Andropause Treatment for Low Testosterone Symptoms in Men
Andropause Treatment for Low Testosterone Symptoms in Men
Testosterone is truly a life source to the male body. Produced primarily in the testes by specialized Leydig cells, testosterone travels through the body via the bloodstream and binds to receptors on target tissues. There are testosterone receptors all over the body. As might be expected there are many in the genital area, however, the largest concentration is in the heart and brain. It is the receptor sites in the brain that create sexual desire, which in turn trigger the release of nitric oxide to facilitate an erection.
Leydig cells in the testicles produce testosterone in response to a hormone called Luteinizing Hormone (LH), which is produced by the pituitary gland. The pituitary is like a hormone thermostat. As it senses the body’s need for testosterone, it releases LH to stimulate the testicles to produce testosterone. Testosterone starts to decline because of aging of the Leydig cells in the testicles and by a decline in the pituitary gland’s ability to produce LH. The result is andropause or hormonal-aging. Decline starts about age 27 or 28 and its effects can usually be felt by age 35.
Fact: Testosterone is an “anabolic steroid,” a term that engenders negative connotations with men who follow sports. The bodies of both men and women produce anabolic steroid (testosterone) naturally. Men require it to live. The negative connotation comes from athletes and bodybuilders abusing combinations of synthetic testosterones — a practice called “stacking.”
Fact: Testosterone is both safe and healthy when used correctly. Studies are now suggesting that healthy levels of testosterone help prevent Alzheimer’s.
Fact: When done correctly, there are no negative side effects from testosterone therapy.
Fact: Replacing testosterone to healthy levels will fix the symptoms listed below in 3 to 6 weeks.
Symptoms of low testosterone in men
- Decreased mental quickness and sharpness
- Decreased energy, strength and endurance
- Less desire for activity and exercise
- Decreased muscle and increased body fat
- Mild to moderate depression and irritability
- Depression and/or loss of eagerness and enthusiasm for daily life
- Decreased sex drive
- Decreased sexual function and/or sensitivity
The good news is that andropause symptoms and low testosterone (low T) can be easily and safely corrected with testosterone replacement therapy, though it does require continuation for the rest of your life. Some men have difficulty accepting this fact. The way to view this “rest of your life” thing is to consider that your grandfather had the same problem — you have a choice he did not have — you can fix it.
Low Testosterone Treatment
Though everyone is different, here is a general progression of how things will change after you start testosterone therapy:
Week 1 to 2
- Lifting of a depression you may not have known you had
- A general increase in enthusiasm and zest for life
- Plus an increased mental sharpness and quickness
Week 2 to 3
- Increase in energy and metabolism levels
- Increase in morning erections and night dreams
- Increase in male sex drive – improved interest, performance and satisfaction
Week 3 to 6
- Start of increase in muscle and decrease in fat — particularly if you are active and watch your diet principally refined carbs
Safety and Estrogen
As mentioned earlier, treatment of low T is safe when done correctly. It should be noted that testosterone replacement does not increase, but rather decreases the chances of developing prostate cancer. One of the causes of prostate cancer is excess estrogen. Excess estrogen in men occurs as testosterone declines allowing the male body to accumulate fat—primarily belly fat—which contains an enzyme called aromatase, which converts testosterone to estrogen. Estrogen may convert to a metabolite, 16 alpha hydroxyl estrone and on to 4 alpha hydroxyl, a carcinogen that can cause prostate cancer. We control the level of estrogen as part of our treatment.
Increased estrogen adds to the symptoms of andropause and as noted above, is unhealthy for the prostate and heart. It is critical to use a medication to suppress excess estrogen during testosterone therapy. If good lifestyle habits are practiced, fat will disappear over 3 to 6 months and conversion to estrogen will stop.
Again, testosterone does not cause prostate cancer. It is the conversion of testosterone to estrogen, as well as lifestyle and heredity that causes an enlarged prostate and/or increases the risk of cancer. Increasing testosterone levels and controlling estrogen lowers the risk of prostate cancer.
Testing testosterone levels
Lab testing produces three numbers:
- total testosterone
- free testosterone
- sex hormone binding globulin (SHBG)
Total testosterone is the number most commonly used and quoted—this also reflects a lack of knowledge of the person doing so. The problem is that the majority of testosterone in any human body is bound to protein molecules by SHBG and is totally inactive. Only testosterone not bound to protein molecules, or free testosterone, is active in the system. Therefore, free testosterone is a key to treatment.
Testosterone levels start to decline about age 26 or 27. Most men start to feel the effects of low T, as free T levels decline to below 140pg. We replace testosterone to levels men had when they were younger and felt their best—250 to 350pg of free T. The “normal” range for free T is 80pg to 350pg (note: range may vary depending on the lab doing the testing). Laboratory ranges are determined by testing both sick and healthy men. Sick (andropause) is the lower end of the range. Healthy is the upper end of the range 250 to 350pg.
Note: Don’t let your doctor tell you “you have normal testosterone for your age.” If you test at the middle or lower end of the range, and more importantly if you are having symptoms, you need to investigate treatment.
When testosterone is introduced from the outside of the body, the glands that produce testosterone read that the body has an adequate supply and they therefore do not need to work as hard. The result, natural production can decline and testicles can shrink. This can be avoided by having you take a medication to stimulate your testicles as you use testosterone.
We use two stimulating medications—HCG injections or clomiphine tablets, which do not require an injection. Your option to stimulate and what medication you will use will be discussed with you.
There is simply no better way a man age 35 or older can take an action, spend a reasonable amount of money and have a more significantly improved quality of life than to treat hormone deficiency. If you are having symptoms, the question is not, “Should I replace hormones?” The question should be, “Who do I work with in replacing hormones to healthy levels?”