androstenedione pills in my local store. Should I start taking androstenedione to increase my own testosterone level?

Within each man’s testicles a steroid assembly line processes one weak steroid to another more powerful steroid. Andro- androstenedione is in this assembly line and is the next to last step before testosterone is formed but it is only the androstenedione within the testicle that can make the transition to testosterone. When a man takes Andro that androstenedione is shunted away from the testicles steroid production line but a man’s body has to do something with all that excess androstenedione. It transforms Andro into estrone a female hormine that can stimulate breast growth in men.

11. My husband has a low testosterone level and the doctor’s are planning to start testosterone treatment. What precautions do I have to take? Will he turn into a sex maniac if his testosterone level is increased?

Answer: The word of mouth mythology surrounding testosterone is stunningly inaccurate-but persists because people want it to. The facts are these.

1. A man’s testosterone surge begins in adolescence. As long as a full ration of testosterone continues to flow he will fulfill his destiny as a sexually and reproductively competent male. But if his testosterone levels fall he will sacrifice some of the benefits he enjoyed when his testosterone levels were normal.

2. Men with low testosterone levels are less strong, less interested in sex, not quite as effective in business dealings and possibly a little testy.

12. My wife and I have been trying to have a baby but cannot. The doctor told her that she is all right but that I have a low sperm count and that is why she doesn’t get pregnant. But I don’t understand how that can be. We have no trouble having sex and I ejaculate lots of semen out when I climax. How can our infertility be my fault?

13. I have heard that some men can get an erection on demand by injecting a chemical into their penis. It sounds creepy. Do men really do this? Doesn’t it hurt?

Answer: The line I use in my book is “Puncturing the penis with a needle is not for the squeamish, Still penile injection has become an accepted and approved form of therapy for many men with erectile dysfunction. Penile injection with Caverject™ works because the injected chemical-alprostadil-once in the spongy cylinders (corpora cavernosae) of the penis encourages a rapid inflow of blood causing the penis to swell and become rigid simulating a spontaneous erection.. The erection caused by penile injection differs from the erection that occurs after men use Viagra in several ways.

1. The erection created by the Caverject ™ occurs within minutes after injection and does not require any sexual stimulation whereas men who take Viagra need some sexual stimulation- manual, oral, or fantasy to develop an erection.

2. The process of injecting Caverject ™ is surprisingly not that uncomfortable but men often experience a burning sensation as the penis is transformed from limp to erect, something that does not happen when men have an erection after using Viagra.

3. A new device called MUSE™ (medicated urethral suppository) allows men to instill alprostadil into their penis without giving themselves an injection. The erection-activating medicine-alprostadil - is embedded in a pellet which is released after being inserted directly into a man’s urethra (the tube through which he urinates). Once released there it has the same effect as the injected alprostadil in causing a spontaneous erection. Men who use this device do get a satisfactory erection but report the same sort of burning pain experienced by men who use Caverject™.

4. MUSE™and Caverject ™ often succeed when Viagra does not, particularly in men whose ED is the result of some nerve damage.