Does your husband suddenly have embarrassing problems in the bedroom?

Of all the things that can send your husband into a quiet, blind panic, few work faster than the discovery that things are no longer functioning for him in the bedroom. It tends to be taken as a quiet humiliation and something to be sorted out discreetly and never discussed.

What many men fail to realise is that it can be something else altogether: a warning.

The arteries that feed the penis are tiny things, far narrower than the ones supplying the heart. So, when the furring and stiffening that leads to heart disease first takes hold, this is very often where the earliest sign appears, sometimes years before a man notices so much as a flutter in his chest.

And the thing that concerns me is how many men answer this alarm bell by ordering themselves a discreet packet of little blue pills and carrying on as though nothing has happened.

When the body starts to stumble in middle age, the temptation is to reach for the simplest explanation. And these days that explanation has a name, and a flourishing industry standing right behind it: the andropause.

Midlife men experience a long, gentle slope of hormonal change as testosterone falls around half a per cent a year – which can slip by unnoticed.

The symptoms – irritability, low mood, lethargy, a vanishing libido and a slow retreat from the world – are so easily mistaken for character or dismissed as an inevitable part of getting older. The andropause is a contested diagnosis (it’s not formally recognised) and testosterone replacement is not something to wade into without proper medical guidance, though for some men it lifts their mood and returns a little energy.

Even so, I now routinely check testosterone in men who have changed in ways no one can explain. Usually, these men are dragged in by their wives, who tell me their husband has become a diminished version of the man they married.

A body that has gone quiet in the bedroom is usually trying to tell its owner something, says Dr Max

And sometimes, not always but often enough, hormones turn out to be part of the explanation.

But this is where I would advise caution. Whole businesses now exist to tell men that a daily gel or a monthly jab will hand them back their 20s. An online clinic, a quick questionnaire, a credit card, and the prescription is in the post.

Testosterone has somehow become the answer to everything – tiredness, feeling gloomy, a thickening waist or a flagging sex life.

The problem is that a low reading on a blood test is common as men get older, and most of the time it’s a result of something else. Too much weight, too much drink, broken sleep, sleep apnoea, depression, type 2 diabetes – all of these drag testosterone down.

Smearing on a gel may fix the initial problem, but it means you’re not going anywhere near the foundational issues. And my concern is that the symptom is rarely the thing that needs solving. It is what the symptom is pointing to that matters.

Some men shrug and put it all down to age. Others reach for the testosterone and assume that settles it. Both have missed the thing that counts.

For some men, low testosterone is part of the picture, and careful, well-supervised treatment helps.

But a body that has gone quiet in the bedroom is usually trying to tell its owner something, and the sensible response is to listen and get properly checked, not shrug and ignore it.

So, when a woman sits in front of me worried about her husband’s mood, I do not assume he is simply being difficult.

But neither do I assume it is one neat hormonal problem with one neat hormonal solution. Sometimes it is his mood. Sometimes it is the drink. Sometimes it is the first faint sign of a heart in trouble.

The job is to look properly, not to grab the easy answer. Because the easy answer, far more often than not, is the wrong one.

Within six months every NHS trust must put its leaders through training on combating anti-Semitism. I cannot decide which depresses me more – that we need this, or the fear that doing a little e-learning will not change a thing. 

Hannah’s dishy doctor 

Hannah Waddingham appeared on the red carpet, glowing at the Variety Power of Women event, and she wasn’t alone. Stood next to her was the new man in her life, Nick Beresford-Cleary. He is, as it happens, a consultant spine surgeon. The Ted Lasso star, 51, has gone and fallen for a doctor. Speaking as one, I’d like to offer her free advice on what she has let herself in for.

Nick Beresford-Cleary and Hannah Waddingham at Variety 2026 Power of Women London

The good news first. A doctor is the one person at the dinner party who doesn’t flap when a guest keels over into the trifle. But now for the not so good news. The hours are merciless: nights, weekends, on-call, the phone going off halfway through dinner. Years of breaking terrible news can leave a person oddly hard to reach once the front door closes. Then there is the ego. Spend long enough as the one everyone turns to in a crisis and a conviction that you are always right tends to set in.

I speak, I’m sorry to say, from experience. But Hannah seems happy and that’s what counts. Happiness, as all doctors know, is the best medicine.

There is one line in the coverage of the Henry Nowak case that I have not been able to shake. Vickrum Digwa, 23, was jailed for life last week for stabbing Henry, an 18-year-old student, to death. The killer’s mother, Kiran Kaur, hid the knife at her son’s request, and has now been convicted of assisting an offender. And the killer’s grandmother, speaking to this paper in the mother’s defence, said she had only done what any mother would have done. 

No. A decent mother would have taken her son by the collar to the nearest police station and forced him to face up to what he had done. It is that unspoken sense that the rules bend for our family that breeds children who grow up certain they can do anything and answer for none of it. Good parents teach their children that actions have consequences. A young man is dead. His mother is grieving a son who is never coming home and she is the only mother in this story who deserves our sympathy. 

Dr Max prescribes… joining a choir

If I could hand out a single prescription for the low, the lonely and the frazzled, it might be this. Find a local choir and sing. Singing alongside other people floods the brain with feel-good chemicals, it slows and steadies the breath in a way that settles the whole nervous system, and it drops you into a room full of strangers all reaching for the same note at the same moment. Studies tie it to reduced stress, brighter spirits and a deep sense of belonging, the very thing we need in our pandemic of modern loneliness. You don’t need to have a particular talent. You simply turn up and open your mouth.