Richmond Times-Dispatch

Dr. Keith Roach

- — North America Syndicate Inc. Send questions to Dr. Roach at ToYourGood­Health@ med.cornell.edu

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 beenmarrie­d for 17 years, and I had never seen this type of behavior from him.

Later, I learned fromone 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 hasmoved 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.

DearD.B.: I amvery sorry to hear about how your husband treated you.

When a doctor prescribes testostero­ne appropriat­ely for aman, it is because his testostero­ne level is low and causing symptoms. This can include fatigue, lowmusclem­ass, loss of body hair and sexual problems, such as loss of libido or erectile dysfunctio­n. Thegoal 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, 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, 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.

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