April 21, 2011 | By Dr. Juan Gargiulo
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d2lkdGg6MTAwJTtoZWlnaHQ6YXV0bzt3aWR0aDphdXRvO3RyYW5zaXRpb246dHJhbnNmb3JtIDAuMjVzIGVhc2V9LnRiLWltYWdlIC50Yi1pbWFnZS1jYXB0aW9uLWZpdC10by1pbWFnZXtkaXNwbGF5OnRhYmxlfS50Yi1pbWFnZSAudGItaW1hZ2UtY2FwdGlvbi1maXQtdG8taW1hZ2UgLnRiLWltYWdlLWNhcHRpb257ZGlzcGxheTp0YWJsZS1jYXB0aW9uO2NhcHRpb24tc2lkZTpib3R0b219IH0g
You used to have lots of energy, looked forward to a tennis match, were able to concentrate and perform, and overall, looked and felt great, but with age, you noticed some of these things started to change. Could testosterone deficiency be playing a role in your performance? Menopause in women has been a long understood condition by both physicians and the general public for some time. On the contrary, a condition called andropause (male menopause) is commonly overlooked as a significant cause of many health problems that middle-aged men experience.
Medical research shows that there is approximately a 10 percent decline in testosterone levels every decade after the age of 30. The transition to andropause is subtle at first, making it different from menopause in women which has a sudden onset. Between the ages of 40 and 55, it is very common for men to experience symptoms consistent with a drop in hormone levels. At an optimal level, testosterone has the ability to: Increase bone density and formation, increase muscle strength and mass, enhance energy, as well as mood and sex drive, improve erectile function, and decrease body fat. It also has a positive effect on lowering LDL (bad cholesterol), increasing HDL (good cholesterol), lowering blood pressure, and creating a sense of well-being. Furthermore, optimal testosterone levels protect the brain against protein deposits that can lead to Alzheimer’s disease.
How to know if you are experiencing andropause?
Many conditions that we used to accept as symptoms of “normal aging” in men are really due to decreasing levels of testosterone. At 20 years, it’s common to feel invincible, and by the age of 30, most feel at their prime—but slowly, things start to change. Men report increased feelings of tiredness and a lack of energy. Consistent reports discuss the inability to obtain the same benefits from workouts that were previously achieved, whether it be for weight loss purposes or to gain muscle mass. Other complaints include difficulty concentrating, changes in mood and sexual dysfunction. Along with the tangible things men experience, detrimental changes in cholesterol, blood pressure and bone composition can also occur. The bottom line is, if you are experiencing several of these symptoms, you may be experiencing andropause.
What diagnostic tools and tests can you use to assess your current hormone levels?
A comprehensive physical history and examination by a physician who understands andropause is the first step. Blood tests are then done to determine current hormone levels and to assess any other risk factors for early markers of disease. Lastly, bone density, DXA body composition, flexibility/strength, and cognitive function tests should be completed to better understand the current state of the body.
Is it possible to raise testosterone levels naturally?
Yes, there are a few things men can do to increase testosterone levels. These include: interval training exercises to increase testosterone and growth hormone, weight loss, eating a low glycemic diet to lower insulin levels, reducing stress and limiting alcohol intake. However, testosterone supplementation is also available to achieve this goal.
Is it possible for testosterone supplementation to cause prostate cancer?
When men receive supplemental bio-identical testosterone treatment to help with andropause, a primary concern is prostate safety (cancer and benign growth). Clinical trials to date have shown no evidence of cancer-causing effects or abnormal prostate tissue growth with testosterone supplementation. Because middle-aged men are at a higher risk for prostate cancer overall, careful monitoring for prostate disease is considered mandatory with or without supplementation.
What choices of bio-identical testosterone supplementation are available on the market?
At this moment, it is important to clarify two points. First, it is not wise to undergo hormone replacement as it is not preferable to shut down the body’s own output. Therefore, testosterone should only be used to reach levels held in the prime years of a male. Secondly, testosterone therapy should not be used for the sole purpose of increasing muscle mass (body building), or enhancing sports performance. Using testosterone in the absence of low blood levels commonly found in men experiencing andropause, and not under a physicians care, is dangerous and illegal. It also has the ability to cause many unwanted side effects.
Bio-identical testosterone can be administered by injection or compounded by a certified pharmacy as a gel. Deciding the proper form will depend on patient preference and response to treatment. A male starting hormone therapy will require regular checkups with their physician, and blood tests should be done every two or three months at the beginning of treatment. Many of the symptoms associated with andropause will start to improve within a few weeks of treatment.
