Main course: this is easy ground as most restaurants will serve grilled fish or steak. But if this becomes monotonous select from other dishes carefully, choosing lean meat or fish dishes first or salads with cold meats that do not include sausage. Of course, nothing fried. Enjoy all the vegetables that are in season unless they are fried or come under a sauce. No French fries but a small portion of boiled potatoes is fine, or one small baked potato.

Beware of selecting pies or casseroles because of their fatty meat content and the flour that will have been used for thickening the sauces.

Sweet: skip icecream and puddings. If you must have something sweet choose a piece of fresh fruit or fresh fruit salad (no cream). Unless you are on a strict diet a small piece of cheese with a couple of crackers is a good substitute.

Alcohol: should be kept down to a minimum. Perhaps a vodka with soda water not tonic before the meal and only a glass of white wine to follow. To quench the thirst and keep the consumption of wine to a minimum also drink mineral water.

*161/153/1*

Independent health screening centres to carry out check-ups are being established in a number of major cities by medical groups — in London one run by the British United Provident Association is known internationally — but if he wishes any doctor can instigate the most essential tests himself and so keep costs down. (Medical centres are expensive. Fortunate are those valued executives working for far-sighted companies who are sent to these centres as a matter of policy and insurance.) The comprehensive tests cover problems peculiar to men in this age group and are designed to show up hidden troubles should they exist. As a matter of survival as much as for peace of mind, every man after forty whether he is in the grip of M-M or not, should have himself checked.

After discussing the patient’s medical history and lifestyle the first tests invariably concern the heart. A doctor listens to the beat, checks the pulse and takes a reading of the blood pressure. If there is anything unusual he may recommend a visit to a heart specialist for an electrocardiogram reading to check where the abnormality exists. At medical centres electrocardiogram readings are taken as a matter of course.

If there is a blood pressure problem tablets are prescribed to bring the reading to an acceptable level. Many men are recommended low-fat or low-salt diets.

*126/153/1*

While some dash about rampant, sex on the brain, an erection ready at a moment’s notice, an equal number enter a No-Go limbo where the male-menopause brings their sexlife to a halt, the penis flaccid. It is the start of sexual trauma. Without appreciating what is happening to them they discover their sex drive has been curbed and they go into deep decline, each man terrified that his penis no longer works. Why?

For no other reason than the fact that the unwanted mixture of depression, anxiety and fatigue that makes up the M-M crisis has created in them a despair far outweighing anything ever before experienced and debilitated both mind and body. Sexlife stops. The one activity that is recognized as being most conducive to relaxation and the perfect antidote to depression is the one activity their mind rejects. When the world appears to be on the verge of collapse, with his emotions in turmoil how can a man think of sex? Many cannot.

*89/153/1*

In keeping up, others involve themselves in their son’s activities as diverse as going camping with the gang or taking up pot-holing or canoeing. For many this is a great pleasure especially if father and son are close and have enjoyed a sporting kindredship since the boy’s childhood. However a number of fathers find that it is only when nearing forty that fitness and sport become important and many sons at this point resent what they see as their fathers’ intrusion into their lives.

And while they may admire the son’s effortless ability to have a life full of fun, a number will desperately demand acknowledgement from the son for the great generosity they are bestowing on him. (This is not a reaction exclusive to menopausal men.) As a result some are unnecessarily strict with the son. Family disagreements can be vociferous especially if there are younger children within the family to be compared with, children who because of their age are more docile and stay-at-home. This can be a trying time until the M-M father accepts his son’s youthful need for adventure, experiment and independence.

*53/153/1*

It is not unknown however for some doctors in the United States to prescribe hormone injections as the antidote to M-M especially if their patients lay the blame for their current problems on a lack of sex drive or poor erection. But this is increasingly being regarded as wasteful treatment unless it has first been established decisively by clinical tests that hormone imbalance exists. If, as is most likely, the man’s production of testosterone is normal, hormone injections are wasteful, and expensive. Many therapists make the charge that these doctors prescribe injections (where imbalance is not proved) because it is easier to apply a syringe than attempt by understanding and consultation to get a man through his menopause by bolstering or supporting his sagging emotional system. Injections they say do no more to cure the man than do the hundreds of Valium tablets supplied by other doctors.

Hormone injections however do have their uses and often a sexually active man in his sixties finds they boost his sexual energy effectively. These hormone injections also form part of geriatric therapy.

*16/153/1*