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Extract from Successful Marriage : A modern guide to love, sex and family life. ed. Fishbein and Burgess.; Doubleday. copyright 1947,1955,1963 Chapter 5:August A.Werner, MD |
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| General Symptoms. | After someone has developed normally and has functioned normally sexually and then has decreased or absent function at some later date, the diagnostic evidence for the condition is chiefly subjective rather than objective. The group of symptoms which will be described result from functional imbalance between the pituitary and the sex glands (the thyroid and adrenal glands may be secondarily involved), with disturbance of the auto- nomic and central nervous systems. The symptoms are, necessarily, chiefly functional. They have been classified as nervous, circulatory, and general. |
| Nervous Symptoms | Most of the patients complain
of an intense subjective nervousness. There is a feeling of tension
and a sensation of inward tremulousness; they are "jittery." Many
state that this is especially noticeable upon arising in the morning or
during the night. It is accentuated by excitement, effort, or fatigue,
and then a tremor may be noticeable.
There is decreased ability for mental concentration, the mental processes are slow, and these persons are forgetful, especially for recent events. If they read an article they cannot tell what they have read and must reread it several times before it registers; names, figures, and dates are especially difficult to remember. |
| Depression | Commonly called "the blues" is an important symptom; when this is present the patients have a loss of interest in their work, in their home, or in their past pleasurable diversions; they want to avoid people, and do not care for social activities. They realize that there is something wrong within themselves; they become introverts, are ill at ease, have fear of some impending danger, and worry unnecessarily. There is a loss of self- confidence and a feeling of futility. At this stage of the condition these patients verge on psychosis, may be self-accusatory, have thoughts of self- destruction, and may actually commit the act. This extreme stage has previously been referred to as involutional melancholia; it is a psychosis, but of definite glandular origin, and should be entitled "climacteric psychosis." |
| Circulatory Symptoms. | Some few men have hot flushes similar to those of women. Hot flushes are characterized by a sudden redness of the face and neck, upper chest, and at times most of the body. It is a very uncomfortable sensation, generally of short duration, but it may last an hour or even longer. |
| Fatigue | Lassitudeand fatigability are often present. Some of these people state that there is pronounced decrease of endurance and that they fatigue easily. Others complain that they are constantly tired, or that on arising in the morning they are unrested or feel more exhausted than when they retired the night before. These people also complain of vague pains, and their location may be in any part of the body or extremities. Frequent sites of pain are in the shoulders, wrists, fingers, and along the spinal column. This pain is usually not accompanied by redness, swelling, or temperature, and is frequently spoken of as rheumatoid arthritis and climacteric arthritis. |
| Decreased libido | Most of these men state that they have noticed a decrease in sex function. Decrease in sex function does not necessarily mean that the desire and ability are entirely lost, for these may persist in varying degrees throughout the life of the individual. In many instances the decline of sex function and the persistence of desire cause many men to consult the physician. |
| Digestive upset | Many of these patients complain of gastric (stomach) distention and eructation after meals; in most instances this is probably a nervous indigestion and disappears with proper treatment. Constipation is frequently present during the climacteric, but in the vast majority of patients it is probably due to improper habits, diets, or other conditions. |
| Hormones for relief | The great majority of my patients volunteered the information that their sex desire and potency were decreased or absent, but this condition, with few exceptions, was not their chief concern. They were more interested in having relief from their symptoms, especially those which were nervous and psychic; they wanted to feel well so that they could work. One can almost surely promise a climacteric patient relief from his symptoms and a feeling of well-being by treatment with the proper sex hormones. |
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