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Let's study emasculation. No, we don't mean the loss of political power. That's a metaphorical sense. We mean the real thing: the removal or chemical destruction of a man's testes. And here we refer not to the manufacturing of courtiers in Constantinople, nor to the construction of a caste of opera singers, but to modern day emasculations.
Although to many people castration signifies a barbarism that disappeared with the demise of the Ottoman empire, the Chinese dynasties, and the castrati movement in European music, there are surely more men living with removed or functionally arrested testes today than at any other time in history. A minority either identify as women and have sex reassignment surgery or sought castration simply to suppress their libidos. 1 2 By far the majority, though, are prostate cancer patients, and it's this group that we focus on here.
Chemically shutting down or surgically removing the main source of testosterone-the testes-can slow the spread of prostate cancer. Castration, of course, has extensive side effects. 3 A castrated adult male will lose muscle but gain fat. 4 He can expect hot flushes like those that women have at menopause. 5 He will lose body hair, and his penis will shrink. Erections will be rare and weak, if they occur at all. 3 He will be sterile.
Castrated men also often experience changes in cognitive function and affect, although the nature of those changes is poorly understood. Recent reviews of the topic have yielded contradictory results. 6 7 8 9 10 11
Right now, in North America, as many as 600000 patients with prostate cancer are coping with the effects of medical emasculation. 12 But unless such a man tells you what has happened to him, his physical and mental changes may not be apparent to you.
Most of those patients are on a short term course of androgen suppressing drugs and believe that their testosterone titres will recover once they stop taking the drugs. However, the longer they are taking these compounds, the longer it takes for their testes to recover; and even with short term use the effects are not always completely reversible. 13
Inaccurate, antiquated, and negative stereotypes of castrated...