Male Menopause, Low Testosterone and Robert Brannigan MD
Posted Oct 07 2010 3:30am
Male Menopause, Low Testosterone and Robert Brannigan MD
by Jeffrey Dach MD
Male menopause and low testosterone is in the news again, thanks to Robert Brannigan MD (left image), and the public relations department of Northwestern University. Their news release was reprinted by all the major news services.
Left image: courtesy of Robert Brannigan MD Urologist at Northwestern University
Dr Brannigan tells us testosterone levels decline with age, and we now have 5 million men suffering from low testosterone levels resulting in "fatigue, mood swings, decreased desire for sex, hair loss, lack of concentration and weight gain." Low testosterone is commonly associated with diabetes and cardiovascular disease. In my experience , I have found both conditions improve considerably with testosterone treatment.
Highly Prevalent Yet Ignored by the Medical System
Although low testosterone is highly prevalent, Brannigan says that "95 percent of cases are undiagnosed and therefore untreated by the medical system. When ignored, symptoms can "seriously disrupt one's quality of life".
Treatment for low testosterone is straightforward. Bioidentical testosterone is given as topical gels or self-injections with a prompt increase in energy and improved sense of well-being. One of Dr Brannigan's patients said:"Once I began treatment, I felt better very quickly, my energy level shot back up; I regained strength and felt I could concentrate much better."
Low Testosterone May Be Killing You
Two reports published in the recent medical literature showed that low testosterone is associated with increased mortality. One study published in 2008 tracked nearly 800 men, 50 to 91 years old, living in California. Their testosterone level was measured at the beginning of the study, and their health was then tracked over the next 20 years. Low testosterone symptoms reported by these men included decreased libido, erectile dysfunction, fatigue, loss of strength, decrease in bone density and decreased muscle mass. Also, these men tended to be overweight or obese, and at higher risk for cardiovascular disease and diabetes. Men with the lowest testosterone, below 241 total serum level, were 40% more likely to die.
Left image: Chemical structure of testosterone courtesy of wikimedia commons.
The ADAM Testosterone Questionnaire
This questionnaire is useful for detecting low testosterone levels. ADAM is short for Androgen Deficiency in the Aging Male.( link )( link )
1. Do you have a decrease in libido (sex drive)? Yes No
2. Do you have a lack of energy? Yes No
3. Do you have a decrease in strength and/or endurance? Yes No
4. Have you lost height? Yes No
5. Have you noticed a decreased "enjoyment of life" Yes No
6. Are you sad and/or grumpy? Yes No
7. Are your erections less strong? Yes No
8. Have you noticed a recent deterioration in your ability to play sports? Yes No
9. Are you falling asleep after dinner? Yes No
10. Has there been a recent deterioration in your work performance? Yes No
If you answered YES to questions 1 or 7, or any 3 other questions, you may have low testosterone, and may benefit from treatment. Next step is a testosterone blood test to determine your level. If low, then testosterone supplementation may be considered. It is important to work closely with a knowledgeable physician who can do a full evaluation, order the appropriate tests, and prescribe treatment.
Northwestern doctor Robert Brannigan for a different complaint.
And when the urologist started getting a full medical history, and heard the list of symptoms: he immediately checked Andruzzi's testosterone levels.
Andruzzi said the levels came back shockingly low, and even more surprising was that Dr . Brannigan told him he was in andropause, or the male version of menopause.
Urology. 2000 Sep 1;56(3):474-6.
Side-effect profile of sildenafil citrate (Viagra) in clinical practice.
Moreira SG Jr, Brannigan RE, Spitz A, Orejuela FJ, Lipshultz LI, Kim ED.
Scott Department of Urology, Baylor College of Medicine, Houston, Texas, USA.
http://jcem.endojournals.org/cgi/content/full/93/1/68 Low Serum Testosterone and Mortality in Male Veterans Arch Intern Med. 2006;166:1660-1665 Molly M. Shores, MD; Alvin M. Matsumoto, MD; Kevin L. Sloan, MD; Daniel R. Kivlahan, PhD .Conclusions Low testosterone levels were associated with increased mortality in male veterans.
http://jcem.endojournals.org/cgi/content/full/93/1/68 The Journal of Clinical Endocrinology & Metabolism 2008 Jan;93(1):68-75.
Low Serum Testosterone and Mortality in Older Men. Gail A. Laughlin, Eliza2008 Jan;93(1):68-75.beth Barrett-Connor and Jaclyn Bergstrom. Department of Family and Preventive Medicine, School of Medicine, University of California, San Diego, La Jolla, California 92093
Low testosterone may lead to a greater risk of death, according to a study presented Tuesday at the annual meeting of the Endocrine Society in Toronto.
Men with low testosterone had a 33 percent greater death risk over their next 18 years of life compared with men who had higher testosterone, according to the study conducted by Dr. Elizabeth Barrett-Connor and colleagues at the University of California at San Diego. "It's very exciting and potentially a groundbreaking study," said Barrett-Connor. "But it needs to be confirmed." The study tracked nearly 800 men, 50 to 91 years old, living in California. Their testosterone level was measured at the beginning of the study, and their health was then tracked over the next 20 years.
http://www.medicalnewstoday.com/articles/153822.php Testosterone Replacement For Men With Low Testosterone Improves Liver Function, Metabolic Syndrome. Testosterone deficiency, which becomes more common with age, is linked not only to decreased libido but also to a number of medical problems. These include the metabolic syndrome a cluster of metabolic risk factors that increase the chances of developing heart disease, stroke and type 2 diabetes.
http://www.news-medical.net/news/2008/03/04/35897.aspx Low testosterone levels linked to depression in older men March 2008
Older men with lower free testosterone levels in their blood appear to have higher prevalence of depression, according to a report in the March issue of Archives of General Psychiatry.
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