A sculpture of Andre, at the exhibition "The strength of art" in Paris, May 9, 2006 (GINIES / SIPA).
Today, a man over the age of 40 is much more active than 20 years ago, especially sexually, and often well past sixty.
Or androgens, including testosterone, are falling steadily and gradually from 35-40 years, while the energy demand in which they participate, remains high. There is therefore a telescope between the natural decrease of these androgens and the increase in needs.
Boosted libido, shrunken testicles
The bodies of these individuals who push dumbbells in gyms, bike 40 kilometers in one day or train in the marathon, will consume a lot of androgens. It is often on the occasion of a decrease in sexual performance that we discover that they lack testosterone. It has been shown that taking androgens in those who really need them will be beneficial, not only sexually, but also in terms of heart and blood vessels. Patients over 40 years of age should be reminded that prostate control is essential before taking any testosterone.
On the other hand, what is not, it is the exaggerated consumption of testosterone without medical control and supra-physiological dosages. While it boosts the libido but it also increases aggression and especially long-term risk of causing testicular failure with unpleasant decrease in the volume of glands.
What is going on ? Under the effect of external (exogenous) testosterone intake, the testes are less stimulated by the pituitary and internal (endogenous) mechanisms are inhibited. Results: on the one hand sperm production is reduced, on the other hand the testicle no longer makes its own testosterone. And this chronic testicular failure may even be definitive if the system is left fallow for too long.
Lack of awareness of the sexual thing
The real question is why men try, either by being prescribed for no medical reason testosterone, or by buying on the internet, to revive or improve their virility or their sexuality through this hormonal bias. In my opinion, it is because there is general anxiety leading men to think that they are not performing enough sexually.
Penis dimension studies, which would shorten, add further discomfort to this climate of anxiety. While measuring the size of the phallus at rest is very random and varies with local temperature, emotions … Men (and women) must realize that one can have normal sexual activity with a medium-sized penis and there is no need to take testosterone in adulthood to hope to grow the penis.
Only by making an effort to educate about the "sexual thing" will it be possible to counter this latent marketing of sex in our society. It is associated with an extraordinary misunderstanding of sexuality. Men and women know each other very badly sexually and individually.
Women do not know how their own sex is done. So I recently had a patient, who had gone to graduate school, who was afraid of vaginal penetration because she thought the penis was going straight into her abdominal viscera.
Men do not do better. A normalist and polytechnician was surprised that I offered him a Doppler ultrasound examination of his penile vessels to assess his lack of erection: "Oh, well it is the blood that produces the erection!" Indeed, since Leonardo da Vinci, we know that it is not air ….
Interviewed by Daphnée Leportois.