Testosterone is linked to men’s overall health, but levels decline with age and are lower in each new generation. Could male hormone replacement therapy provide the solution?
By Patrick Kenney
Testosterone is manliness and virility; muscles and hairy chests. It’s also crucial to many other aspects of a man’s life. Falling testosterone levels can leave men feeling anxious, listless, unfocused and depressed, leading to depression as well as sleeplessness and cognitive problems. And it takes a toll on the body by decreasing muscle mass while increasing body fat, inciting loss of bone density, loss of body hair and thinning of skin.
These symptoms may sound familiar to any woman experiencing the effects of menopause. In fact, andropause, the name used for the male experience, is not unlike that unpleasant mile-marker that all women must pass.
Testosterone is to a man’s overall health and well-being as estrogen is to a woman’s. And, similarly to women, as men age, their hormone levels begin to fall. From the time they hit their 30th birthday, men experience a decline of about 1 percent in their testosterone levels each year.
Low testosterone levels aren’t just an age-related problem. Base levels of testosterone appear to be in decline with each successive generation.
“Your testosterone levels are about 26 percent lower than your father’s were, on the average, at the same age,” says Mark Rosenbloom, MD, chief medical officer of LIFEFORCE Medical Institute. “So it’s a double whammy.”
It isn’t completely evident what’s causing this to happen, but the problem is so systemic and not easy to fix. “A major [theory] has to do with contaminants and the toxins we’re exposed to; the toxins in plastic [for example],” explains Rosenbloom. Some of these toxins mimic estrogen, which can tell a man’s body to stop producing testosterone.
Because levels vary by individual, and it remains unclear what exactly constitutes a normal level for any one person, the choice to pursue hormone replacement therapy is not necessarily an easy one.
“If I draw a blood test and [the patient’s] levels are low—the bottom 25 percent—even if they aren’t symptomatic, I’d have a discussion about risk factors and general health,” says Rosenbloom. Testosterone replacement can be beneficial, he explains. “Because it decreases your risk of heart disease, it decreases your risk of Alzheimer’s disease—[and] a whole host of diseases. [Treatment depends on] a combination of what the blood test results and symptoms are.”
About three years ago, John Geocaris of Wilmette was experiencing unusual anxiety and fatigue. Many men in their early 60s might accept that as part of the equation when working a stressful job running a company like Geocaris, but he thought it was worth looking into. So, at his regular checkup with his general practitioner, Geocaris asked his doctor to check his testosterone levels. The results revealed that levels were significantly low.
“I started [testosterone] injections on a two-week cycle with [my general practitioner] and immediately noticed an increase in energy, better mood and concentration, better sleep and so on,” Geocaris says. “So I started to think more and more in terms of ‘I’ll probably do this for an extended period of time.’”
Once he was convinced that replacement therapy was right for him, he sought out a doctor who specialized in the field, which brought him to Rosenbloom.
“I liked his approach because it’s not only the hormone replacement; it’s diet; it’s exercise; it’s really [an entire] holistic approach as far as long-term health is concerned,” says Geocaris. “I get my blood monitored more often, and I’m on a diet-and-exercise program. I’m on what I would call a sustainable path; in fact, the amount of testosterone that I take has been decreased by about a third, thanks to better monitoring.”
Paul Savage, MD, who specializes in the field of bioidentical hormones, antiaging and regenerative medicine, stresses that as valuable as hormone replacement therapy can be, the first step should always be the making of adjustments to your lifestyle, even the small ones. Eat more fruits, vegetables and whole foods, sleep more hours, exercise (especially resistance weight training) and manage your stress. All of these things can help you to be happier and healthier, and can help maintain or boost testosterone levels. While men face the disadvantage of andropause being trickier to diagnose, it can be easier to treat, or even to prevent, than the unavoidable experience of menopause that women face.
Perhaps it’s easy enough to skip the donut and eat an apple or take the stairs instead of the elevator, but then there’s the tough one; managing your stress.
Savage points out that there are two types of stress; perceived and physical. Physical is simple enough to identify and take action against, but perceived stress is far more elusive. And we live in a world where perceived stress may be at an all-time high. Our technological age seems nifty and convenient, but it has left us hyperconnected to one another; accountable to everyone all the time.
The answer? “A different way of thinking about things,” says Savage. “Recognize that there is power in being powerless.”
“We all feel we’re responsible for our children; [for] taking care of our parents,” says Savage. But there is a limit. People make their own choices, and it doesn’t have anything to do with you.”
As a man, it’s good to keep in mind that hormonal problems aren’t just for women anymore. You may be in the grip of andropause, and with a simple blood test, your doctor may be able to tell whether that’s the case. You never know—it could be only that marker of manliness that’s standing between you and good health.
Published in Chicago Health Winter/Spring 2014