Dear Dr. G,

I am a man in my mid-forties and while balancing my career and family time is always difficult, I manage it and I am mostly content with my life – except for two issues.

Firstly, my sexual appetite has been diminishing since my late 30s. My wife says that it is normal as we are raising two teenagers and as such have no time and energy for ourselves. Also, my wife and I have sex once every few months, and my friends tell me it is abnormal.

Secondly something that is not making me feel so sexy about myself is my balding head, and I have read that male pattern baldness is characteristic of a virile man with high levels of testosterone. Isn’t that why Bruce Willis is perceived to be more masculine with a thinning scalp?

Therefore, I would Dr. G on the spot by asking if there is a link between hairlessness and virility. Is my declining sex life a symptom if an illness, and is this a reflection of a poor level of testosterone?

Also, would the use of hair loss products enhance or reduce my sexual appetite?

Hairless Harry

A close correlation between testosterone and male pattern baldness has been postulated for centuries. In fact, such a link had already been documented in the era of Hippocrates and Aristotle.

In the modern era, the first scientific evidence of the influence of testosterone on hair is studied by Hamilton from Yale in the 1960’s in a study of 21 boys castrated for behavioural and mental problems.

The study – which continued until the boys were 18 – found that the castrated subjects had no endogenous testosterone and also had no signs of developing male pattern baldness in adulthood while the men with normal testicular functions tend to be more likely to have receding hair loss.

With that said, the association of hair loss with male hormone harbours a great deal more complexity than previously speculated.

The mere level of the male hormones does not determine hair loss, but testosterone is converted into a more active substance, dihydrotestosterone (DHT) that is more important in sexual desire and hair growth.

The active component of this metabolite is also believed to shrink the hair follicles in the scalp, stopping further growth and resulting in male pattern baldness.

Additionally, a man’s degree of baldness is clearly not just determined by testosterone as it is also controlled by the genetic make-up of the man and their susceptibility to enzyme conversion.

Similarly, the libido of a man is not simply controlled by testosterone. Other factors play important roles may include cultural upbringing, attitude towards sex and overall state of health. As for hair loss products, the use of medications like Finasteride is well recognized in reversing male pattern baldness.

The mechanism of action for such drugs is to inhibit the conversion of testosterone to DHT, and as such it is not just useful in stopping the shrinkage of shrinking of hair follicles in the scalp; it is also widely used to prevent the progression of prostate enlargement.

Although the medication is useful in the treatment of prostatic aging process and hair loss, the side effects of diminished libido and erectile dysfunction is also well documented.

The American actor and producer Bruce Willis is widely regarded as an action hero after his portrayal of John McClane in the Die Hard franchise.

Of course, Willis is also well recognized, having a receding hairline from his moonlighting days to complete baldness as his career progressed.

Willis once admitted that “hair loss is God’s way of telling me I am human”. In reality, male pattern baldness is a general progression of male aging. It is a biological process that is influenced by multifactorial parameters, rather than a surrogate market of male virility.

Similarly, sexual desire and libido is also a variable between men, influenced by the state of mind and state of health. Many men facing dwindling sex life, with or without hair, often put Dr. G on the spot for answers to revive their “action hero” bedroom days.

His response is that “hair loss and libido loss is God’s way of telling you are human, therefore do whatever is humanly necessary to be healthy and relive the action days!”

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