It's Men's Health Month, and just as I reflected on the evolution of women's health, I want to share what I've seen happen in men's health over the past four decades. I started practicing in the mid-1980s, and even then, men were expected to be "fine" — to work, provide, push through, and rarely talk about what was going on inside their bodies or their minds.
While women were (rightfully) claiming more space in conversations about hormones, fertility, and menopause, men often got a very different message: be strong, don't complain, and definitely don't talk about emotions or fatigue. We didn't give men a real vocabulary for their inner world or their physical changes. Instead, we wrapped everything in jokes about midlife crises, grumpiness, or "just getting older."
I used to tell my female patients, half-jokingly, when they were frustrated with their husband's silence, "You know men are only given 2,000 words a day, and by noon they've run out. Women get 10,000." Everyone would laugh — but underneath the humor is a serious problem. If you don't have words, it's very hard to ask for help. It's even harder to explain that you've lost your drive, your energy, your focus, your joy, or your libido.
And yet, the need was always there. I had what I called the "doorknob sign": as soon as my hand touched the exam room doorknob to leave, a male patient would blurt out, "Uh… is there something you can do about my erections?" That's when I knew the visit wasn't over. Many men also quietly transferred to my practice from my male colleagues because they simply weren't comfortable talking to another man about any of this "stuff."
What We Didn't Talk About
When I began practicing, we didn't talk openly about low testosterone, even though I could see it walking into the exam room — in the tired eyes, the softer muscle tone, the quiet admission of "I just don't feel like myself." Men might mention erectile issues in a whisper, or not at all. Libido, mood, and energy were rarely framed as legitimate medical concerns that deserved a full workup.
Over time, we learned much more about male hypogonadism: that low testosterone is associated with decreased libido, fewer morning erections, reduced muscle mass, increased body fat, low energy, depressed mood, irritability, and poor concentration. We also came to understand that these symptoms cluster with cardiometabolic issues like obesity, insulin resistance, sleep apnea, and type 2 diabetes. In other words, men's hormones are not a "vanity issue" — they sit right at the crossroads of heart health, brain health, and quality of life.
The Double-Edged Sword
Unfortunately, the rise of the internet brought a double-edged sword. On one side, men finally had access to information; on the other, they were flooded with confusing, sometimes fear-based or marketing-driven messages. "Low T" became a buzzword. Quick-fix clinics popped up. Some men were given hormones without a proper evaluation; others were scared away from any discussion of testosterone because of headlines about heart risk or prostate cancer, without context or nuance.
Meanwhile, many traditional clinical settings still didn't ask the right questions. Men continued to hear:
- "You're just getting older."
- "You're stressed; try to relax."
- "Maybe it's depression."
Those can all be part of the picture — but they are not the whole picture. A thoughtful men's health evaluation looks at:
- Symptoms (libido, erections, energy, mood, cognition, muscle strength, recovery)
- Morning testosterone levels, on more than one occasion
- Other hormones and contributors like sleep apnea, metabolic health, medications, and chronic illness
What Four Decades Have Taught Me
Here's what I've learned after decades of caring for men and their families:
- Men are often suffering in silence because they were never taught how to describe what's wrong.
- Many of the "normal" changes blamed on age are actually signs of treatable hormonal, metabolic, or cardiovascular issues.
- When we take men's symptoms seriously, do a proper workup, and create a personalized plan, their lives — and their relationships — can change dramatically.
Just like with women, my goal is not to "put everyone on hormones." My goal is to listen, investigate, and treat the root causes. Sometimes that means testosterone therapy with appropriate monitoring. Sometimes it means addressing sleep apnea, optimizing nutrition and exercise, reducing alcohol, or rethinking medications that suppress testosterone. Often, it's a combination of these — plus finally giving men the words and the permission to say, "Something isn't right, and I want to feel better."
From the 1980s to 2026, the tools have changed — lab testing, imaging, our understanding of hormones and cardiometabolic risk. The internet has changed. Our culture has shifted. But one thing has not changed: my commitment to caring for the whole person, and to helping men and the people who love them get the thoughtful, evidence-based, compassionate care they deserve.
If you're a man who feels more tired than you should, less motivated, less strong, less interested in intimacy, or just "off" — or if you love someone who is — this is your invitation to be heard.
Men's Health Month Special
Schedule a visit this month and receive:
- A personalized men's health and hormone consultation
- A B12 injection to support energy and metabolism
- Your choice of a TREVI supplement to support your next chapter in health
Because men deserve more than silence, jokes, and "you're fine." They deserve real answers — and a plan.
