When I went to school as a biology/pre-med major I was looking at going to into veterinary medicine. I never considered that what I would learn in biology and anatomy would be used to keep my family alive and healthy. On the other hand, since becoming a stay at home mother, at least my education is being used for something.
I have a bad habit of assuming that the knowledge provided by my science based education is shared by everyone. More often than not I forget that it’s not and that many people never sat through a science class outside of high school.
I also have a bad habit of assuming that doctors spend time with their patients and explain things to them. Because I have been spoiled by having an gynecologist that does this, I assume all doctors are like this, even the ones who are constantly overbooked and have less than five minutes to spend with each patient, as the case is with the doctor my husband has been seeing for the last several years for a number of health issues.
I was there fifteen years ago when he was told he had hypothyroidism and the doctor explained what this meant to him. I was there ten years ago when he was diagnosed with asthma and was given a medical discharge from the Navy. Unfortunately I was not there several years ago when he was diagnosed with hypogonadism. I just assumed that the doctor told him what he needed to know prior to putting him on hormone replacement therapy.
I found out a couple days ago, after listening to him complain that he didn’t feel well, that the doctor did not explain the first thing to him about the condition and just tossed a prescription at him and told him to take it. My husband is one of these people who has a hard time remembering to take his medications. Fifteen years with hypothyroidism has destroyed his short term memory. I am lucky if he remembers what we need at the store on his way home from work. Then again, he usually calls me as he is pulling into the parking lot these days to double check. It’s better than forgetting, wandering around the store and picking up random items hoping that its right. With seven children in the house and forgetting something as important as toilet paper, bad things happen.
I can usually tell when he hasn’t taken his thyroid medication for several days because his bad memory is worse than ever, he can’t concentrate, he’s irritable, depressed and self-absorbed wallowing in his own pity. Most couples argue about money or how to raise the children. We argue about him not taking his medication.
So, after a week of complaints that he didn’t feel well, that his joints ached, that he was getting headaches and he wasn’t sure his blood pressure medication wasn’t working and constantly being tired I asked him when he took his hormone replacement last. I was greeted with the normal response, “I have to take it yet today.”
What about the last week? The prescription hasn’t been filled in over a month and there is still over two weeks of it left. Irritated doesn’t even touch of the surface of what I felt. After telling him that a week without one of his medications was why he felt like crap I had to ask, “Didn’t the doctor explain what hypogonadism is, what it does to your body and why you need testosterone?”
The answer I got irritated me more, “No.”
I would rather explain about the birds and the bees to my children and get some crazy argument about how that isn’t what was said on the Discover Channel about birds or bees than explain medical things to my husband. He’s a technical person with a better understanding of how electronic equipment works than his own body. I am sure that part of the doctor fee that is charged is for explaining these things, so how I get stuck doing them is beyond me.
The questions my husband should have asked the doctor and what should have told him.
What is hypogonadism?
Male hypogonadism is when the body doesn’t produce enough male sex hormone, testosterone.
Why is testosterone important?
Testosterone is a hormone produced by the endocrine system that has more responsibility than just the male sex drive and secondary sex characteristics such as the growth of facial hair and nothing else. This couldn’t be farther from the truth. Testosterone is needed to prevent heart disease, it protects against osteoporosis, stimulates the production of red blood cells, helps prevent diabetes, is responsible for energy levels, and helps regulate the metabolism.
Tiredness, muscle aches, loss of libido, erectile dysfunction, infertility, dry skin, hot flashes, depression, moodiness, weakness, weight gain, and difficulty concentrating.
What causes hypogonadism?
Low testosterone levels affect 13 million men over age 45 due to the normal aging process. Prior to age 45 there are a number of things that cause hypogonadism; testicular trauma, undescended testicles, Klinefelters Syndrome which results in a chromosomal abnormality that causes a man to have two X chromosomes in addition to the one Y chromosomes, a mumps infection involving the testicles, cancer treatment, obesity, hypothyroidism (another condition affecting the endocrine system), AIDS/HIV, pituitary or hypothalamus malfunction. Obviously it’s important to determine why hypogonadism is occurring because the majority of underlying conditions are relatively serious and carry their own risks.
How is it treated?
Hypogonadism is treated with hormone replacement therapy to bring the testosterone levels back up to normal. This can be done either with injections, a transdermal patch, gel that is applied directly to the body and more recently a gum like substance that is applied to the gums in the mouth that when mixed with saliva turns into a putty that allows the testosterone to be absorbed into the body through the mouth. Each of these forms of replacement therapy have their own side effects and risks that need to be worked out with your doctor.
