There has been a lot of buzz about women’s hormones, but you hear very little about men. To make it worse, men do not seek or share this information as women do. How many men do you know who go out for coffee with their buddies and talk about their hormones? Few people appreciate the pervasive effects of testosterone on men’s general health.
The fact is that as men age, they lose their testosterone. The loss of youthful levels of testosterone with the onset of its associated symptoms is sometimes called andropause. It is the natural diminution (or pause) in production of male hormone (an androgen) as men age.
Testosterone loss in men is a gradual process. Testosterone decline starts around age 30, and may drop 1% to 3 % per year depending on genetics and lifestyle. That means that men can sustain a 20% drop in testosterone by age 50, and a 50% drop by age 80. Each man may experience the symptoms of a decline in testosterone differently depending on what his normal was at his hormonal peak. Often the symptoms are ignored or rationalized away until the resultant decreased functioning becomes a way of life.
The most obvious and disturbing changes for men are those of sexual function, but equally troubling symptoms of low testosterone may manifest as a decline in mental functions, musculoskeletal conditions, and metabolic or physical diseases.
Changes in mental functioning may manifest as spells of mental fatigue and inability to concentrate, feeling burned out, low energy, tiredness or sleepiness in the afternoon or evening, decrease in mental sharpness, attention, and wit, or a change in creativity like getting spontaneous new ideas. There may be a decrease in desire to start new projects, or a decreased interest in past hobbies or new work-related activities. Competitiveness may diminish and irritability increase. Memory functions may become impaired with increased forgetfulness. Men can experience a sense of depression with a sense that work, marriage, or recreational activities have lost their significance.
Musculoskeletal symptoms may appear as sore-body syndrome with aches and joint and muscle pains. A decline in flexibility and mobility may be noticed with increased stiffness. Muscle size, tone, and strength may decrease. Physical stamina and athletic performance may decline. Some men experience back pain, neck pain, or a tendency to pull muscles or get leg cramps. Some develop osteoporosis or inflammatory arthritis.
Low testosterone levels correlate with more risk factors of heart disease than any other individual factor in the male body. Cardiovascular risk factors increase in men as testosterone decreases. Cholesterol and triglyceride levels increase, coronary and major arteries constrict leading to a greater risk of cardiac events, and blood pressure rises. Insulin resistance increases with obesity, adult diabetes, and increased cortisol levels. There is increased central abdominal fat with increased waist to hip ratio. Estrogen levels associated with higher stroke and heart attack rates (and increased fat in the breast and hip area) increase. Another increase associated with decreased testosterone is in lipoprotein A and fibrinogen, which correlate with cardiac events. Also, human growth hormone output decreases leading to a decline in energy, strength, stamina, and heart muscle mass and output. Low testosterone levels are associated with increased incidence of death even after researchers adjust for age, medical problems, and variables.
Although not all signs and symptoms of aging are due to hormonal decline, many correlate well with a decline in hormones and can be alleviated by hormone adjustment.
Treatment of low testosterone should be administered by a doctor trained in hormone therapy after a full history, examination, and laboratory testing. Regular follow-up is important to control symptoms, prevent side effects, and to make sure hormone levels are optimal.
Dr. Candice Laneis a physician specializing in hormone replacement therapy. She is a Diplomate and Fellow of the American Academy for Anti-aging and Regenerative Medicine. Her practice is at 1250 La Venta Drive, Ste. 206, Westlake Village, Ca 91361. 805-496-7869.