Quietly and slowly, the man who would tackle a Saturday run, DIY project, or braai with friends with vibrancy has gradually faded.
“It must be stress or that natural march of Father Time,” every man in his late 40s who has experienced this immediately thinks, yet it was a deeper fatigue than one sleep could fix.
The mental fog had made concentration a struggle and motivation a distant memory.
But why? What happened to the man who used to take to the gym with vigour?
The most common assumption is that testosterone, the hormone associated with strength and performance, is all about muscles and sex.
But it goes much deeper than fading intimacy to affect physical, mental, and overall well-being.
As Ingrid Singels, associate director of Pharma Dynamics’ scientific division, explains,
“Testosterone underpins much of what men take for granted—strength, drive, focus and mood. When it dips, the effects ripple across body and mind.”
For some, these ripples become waves—irritability without cause, accumulating belly fat despite a strict diet, and a general lack of zest are potential flags for a deeper, endocrine issue: low testosterone, or male hypogonadism.”
Many men dismiss these subtle changes as an inevitable part of ageing. Yet, low testosterone can stem from various causes, according to Singels.
“Yes, levels of testosterone naturally decline by about 1% a year after 30 but never deplete completely.
“So, in many such cases, the problem could be linked to secondary hypogonadism, where the brain fails to signal the testes properly, triggered by factors like obesity, type 2 diabetes, poor sleep, or chronic stress.
“We often see a silent onset of hypogonadism. Men don’t realise that the chronic fatigue, reduced strength or mood dips may have an endocrine root.
“That’s why early screening and dialogue with healthcare providers is absolutely critical.”
The consequences of ignoring these warning signs extend beyond quality of life.
Beyond reduced muscle mass and libido, low testosterone is linked to poorer bone density, raising fracture risk, and observational studies suggest a correlation with higher cardiovascular risk.
Fortunately, the path to diagnosis has been made more accessible, such as taking a digitised, internationally recognised ADAM Screening Questionnaire for Low Testosterone online.
“The questionnaire provides men an easy way to start important conversations with their GP – talks that many tend to put off or avoid because of stigma or embarrassment,” says Singels.
The results from the test, if adverse, should lead to a visit to the doctor and a blood test.
If the condition is confirmed by a medical practitioner, treatment can begin with
addressing underlying lifestyle factors, of which weight management, regular strength training, improved sleep hygiene, and better stress control can often make a noticeable difference.
For men with confirmed low testosterone and clear symptoms, testosterone replacement therapy (TRT) is an option.
“This is available in gels, patches, or long-acting injections that provide stable levels for weeks.
“TRT is a regulated medicine that must be carefully guided by a doctor,” says Singels.
“Understanding that this struggle is not a personal failing but a medical condition can be transformative.
“Low testosterone is not simply a sexual issue—it’s a systemic issue affecting strength, vitality, mood and long-term well-being.
“If you sense something is wrong, don’t wait—early screening can help catch it before downstream damage sets in.”
For men, the message is clear: caring for hormonal health is the key to reclaiming the
vitality, once thought gone for good, and, of course, a happier household.
