Low T, no T

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andrea@altsexcolumn.com

Dear Andrea:

I read your column about potential causes of a husband's lackluster performance in the bedroom [8/8/07]. You mentioned that the letter writer's husband should talk to his doctor about low testosterone, and I thought you might be interested in more information on that. As you said, low testosterone (low T) and diabetes are linked. In fact, a recent study found that men with diabetes are more than twice as likely to have low T than other men. To educate men about the link between low T and diabetes, the American Association of Diabetes Educators created the "Take Charge. Talk T." program, which includes a pamphlet men can take to their doctors or diabetes educators if they think they are experiencing low-T symptoms.

[List of low-T facts here: an estimated 13 million American men have low testosterone; symptoms include low sex drive, erectile dysfunction and depression; treatment is available in various forms; obesity and hypertension are also risk factors, etc. — A]

If you would like more information, please visit www.TalkLowT.org. On behalf of my client, Solvay Pharmaceuticals, which markets the testosterone therapy AndroGel, I am including fact sheets. If you plan on covering low-T or T therapy in the future, I would be happy to set up an interview with a doctor or low-T patient.

Best,

PR Lady

On behalf of Solvay Pharmaceuticals

Dear PRL (be glad I didn't call you PharmGirl):

I have to finish poking myself in the eye with these sticks first, and then I believe I'll have lunch, but I appreciate the offer. (Seriously, I may take you up on it at a later, less summer-vacationy date.) Unlike many people I encounter while doing vaguely progressive work in a place where more people practice Tantra than go to church on Sunday, I don't dismiss out of hand the idea that so-called "Big Pharma" can be a source of good. How can I, after all the intensive interventions that got my kids and me through a dicey beginning, not to mention my long love affair with antidepressants and a devoted fan-girl relationship with Viagra and the gang? While dispatches from Big Ph are best taken with both a grain of salt and a diuretic for the sodium sensitive, I'll still take them. And I do like the idea of checklists the patient can take along to the doctor. What with the research being newish and the subject being vaguely sex-related, some doctors are just going to nod and smile and pretend they never heard a request for a testosterone test, and one may be able to catch their attention by waving a few brightly-colored pages about. There are some such available on the pharma-sponsored site to which Ms. Lady linked, www.talklowt.org, and I can't see any reason not to use them, although they do contain a few quibbleworthy statements like "A simple blood test ... will determine if your testosterone levels are below normal." From everything I've read elsewhere, this ought to be precisely untrue: testosterone may be bound by sex hormone binding globulin, so either high or low SHBG, both common, will produce inaccurate test results. You will want to wave around some pages about how to get an accurate testosterone test done along with the others.

Speaking of hormones, the other noteworthy note I got last week came from a trans woman (I assume) incensed at my — what else? — insensitive use of language. The subject was a recent "Why does my guy look at tranny porn?" question [8/1/07], and in case the one letter I got really was standing in for a thousand equally pissed-off people too lazy to write letters, I thought I'd clear up a misunderstanding or two while I'm waiting for lunch or a poke in the eye, whichever I was going to do first while avoiding a visit from a doctor or a patient with low testosterone.

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