Dr Suren specializes in this area and we are starting Anti Aging Clinics where we can help you maintain vitality as you age. Of course we will also be looking at menopausal issues and helping women age gracefully, but for today, we will talk about men first.
Below is an article by Dr Suren on what happens when men age.
Testosterone: It is not just about SEX
Testosterone is the main sex hormone produced by the testes. Testosterone together with it's derivatives, estradiol(E2) and dihydro testosterone (DHT) act directly on diverse target organs such as the sex organs, bones, muscles, blood-forming tissue, the brain,skin and hair. Thus, testosterone has a vital role in proper function of multiple systems in our body.
As men age, the levels of testosterone will fall. At age 70 the testosterone level is only 30% of the peak at age 25. Late onset hypogonadism, also known as andropause usually starts after age 40. It is characterized by symptoms such as fatigue, lack of energy, low mood. There can be loss of muscles, increase of fats especially in the abdomen, decreased exercise capacity and endurance. Of course there can be loss of sexual interest and erection difficulties.
Andropause is now recognized as a serious health problem. The good news is that we are able to treat it and reverse many of the above problems.
Prevalence of hypogonadism ( Low levels of testosterone)
The prevalence of andropause is from 6 to 13% in those aged between 40 – 69 years old. Prevalence increases with age. (1)
Testosterone deficiency is associated with Diabetes
Testosterone deficiency plays a central role in the cause of Type 2 diabetes, Metabolic Syndrome and Insulin Resistance. It contributes to the accumulation of abdominal fat. This abdominal fat is an active endocrine organ producing chemicals (cytokines) that cause inflammation such as causing abnormal lining of the blood vessels. Testosterone treatment of hypo gonadal men improves diabetes.(2)
Testosterone restoration improves muscle strength
Replacement of testosterone increased fat-free mass, muscle size and strength in hypo gonadal men. (3) Oral testosterone treatment in diabetic men with deficiency improves body composition, decrease abdominal fat, improves glucose homeostasis and improves erectile dysfunction. (4)
Optimal testosterone levels associated with better cognitive function
One study showed that older men with high testosterone and low estrogen level performed better in several tests of cognitive function. (5)
Low testosterone is associated with poor cholesterol and potential risk to heart health
Low testosterone is associate with high total and bad (LDL) cholesterol. The lining of the blood vessels are also slightly damaged, making it prone to accumulate fatty plaques. Also due to the association with obesity and poor glucose control, low testosterone can affect the heart health.(6)
Should you have testosterone restoration?
There is convincing evidence of the benefits of testosterone replacement. Before starting we recommend that you speak to us, so that we can ascertain that you do indeed have andropause. We will then do a blood test of your hormones for confirmation.
Are there any risks of restoration?
Some researchers have warned that restoration can be a risk of aggravating prostate cancer. As we become more familiar with testosterone replacement we belief the risk of prostate cancer is very low. There is no scientific evidence that testosterone supplement increased the risk of prostate cancer.(7) Nevertheless we will still do a blood test before and after treatment to make sure that we do not put the patient at any risk.
Testosterone restoration can also increase the red blood cell count. This is easily detected and effectively treated without any risk to the patient.
What do I do now, if I want to check for andropause?
Dr Suren Baskaran now conducts special clinics for this condition. If you wish to check for andropause, just call us for an appointment.
1. Araujo Ab et al. Prevalence and incidence of andropause deficiency in middle aged and older men. J Clinical Endocrinology Metabolism 2004 Dec;89(12):5920-6.
2. Traish. The dark side of testosterone def II. J Androl 2009;30:23-32.
3. Bhasin S. et al. Testosterone replacement increases fat-free mass and muscle size in hypo gonadal men. J Clin Metab. 1997 Feb;82(2):407-13.
4. Boyanov MA et al. Testosterone supplementation in men with T2D, visceral obesity and partial androgen deficiency. Aging Male. 2003 Mar;6(1):1-7
5. Barrett-Connor E et al. Endogenous sex hormones and cognitive function in older men. J Clin Endocrinology Metab 1999 Oct;84(10):3681-5
6. Traish et al. The dark side of Testosterone deficiency III. J Androl 2009;30:477-94
7. Morgentaler A. Testosterone replacement therapy and prostate risks. Can J Urol.2006 Feb;13 Suppl 1:40-3