DEAR DR. ROACH: After five years, I still have questions after my husband (at the time) started getting more and more critical, until culminating in a few weeks where he started ranting, calling me profane names and leaving me emotionally depleted and confused. We had been married for 17 years, and I had never seen this type of behavior from him. Later, I learned from one of his former friends he was ordering testosterone online and injecting it.
At the time, I noticed many “men’s clinics” in my town featuring testosterone, although now it seems the push has moved to online advertisements for erectile dysfunction, with all sorts of good side effects implied.
With some counseling, I learned I had PTSD, and then worked with a PTSD counselor, only realizing later that during his rants I was afraid he might try to kill me.
Do men who inject testosterone remember the things they did and said during these rants? I don’t seem to be able to find someone who has developed expertise in the area of how testosterone injections affect men, and thereby, how their behavior affects the mental health of people who have had to rebuild their lives after the experience. — D.B.
ANSWER: I am very sorry to hear about how your husband treated you.
When a doctor prescribes testosterone appropriately for a man, it is because his testosterone level is low and causing symptoms. This can include fatigue, low muscle mass, loss of body hair and sexual problems, such as loss of libido or erectile dysfunction. The goal is to return the testosterone level to the normal range and relieve symptoms. When used properly, the risk of psychological adverse effects is minimal.
When anabolic steroids like testosterone are used recreationally, especially by bodybuilders or other athletes, the doses used are much higher than replacement doses. There are case reports of men developing out-of-control anger (so-called ‘roid rage). This appears to be a rare or at least unusual complication of anabolic steroid use, and there is speculation that men who are going to abuse testosteronelike steroids already are more likely to have preexisting psychiatric diagnoses.
Since there is not a lot of well-done studies on the phenomenon of steroid rage, and some of it is contradictory, I’m not able to answer your questions directly, but extrapolating from other psychiatric conditions, I think it very likely that the person recalls what they did and said during the events, although they may have difficultly admitting it. I also suspect that the experience of mental health professionals who have helped women and men deal with the psychological aftermath of abuse would be able to help a person in your situation.
DR. ROACH WRITES: A recent column from a writer (“L.L.B.”) with an inability to urinate despite a large amount of urine in the bladder led me to suggest additional testing to find the underlying cause. He wrote back and unfortunately was found to have bladder cancer. He has gotten some radiation treatment and may get chemo as well. He said, “If I do go down, I will go down fighting.” I admire his attitude and wish him the best in fighting bladder cancer.
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Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu or send mail to 628 Virginia Dr., Orlando, FL 32803.
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