Johannesburg - It is referred to by many names and phrases.
“A sign of wealth”, “beer belly”, “love bubble” – and while these terms can be endearing, men’s health experts warn that a “boep” or rather, a big tummy, may be a red flag to something more sinister.
Testosterone deficiency syndrome (TDS) is just that something.
“What happens to a man is that from the age of about 40… testosterone levels drop in the body every year. Unlike women who go through menopause, for men there is no single defining experience, so when the testosterone levels drop, men might not notice anything,” the head of urology at Wits, Professor Mohamed Haffejee, said on Monday.
When testosterone levels drop, men risk diabetes, cardiac illnesses and obesity. The hormone is key for the body’s metabolic processes, bone and muscle mass, and healthy levels of red blood cells.
“As testosterone levels in the man’s body drop, the first thing we usually see is the boep. But to make a diagnosis, one needs to present with the symptoms, have a blood test and be able to exclude other diseases like thyroid deficiency,” Haffejee said.
Senior urology consultant at Medunsa, Professor Shingai Mutambirwa, said that while the country did not have “robust data” on the prevalence of the syndrome, it certainly had a link to obesity.
Generally, some of the signs of testosterone deficiency were poor erections, loss of energy, sleeping problems and depression.
“The first line of treatment is… a healthy lifestyle, as the natural way to raise testosterone levels is to exercise. You generally cannot take oral testosterone as treatment as it may damage your liver and increase… blood clotting,” he said.
Haffejee echoed Mutambirwa’s sentiments about the need to exercise, but stressed that a healthy diet was even more important.
“You need to eat right. You are what you eat… sugars and carbohydrates are… the biggest drivers of obesity and it’s absolutely essential that we go back to our ancestors’ basic diet of fresh produce, limited fruits and good fats,” he said.
At the Pan African Diabetes Conference last month, Dr Sindeep Bhana, an endocrinologist at Chris Hani Baragwanath Academic Hospital, highlighted the unavailability of local guidelines for treatment of testosterone deficiency, particularly in patients with diabetes.
Bhana said: “We are missing an opportunity to… improve metabolic parameters in male diabetic patients. Statistics show that up to 30 percent of type 1 and up to 50 percent of type 2 diabetic patients may have TDS. This is very significant. Funders will need to be engaged to assist in the development of such guidelines and thereby help reduce the incidence of such cases.”
The Star