A urologist proposes a new approach to treating aging in women.

In this follow-up to Ageless Man (2017), Debled theorizes that many of the negative symptoms that are associated with aging and menopause in women can be attributed to a decline in testosterone production. The book reviews clinical evidence for such a decrease in testosterone and other hormones, and it goes on to draw connections between lower hormone levels and symptoms generally associated with menopause and aging, including muscle loss, Type 2 diabetes, and cardiovascular disease. Debled discusses each symptom in detail and talks about how it may be the result of androgen deficiency. As the book addresses existing research, it also makes suggestions for new areas of study with a focus on androgenic hormones in women. Debled concludes that the aforementioned physical conditions, which he calls the “androgenic diseases of menopause,” can be best treated with mesterolone supplements, though he acknowledges that mesterolone is not approved for use in the United States. He also discusses ways in which standard hormone replacement therapy, with its focus on estrogen and progesterone, is harmful. Over the course of this book, Debled presents a thought-provoking interpretation of clinical evidence that runs counter to accepted scientific practice. However, he doesn’t make a convincing case for his fundamental upending of conventional wisdom. Readers who are inclined to treat women’s aging as a natural process are sure to find the author’s perspective challenging. Throughout, Debled treats the symptoms of aging as extremely negative (“If you are over forty, don’t you believe yourself to be sick?”). In particular, he presents them as distasteful from an aesthetic perspective; his descriptions of older women (“Old, frustrated obese women often deploy ingenuity and diet-program calculations, generally without result”) are extremely unflattering. In addition, the book’s description of women’s sex organs as their “male genitalia,” because they respond to androgens, isn’t linguistically or conceptually standard.

The goal of the author’s method of treatment is the elimination of aging (“mature human beings will no longer know the inexorable decrepitude that leads to death at around age eighty”). To that end, Debled generally does a good job of explaining physiology in chapters detailing conditions associated with getting older and how they may be connected to decreases in hormone production. In the book’s conclusion, he links his advocacy of mesterolone treatment to an episode in his past, when his approach to treating impotence resulted in the end of his teaching career and his establishment of a private clinic. The observations and recommendations in this book are based on the author’s work there, which includes the use of mesterolone. The book does include research citations, although readers should be advised that many of the papers are in French and refer to Debled’s own work. The book is enthusiastic about reevaluating the aging process, but it does not provide enough evidence to persuade readers to try the treatment that it endorses, which isn’t approved by U.S. government regulators.

An impassioned but unconvincing argument for a medical treatment.

A scholarly how-to guide targets men eager to impede “the shipwreck of old age.”

Firmly believing that sexual aging in men “should be a priority of public healthcare,” European urologist and gerontology expert Debled has crafted an exhaustive debut manual. It is geared toward educating readers in what he believes to be the proven methodologies and therapies in delaying and preventing the aging of the male body. He writes that beginning at age 40, a majority of men begin to develop disorders such as tiredness, depression, inexplicable weight gain, hypertension, cardiovascular problems, and sexual regression. Debled directly attributes these potentially serious conditions to a naturally occurring phenomenon called andropause, which causes a pathologic fall in the production of dihydrotestosterone, the hormone responsible for male sexual vitality and function. With a sense of urgency and backed by a wealth of supporting medical information, the author delivers his verdict that andropause, though largely unacknowledged, is responsible for sexual aging in men and a contributor to a host of other related diseases. As a chief researcher of this gerontological condition for many decades, Debled fortifies his book with pertinent clinical facts, background data, and professional opinions that provide a firm case for the use of the synthetic steroid mesterolone as a defense against the progressive, systemic deterioration of the aging male. Accessible explanatory opening chapters describe the role of testosterone (“the hormone of long life”) within the male body and the side effects of hormone deficiency–causing andropause as men typically approach their fourth decade. The author dutifully incorporates photographs, charts, medical illustrations, diagrams, and a great amount of historical and current statistical data to further reinforce his assessment that a consistent supply of free-flowing hormones is the key to healthy male longevity. “Causes of aging are the main source of discomfort,” he writes. “They must be the subject of special attention.” Debled repeatedly gives due consideration to his own urological medical practice, where he has been prescribing hormone replacement therapy to aging patients for decades and has seen great restorative success in their “physical, psychic, and sexual activity.” While eye-opening sections on the maladies older men face—including premature sexual aging and prostate cancer—are distressingly worrisome, the author vigorously promotes the use of revitalizing male hormone replacements and presents a firm, convincing argument for their clinical administration. Though clearly Debled’s primary focus is on the preservation of male vigor, his comprehensive book is not esoteric. Female readers may find some useful knowledge and food for thought buried within commentary on sustaining optimum health through the consistent monitoring of cholesterol, blood pressure, excess weight gain, and age-associated frailty. This kind of general medical information can serve as a universal reminder of the need for proactive health maintenance. Obviously, Debled’s prescription for restorative wellness is not the definitive answer to agelessness. But he offers illuminating advice and a surfeit of information that men of a certain age in particular should certainly appreciate and perhaps act on.

A practical, motivational compendium on aging healthfully, gracefully, and as slowly as possible.