Now we're both on hormone therapy

Richard and Janet have more things in common than most couples - they are both on hormone replacement therapy. The Grahams are one of a small but growing number of partners who are both using the treatment to combat the age-related effects of the male andropause and the female menopause.

Janet, aged 51, who has been on HRT for five years, has been joined by her 57-year-old husband, who is now taking testosterone supplements to boost his flagging hormone levels.

He says: "I was getting a bit jaded, I'd lost my edge, and I was going through a bit of a depression. It was so bad my friends were calling me Victor Meldrew. Janet was calling me Picky, too, because I picked on anything and everything.''

New research shows that testosterone supplements can reduce levels of irritability, tiredness and the effects of stress. There are some suggestions, too, that it may have a protective effect against heart disease and dementia.

Research also shows that testosterone replacement therapy, or TRT, can protect men from osteoporosis just as the female hormone oestrogen in HRT offers some protection for women. Although osteoporosis has long been seen as a degenerative condition that affects only women because of the hormonal changes triggered by menopause, new research shows that men are increasingly suffering. Osteoporosis now affects one in 12 men in Britain, and a third of hip fractures occur in men. It is estimated to cost the NHS more than £1.7 billion a year.

The sex hormones oestrogen and testosterone play important roles in maintaining health, but both decline with age. In women, the decline is rapid and abrupt as a result of the ovarian changes at menopause. In men, although the change is a much slower and less noticeable reduction in testosterone production, by the age of 50 levels may be as low as a third of that in their early twenties.

Some men may experience no apparent ill effects from this drop, while others will have severe symptoms. The reduced testosterone production can result in osteoporosis, a drop in muscular strength, energy and libido, as well as depression, and joint and muscle pain. There can also be an increase in upper body fat, anaemia and some loss of mental agility. A common complaint from men is that they feel they are losing the competitive edge at work.

To combat such age-related conditions, an increasing number of men are turning to TRT, which they take either as oral capsules and pills, or in the form of skin patches, fortnightly injections, or implanted, slow-release pellets.

Dr Malcolm Carruthers, a Harley Street specialist in men's health, who is chairman of the Andropause Society, author of Maximising Manhood, and a pioneer of TRT, says the number of men who could be helped by the treatment is huge. "About 50 per cent of men in their fifties, and 60 per cent of those in their sixties could benefit. We want to make it more widely available,'' he says. "Research data is very much in favour of testosterone treatment being effective and safe, and andropausal societies are being set up throughout the world.''

Janet, a mother of three, had been on HRT for some time before Richard became aware that all was not well with his own hormone levels. She says: "My doctor advised me to go onto HRT as a way of protecting the bones and heart. Afterwards, I noticed that I was more steady, had better concentration and was less irritable. My skin has benefited too."

With Richard, the benefits were more immediate. "I was coming home from my job selling cars and falling asleep in the chair. I stopped swimming and playing with the kids. I started looking ancient, my stomach got bigger, I thought it was just getting old.

Then he heard about the testosterone treatment. "I was prescribed some capsules to take daily, and the effect was amazing. It felt as if I had been given an injection of youth. I felt sharp again, excited about the next day and keen to get up in the morning.

"I go to a lot of car auctions and you have got to have a lot of bottle because you are putting your money on the line. After taking the testosterone, my bullishness came back; I was assertive and dominant again. I also got hairier, my muscle tone was good, I felt more alive, supple, and the physical side of the marriage improved.

"But after six months things deteriorated. I was tired again, and I was slipping off in the afternoon to put my feet up by the fire. Then I had these implants in my buttocks which slowly release the testosterone. Dr Carruthers calls them the batteries.

"What a difference. I had my latest implant 10 days ago and everything is fine - I get the testosterone I need every day. I have seen the effect HRT has had on Janet and I think this is its equal for men. The problem for men is that they actively have to seek it out. I think it should be generally available. I'm not rich, but I am in the fortunate position that I can get it done every six months. It costs me £700, or £1,400 a year. A lot of men who could benefit can't afford it.''

? Dr Malcolm Carruthers, AndroScreen Centre, 20/20 Harmont House, 20 Harley Street, London W1N 1AL. Tel: 020 7636 8283.