A Decline in Testosterone
May Give Rise to Many Ills
January 17, 2008

What happened to our testosterone? Did the ballplayers siphon it off? Some theorize changes in the environment are responsible for the broad decline. A physician friend who works out regularly told me recently that he could really start to feel the effects of his age after he hit his 40s. The signs: Slower recovery from activity, less tolerance of long hours and less muscle flexibility.

Testosterone levels start to drop for most men in middle age. For those wanting to start their testosterone decline sooner than that, getting married may help.

Married men have lower testosterone levels than single guys. A recent study among the Ariaal people in Kenya showed that unmarried men had higher testosterone levels than men with a single wife. And men with two or more wives had even lower testosterone than those with one.

It's estimated that two million to four million American men have a significant testosterone deficiency and that less than 5% of them are getting treatment. That mirrors what I see in my own practice. Most men who might need treatment don't come in with any regularity. Overall, I'm probably not helping as many men with the problem as I need to.

Low testosterone may lead to loss of body hair, sleep disturbance, sweats, depression, impaired thinking, lower bone mass and strength, fatigue and weak bones. Some signs are more subtle. Decreases in sex drive, energy, motivation, initiative, aggressiveness and self-confidence are other signals. Testosterone levels can be measured with a blood test. It's best to have it done before 10 a..m. because levels fluctuate during the day.

I discovered one of my patients was low on testosterone after he fell during a minor mishap and unexpectedly broke his forearm. He turned out to have osteoporosis due to low testosterone. He developed type 2 diabetes around the same time. Adult onset diabetes in men is also associated with low testosterone.

Carrying extra weight around the middle and a drop in muscle mass were warning signals that became clear after the fact. Low testosterone levels are increasingly prevalent and often under diagnosed by the medical community. It's one of those chronic things that can drag on for years without much beyond vague symptoms that a guy might wonder about but not come in over. Doctors often overlook it because other important and more pressing health problems.

FORUM

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¹ How do you separate what's normal aging from a serious medical problem? And how bad would it have to be before you would bring it up with your doctor? Men, do you find it difficult to discuss "nonpressing" issues with your doctor? What about sex-related disorders like erectile dysfunction and lowered sex drive? Women, do you have a tough time convincing the men in your life to seek medical counsel? Share your views on the board.

• Low Testosterone and Men's Health, the Hormone Foundation³ (PDF)

• Testosterone Therapy: The answer for aging men?⁴ (Mayo Clinic)

Are you Testosterone Deficient??

Testosterone levels decline gradually and because it comes on slowly, men and women often accommodate to the symptoms and do not realize how much they have lost.

Questions to ask your-self:

• Do you tire more easily?
• Is it more difficult to get and stay in shape?
• Not getting the results from your exercise routine?
• Is there less desire to exercise and the time to recover after exercise is longer?
• Have you lost some of the zest for life?
• Is your body getting soft?
• Are you eating the same or less and putting on weight
• Have you lost some of your mental quickness and reaction time has slowed?
• Is the fire going out of your sex drive?

Testosterone is a principal androgen, or male sex hormone. Even though testosterone is a "male sex hormone," it's important to realize and understand the benefits for women. One of the group of compounds known as anabolic steroids, testosterone is secreted by the testes but is also synthesized in small quantities in the ovaries, cortices of the adrenal glands, and placenta, usually from cholesterol.

Testosterone begins to decline in men at about age 30 - 40. Low testosterone has a number of negative effects on mental, sexual and physical health. The most common type of treatment for testosterone deficiency is known as testosterone replacement therapy and it is prescribed to treat symptoms and problems associated with Hypogonadism - the medical term for low levels of natural testosterone and/or relative Andropause - the medical term for low –normal levels of natural testosterone.

Symptoms of Hypogonadism:

• Decreased mental sharpness
• Decreased energy and strength
• Decreased muscle and increased fat
• Decreased sex drive
• Decreased sensitivity to stimulation
• Decreased strength of orgasm
• Decreased erectile function
• Depression and/or loss of eagerness and enthusiasm
• Irritability (20-25% of men – heard of "grumpy old men")
• Increased risk of cancer (low testosterone levels increase risk)

Men who receive testosterone therapy consequently report that they feel sexier, stronger and healthier. They state that it makes them feel as they did when they were in their prime. After all, this is what replenishment of hormones is all about. It is about restoring hormones to youthful levels so you can feel as you did when you were at the peak of your physical, sexual and mental ability. Testosterone can stop and reverse the physical decline that robs men of their energy, strength and libido. Testosterone can restore muscle tone and improve stamina. Testosterone can restore healthy sexual excitement and desire, which in turn, results in an improvement in mood and overall well being.

Testosterone is responsible for the sex drive for both men and women. As testosterone diminishes with age, so does the sexual functioning in both men and women. Restoring testosterone to youthful levels in both men and women can reverse the situation. All too often, men and women automatically assume that as they age, their sexual capacity will diminish. There is no need to accept this loss of sexuality. Testosterone can play a critical role in helping to preserve and even restore sexual function so that we can live our extended life span with the same excitement and enthusiasm we enjoyed during our youth.

