It is the first day of February and I am rather surprised that I am still sticking to my New Year resolution to shed some fat. I confess, in my previous weight loss attempts I really did not last more than a fortnight. Many friends ask me for my secret, as they witness the disappearance of my “beer belly” (truthfully, I am also in disbelief). One effort I am trying differently, to overcome the boredom of a treadmill this year, is watching the DVDs that I was meant to watch while working-out. Somehow, the sweats will effortlessly evaporate.

I was fixated on one movie, A Good Day to Die Hard. OK, OK, I hear you, the movie was released in 2013, and I’m trying to keep up with my backlog of films. But it was still a classic Willis. Believe it or not it has been 27 Years since McLane, the original action hero, was introduced to our lives in the first Die Hard movie. Five installments of the series later, my idol Bruce still has the magic at the grand age of 59 years old. So, what is the real secret of this hard man?

For those of us born in the sixties and lived through the eighties, Bruce Willis started his silver-screen success in a small screen playing private detective, David Addison, in Moonlighting. The irony is, Willis was less of a hard man when he had a scalp full of luscious hair.

Don’t get me wrong. I like the man. The man who once said: “Fifty is the new forty. I always thought my best work would come in the year forty to sixty, if I was fortunate to hang around and it is hard to stick around” certainly gets me excited to advance to my fifth decade of life.

So, why is Willis perceived to be more masculine with thinning scalp? Is it true that testosterone increases sex drive at the expense of the thinning head? With such a conundrum in mind; let’s unravel the mystery of the correlation between male pattern baldness and masculinity.

 

Dear Dr. G,

I am 46 and have a life I always dreamed of.

I have a beautiful wife who was also a childhood sweetheart. We have two amazing teenage kids who are doing well.

You may say I should be contented with life. Well, I am. Except for my sex-life.

I describe myself as someone normal. I am focused on my career and role as a Dad.

Since the late thirties, I noticed that my sexual appetite has been diminishing.

Although sexual relations used to be an important part of our relationship; lately, the intimacy is no longer on our list of priorities of life. At least not mine, as we never discussed such matters openly.

My wife and I have sexual contact once every few months, and my friends tell me it is abnormal. Do you think this is uncharacteristic of a man in in his mid forties?

Can you tell me what is the frequency of intimacy that is considered normal at my age?

Is my declining sex life a symptom of an illness? Is this a reflection of poor level of testosterone? I have had male pattern baldness since 38 years old.

Isn’t that a symbol of my virility?I value your opinion.

PC

 

It is true that testosterone levels are closely linked to male pattern baldness. In fact, such correlation had already been documented in the era of Hippocrates and Aristotle. In reality, the association of hair loss with male hormone harbors a great deal more complexity than previous speculated.

The first scientific evident of the impact of testosterone on hair is studied by Hamilton from Yale in 1960’s. Shockingly, the investigation was based on a report of study of 21 boys castrated for the behavioral and mental problems. Let us be thankful we live in a more enlightened time and such “therapy” is no longer applicable. In fact, it is really unthinkable to imagine such intervention was acceptable just four decades ago.

In Hamilton’s surveillance of the boys up to 18 years, the castrated subjects with no endogenous testosterone had no signs of developing male pattern baldness as they aged. On the contrary, the other men with normal testicular functions tend to be more likely to have receding hair loss.

In reality, it is not just the level of the male hormones that resulted in the hair loss, but the mere presence of testosterone allows its conversion into a more active substance, dihydrotestosterone. The active component of this metabolite is believed to shrink the hair follicles in the scalp, prohibit further growth and resulting in baldness. Such mechanism is reversed when men are treated with finasteride, which is used to reverse the process of hair loss.

The degree of baldness is not just determined by testosterone, it is also controlled by the genetic composition of the men and their susceptibility to the enzyme conversion. Hence, the early male pattern hair loss is not a reflection of masculinity (Unless you are Bruce Willis, I guess)

The libido of a man is not simply controlled by testosterone. Other factors that play important roles may include cultural upbringing and attitude towards sex. Many studies had been carried out to outline the frequency of sexual activities amongst couples in different countries. Such statistics are only observations of a small minority of the population, and hardly a reflection of norm. Therefore, statistics such as forty-year-old Malaysian men engaged in sex six times a month, is hardly helpful for most couples. (Besides, most men would probably lie about their frequency of sexual encounters, anyway)

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 (Although, some Willis inspired men, may lead you to believed) “Hair loss is God’s way of telling me I am human,” the bald action superhero once admitted. Along the similar line, sexual desire and libido is also humanly variable between men. Therefore, individual couples and their way of lives can only determine what is considered normal!

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