To prepare, I was working between six and 10 hours every day for five months. From there I went straight into rehearsal for six weeks with Patrice Chéreau. As if that wasn't enough, immediately afterwards Placido Domingo had taken me to sing my first Otello in America. I think I was home for four days in 13-and-a-half months. Afterwards, I went back to La Scala to do it all over again.
It was, to say the least, a hectic schedule. So when I began to feel a bit tired I just put it down to work. As 2008 turned to 2009 it only got worse. Early on in the year, I developed pleurisy and pneumonia. I took three weeks off, which is not long enough, really, to recover from something like that, but I was singing roles that very few people can do and I don't have a reputation for cancelling. I just keep going.
Eventually, when the exhaustion didn't go away, my wife said I should go back to the doctor. I had come home for a few days and, instead of doing all my usual work around the house, I was sitting around watching TV. The thing is, I tend to be very in tune with my body. If I'm coming down with a cold, it shows in my voice. Everyone imagines opera singers are these obese blobs who can't move – but, of course, there are very few people like that these days. I'm a physical performer, so on a cardio-vascular level, I'm quite fit.
I went to the doctor, expecting him to tell me I was run down. I thought he would tell me to take some iron pills and that I'd be fine. And initially, it looked like I might be right. We ran some tests and everything was coming back in good order. Because of the pleurisy and the pneumonia, I went to a respiratory specialist, too. That's when they discovered the nodule in my left lung, 4mm in size. No-one knew what it was. It could have been scar tissue from the pleurisy, but it could have been something else. All the doctors could do was to leave it and see if it grew over the next three months. If it didn't it wasn't malignant. If it did, well, then we'd have to deal with it.
From that point on, I was in and out of doctors' surgeries. One day, I saw four different specialists and then went to the GP. They discovered that my body was lacking in certain hormones. The endocrinologist ruled out diabetes and it began to look quite serious. He said my testosterone levels were very low and that, as result, he would expect the chemicals from the pituitary gland to be high, but that in fact they were very low as well. Of course, I immediately started thinking of brain tumours and so on. So there I was, still waiting to find out if I had lung cancer, faced with the possibility that I had something wrong with my brain.
Yet, despite all of this, I surprised myself. I was so calm about the whole thing. I had lost two of my closest friends to cancer. I thought about them; about how pragmatic they had been and it reminded me that I had no control over life and death. Then, just before Christmas, the results of my MRI scan came back. I had no lesions; the brain was completely clear. It was a great Christmas present.
It was then that they first suggested male menopause – andropause, they call it. To be honest, I'd never even heard of it, aside from catching the odd joke about it a couple of times.
They asked if my libido had lowered; I had just put that down to being tired. My GP explained that it was a relatively new thing, often unrecognised. A lot of people experience the symptoms, but just put it down to the stress of their job or to the fact that they're just tired or not sleeping well. With women, doctors are often reluctant to offer any kind of treatment, as it were, but for me they prescribed some testosterone patches. They last for 24 hours, releasing small amounts of hormones through the skin. Just a month after I started using them, I was feeling back to normal.
I don't know how long I'll be applying the patches for. It may well be for the rest of my life. I know there are other options – an injection lasts a number of months – but again I'm not sure how good that would be.
Sometimes the patches can be an inconvenience – on stage, what with the heavy costumes and hot lights – they don't tend to stick very well. So it all takes some getting used to.
I don't have the time in my life to experiment and leave the patch off, because I don't want to be in a situation where I lose the energy all over again. When you sing, there's a responsibility; I'm one of three or four people in the world that can sing certain roles, so if an opera house hires me, I can't pull out. The problem is that there are still doctors out there who say male menopause doesn't exist. But I think I've proved it does.
At the end of the day, thanks to the patches, I'm fit and well and my energy levels are as good as three or four years ago. I've been singing another very heavy, difficult role – the title role in Tannhäuser by Wagner – and I've done three shows in six days and there are more to come.
I don't feel tired at all; I feel absolutely fine. I sleep well and every day I'm refreshed and ready to go. If anything, I'm working harder now than I've ever worked in my life.
Since I began to talk about it, I've heard of so many similar cases. I've found that people are really interested in the subject. I've had people who are around about my age (I'm 52) – friends of mine – who have actually rung up and said: "Wow, I've heard you're doing this. What exactly were you feeling? Can you tell me about it?" I've had more than 40 emails from people I've never met. Some ask questions, others write to say thank you. They were feeling the same – or similar – and went to the doctor. Now the quality of their lives have improved as a result. That's why I talk about it. I thought that, actually, if I only received one email, from one person, saying thank you for doing this, then it would be worth it. If you look at the really dark potential of this, I could have been developing adenomas or whatever in the brain and not known about it. If somebody is experiencing the symptoms I did, I would urge them to make time for the doctor. You can take a morning off work; go to your GP; it could very easily change your life.
Interview by Alice-Azania Jarvis
Is it the andropause?
* The existence of "male menopause" or andropause has been a controversial subject for some time.
* In June last year – shortly after a rival study argued the opposite – a team of British scientists claimed to have definitively identified the condition. Published in the New England Journal of Medicine, the results made headlines around the world.
* Symptoms of andropause are thought to include fatigue and a lack of energy, declining sex drive, inability to concentrate, forgetfulness, irritability, depression, weight gain and sleep problems.
* Those diagnosed by their GPs are likely to be advised on certain lifestyle changes, including healthier eating, regular exercise and finding ways to reduce stress. As well as these adjustments, Testosterone Replacement Therapy (TRT) may be prescribed, administered in the form of tablets, injections, gel or patches while blood levels are closely monitored.
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