A 55 years old male complains to his Doctor:
“My sex drive is down, my muscles are shrinking, my belly is growing, my overall energy level is low and on top of that I am feeling moody and with hot flashes. Am I going through menopause?”
The answer he will probably get is
“No, but you might be going through Andropause”
Andropause, also known as male menopause, hypogonadism or Low T (for low testosterone), is the male equivalent to menopause and shares a lot of its symptoms and discomforts.
After the age of 40, production of the male sex hormone, testosterone, starts to drop by approximately 1% or more per year. This decline can be accelerated by factors like obesity, diabetes, lack of physical activity, stress, some medications, poor nutrition, etc. At some point, which varies among individuals, symptoms start to arise. Andropause is a set of symptoms and signs caused by abnormally low levels of testosterone.
But, how does somebody know when to ask his doctor and seek treatment? An easy way to remember is by understanding what functions testosterone is responsible of.
Contrary to what is promoted by some, elevating the testosterone level above normal will not turn you into a sex-machine. In fact, could have harmful effects…
a) Sex drive. Testosterone is one of the many factors that increase libido. Men with low levels of testosterone or who have been castrated show low sexual interest. This is, therefore, a common symptom in men who are undergoing andropause. Once testosterone levels are back to normal a significant improvement in libido is seen. Contrary to what is promoted by some, elevating the testosterone level above normal will not turn you into a sex-machine. In fact, could have harmful effects.
b) Erection. Are you familiar with the morning spontaneous erections that most men experience? They are caused by a normal pick in testosterone production that happens in the first hours of the morning. Testosterone is essential for a normal erection to happen and its decline usually results in erectile dysfunction. However, having erectile dysfunction (ED) doesn’t necessarily mean that testosterone is low, there are many causes of ED and low testosterone is not a frequent one. Bringing the levels of testosterone back to normal may improve ED only if its deficit is part of the problem, and as mentioned before, higher than normal levels of testosterone aren’t associated with abnormally powerful erections. Sorry.
Testosterone is a naturally produced anabolic steroid. Does the term sound familiar?…
c) Muscle mass build-up. Testosterone is a naturally produced anabolic steroid. Does the term sound familiar? Exactly, the substances used by athletes, bodybuilders, wrestlers, etc., to get bigger, stronger and faster are anabolic steroids. Anabolism is the part of our metabolism that “builds and repairs” and it’s controlled by hormones some of which are steroids like testosterone, while others are proteins like growth hormone. The difference in muscle mass between men and women is mainly because men produce between 5 and 10 times more testosterone than women. Once testosterone levels start to drop, men begin to lose muscle mass and find it increasingly difficult to gain it back through exercise. Muscle strength also decreases, not only due to mass loss but also due to a decrease in the muscle cell contractility. Replacing testosterone can slow this process (called sarcopenia), and help men maintain quality of life and capacities, being nowadays an important pillar of the so-called anti-aging movement. However, testosterone is a controlled substance for a good reason and must be prescribed by your physician based on sound medical criteria. The abuse of testosterone usually comes with serious heart and liver side effects that can shorten the life expectancy of the user. Don’t believe me? Look at the life expectancy of pro-wrestlers.
d) Body Fat: Testosterone blocks the storage of fat and increases its use as a source of energy, therefore “burning it”. Low testosterone can contribute to an elevated body fat content, which in turn is problematic for testosterone production.
e) Bone density: Testosterone is in part responsible for maintaining bone density in men. Low testosterone is associated with osteopenia and osteoporosis, making men susceptible to fractures. Replacing testosterone improves this condition.
f) Brain and behavior. Testosterone has an apparent effect on memory recall, aggression, dominant behavior, and self-esteem. Andropause courses with depressed mood, lack of energy and motivation and in general a lower sensation of well-being not otherwise explained by external factors.
Treatment of Andropause
So, we have established that Andropause does exist and can be very problematic. Now, what to do? And just as important, what NOT to do?
The very first step is to determine whether low testosterone is the cause of your symptoms. Unlike women, men can live to an advanced age without experiencing a significant decrease in their sexual hormones. The normal level of testosterone fluctuates during the day, it goes from 300 to 900 ng/dL and the right time of the day to measure it is between 7 AM and 11 AM. During the afternoon and night hours, our testosterone levels are naturally low.
So, let’s say you are found to have low T, now what? Testosterone is a controlled substance in the USA, and it’s so for one reason, potential for abuse. Not because it will create addiction, but because traditionally it has been misused with terrible consequences.
Like every hormone, testosterone is beneficial only if you achieve normal blood levels. If you go too high, the potential for side effects, like heart problems, is higher, if you go too low you are wasting your money.
Every man will require a different dose to achieve normal levels, so measuring the blood level after therapy has started and adjust the dose based on results is the recommended method.
Now, what not to do. You know that guy at the gym who looks like an ice cream cone with a huge back and arms and tiny legs? Please don’t take health advice from him and by all means, don’t take or buy “prescriptions” from him!
You know the guy on TV selling miracle pills imported from an exotic place that supposedly cleans your liver, cures diabetes and hypertension, stops hair lose, relieves stress and will make you taller and handsome? That is not the solution either.
Testosterone replacement can help, just don’t get it from the guy in the gym or on the midnight infomercial…
Talk to your doctor, have your testosterone measured and start a controlled, well-managed treatment.
You might not even need to be medicated. Lifestyle, stress, lack of sleep, lack of exercise, etc., might be the cause of your low testosterone level and improving these issues will take care of more than one problem.
Participating in a clinical trial is another way to be diagnosed and potentially being treated without spending money. Trials offer a structured and carefully designed protocol to make sure your need for the medication is carefully determined and that you are not prone to be harmed by it.
Clinical trials are the way we learn about medications and are conducted with the help and participation of patients who need treatment and who provide important feedback on the safety and efficacy of the medication being studied. In exchange, patients receive treatment (or sometimes placebo) and all study evaluations at no cost. Almost always monetary compensation for their time is provided as well. If you want to learn more click here for more information.