Effects of testosterone therapy

• SEXUAL POWER Increased sexual potency and frequency.
• CHOLESTEROL Lowers cholesterol levels.
• ENERGY Increased energy, stamina and endurance.
• MEMORY Improved mental functioning and ability.
• MOOD Improves mood and feeling of well-being.
• HEART Protects against heart disease.
• CONCENTRATION Improved concentration and focus.
• MUSCLE Increased muscle strength and mass.

Physicians are witnessing an explosion of interest in testosterone as a result of our growing realization that testosterone levels decline with age and that many men suffer serious consequences to their physical and mental health as a result. In women, it is expressed as Menopause, whereas, in men, it is expressed as Andropause. Many of these symptoms and disease processes that we come to accept as normal aging are processes that are actually secondary to low testosterone levels and are easily correctable.

Clearly, testosterone is shown to have a positive impact on our health and well being, our moods and our ability to learn and retain information. Testosterone is administered in the form of injections, transdermal gels and oral supplements. Testosterone patches are also available.

Testosterone cannot be used if one has prostate cancer. Testosterone has not been shown to cause prostate cancer, however, if one does have prostate cancer, testosterone may cause accelerated growth of this tumor. Prostate cancer is the most common cancer in men. It can be easily detected by an annual PSA test. In addition to testosterone supplementation, AAG Health recommends the daily use of Saw Palmetto, which is a medication to protect the prostate and prevent enlargement of the prostate due to formation of DHT. Most men develop prostate hypertrophy in their later years, and this can be effectively treated, in most cases, by the daily use of Saw Palmetto. and some prescribed drugs such as Propecia, Proscar and Avodart.

In men, Hypogonadism is a condition in which the testes produce a less than normal amount of testosterone, the male hormone. When too little testosterone is present, men tend to undergo a drop in sexual desire and performance. They may also experience depression, fatigue, loss of motivation and osteoporosis.

The size and strength of their muscles may diminish and their body hair may become sparse. These symptoms are not specific to testosterone deficiency, however, some men with Hypogonadism often don't recognize that they have a medical problem that is treatable.

Hypogonadism is a term medical professional’s use for this condition and you'll see why it is often overlooked. Women go through menopause when their production of female hormones drops off dramatically, usually during middle age and men go through Andropause when their production of the primary male sex hormone, Testosterone, declines gradually over the decades.

What is Andropause?

Andropause (male Menopause) are symptoms caused by declining hormones in men. Like the menopause in women, it is caused by a decline in hormones primarily testosterone, growth hormone and DHEA. Replacing these hormones to optimal levels can and will reverse the effects of Andropause.

Hormones start to decline in mid to late twenties and that is when the aging process sets in. We maintain fairly healthy hormone levels until age 35 to 40 and that is about how long we could be expected to live until about 100 years ago. The effects of declining hormones have only been a problem since we started living longer. Declining hormones, coupled with poor lifestyle, diet, exercise and high stress are largely responsible for health problems and frailties of later years.

It seems that men, after forty-five, often have a hard time rising to the occasion and dealing with the challenge of daily stresses. This is what is known as Andropause or male Menopause. So why do most men not know anything about Andropause? It has only been recently that Andropause has received attention and recognition, but why the holdup? There are many reasons behind the stifling of its discovery along with many frames of mind that are still hindering its cure.

Because female Menopause is so sudden and violent, ways to maneuver around its life altering effects and health diminishing aftermath have been under microscopic observation for decades. Doctors and scientists are well aware of the ramifications due to the absence of estrogen and progesterone. In the mean time men have kept their focus from themselves and their own hormonal induced weaknesses. Why?

• The fact that it comes on so gradual, many men accommodate to the change.



• Ignorance. Men do not talk or complain since it is not the "manly thing to do". Boys learn form their fathers to rise above their afflictions and never give the slightest indication of weakness. Our men patients here at the clinic talk openly about their needs. But each of them would also admit that they had difficulty making that first call and that they still can not admit or talk to their friends about their hormone replacement.



• Male pride is often a man's greatest strength and his greatest weakness.

The truth is, men are blasted with a reality check during their mid-forties. Their hormone levels have dropped sufficiently that the erection that once greeted them in the morning ceases while their muscle definition fades and they notice they are getting a bit flabby around the middle. "It's all part of aging," they are told and they settle grudgingly into old age.

That is the past. The present and future is bright. There is a solution, there is a cure, and that is to replace lost hormones.

• Testosterone, Growth Hormone and DHEA start to decline in mid to late twenties. That is when the aging process begins in earnest.
• Decreased hormone levels are not "normal for your age" (a phrase used by doctors who do not know how to treat it).
• Hypogonadism and Andropause is a health problem that requires treatment.
• Medical science has known it is possible to regain youth by replacing hormones since the early 1990’s.
• Hormones do not decline because we age – we age because hormones decline.
• There is a simple and effective treatment – replace hormones like testosterone, DHEA and/or Growth Hormone to optimal levels.