Low testosterone levels in men are an untreated epidemic and many doctors are clueless about the problem.
Most doctors have only seen a handful of testosterone lab results and the tests they tend to order are too basic for such an important problem.
They think if you don’t have ED (erectile dysfunction) then there is no way you could have low testosterone levels.
There are many myths about low testosterone. The truth is that men in the United States 20 years ago had much higher testosterone levels on average than men today.
Aging is one factor that can increase your chances of having low testosterone since testosterone levels tend to decline with age (just like many things tend to decline with age) but we are seeing men at all ages having lower testosterone levels than we would expect (and want for optimal health).
Testosterone Declining More Than Expected – Travison et al.
We do know that environmental pollution can decrease testosterone levels and that the higher your testosterone levels the lower your risk of death by ALL causes.
In a study of 3,942 men, the risk of death by ANY cause was decreased in men with higher testosterone AND growth hormone (igf-1) levels. IGF-1 is one of the blood markers we use to evaluate growth hormone levels. So the higher your growth hormone and testosterone levels the longer you’ll live! (Steroids Journal, 2012)
HPA Axis for Testosterone Control in the Body
What is aging?
Many doctors consider low testosterone part of “normal aging”, but what is aging? There are a number of factors that influence how we age, including nutrition, lifestyle, exercise, AND hormone levels. In women, menopause is very obvious. You’re menstruating and then you’re not menstruating.
After a woman goes through menopause many things change. Her risk of stroke increases. Her ability to become pregnant ceases. Her risk of osteoporosis increases along with increased risks for certain cancers. Thus, there is a very clear point in woman’s life when things shift and this can lead to many problems including divorce!
In women, we will get to men soon, before menopause there is a monthly cycle. During this monthly cycle hormones are increases and decreases as part of a monthly rhythm. Each hormone has many different effects in the female body. For example, estrogen rises during days 1-25 of a monthly cycle and estrogen helps to increase mental clarity. In addition, progesterone rises in the second half of the cycle and helps increase the feeling of mental calm. Thus, if certain hormones drop too low you get PMS.
So imagine what happens after menopause with almost NO estrogen and progesterone! This can lead to many different marital problems such as feeling more distanced, low libido, and feelings of being misunderstood. And I digress.
For MEN, there is something similar that happens as we age called andropause. Andropause is the male version of menopause but is much more insidious (happens slowly over time) and it can happen slowly enough that you only notice it after several years or someone else points out there you seem different. Some guys seem to hit a breaking point where their low testosterone level seems to catch up with them and they all of a sudden start having symptoms, such as erectile dysfunction.
Stress increases cortisol levels in the body. Cortisol is part of the “fight or flight” system and if cortisol remains elevated due to ongoing stressors this can further suppress testosterone levels. I have had a number of men come to our clinic that report their low testosterone symptoms started after a stressful event.
The grumpy old man syndrome is an example of how important adequate testosterone is for brain function. It is like PMS for men but it is ALL the time! Interestingly, the men in the movie “Grumpy Old Men” are chasing after a woman. The grumpy part is realistic but since most older men who are experience grumpiness as a result of low testosterone tend a have lower libidos.
Testosterone has an affect on brain function and low testosterone increases your risk of getting Alzheimer’s disease.
I have had a number of patients with low testosterone who say their libido is great but they have all the other symptoms of low testosterone. While it is certainly possible they have a “healthy” libido (sex drive) it very likely that their drive is less than when they were 25 years old. When you’re 25 years old your testosterone production is at its peak. The fact that the decline happens so slowly is part of why guys may notice the decline in their libido less. When I ask how their libido compares to when they were 25 years old the response is usually that it is now less. It is all relative.
The solution to fixing the problem of low testosterone in the individual is generally quite simple. We use a combination of medications that increase your natural production of testosterone while adding additional testosterone in the form of a cream or injection along with medication that reduces the conversion of testosterone to estrogen if needed. Most guys are unaware that they naturally produce a little estrogen. The only problem is when they produce too much.
This approach to testosterone therapy is used widely in Florida and Southern California at men’s health spas and tends to get the best results with the least amount of work required by the patient so they can focus on living their life to fullest and we take care of ensuring good results with the treatment.
The first year of treatment we typically do about 5 very comprehensive lab tests and after the first year we only need to do labs every 6 months for most patients. The cost of testosterone therapy is about $200 per month and is priceless for most men with low testosterone, which based on new research is most men over 35 years of age.
I personally have seen thousands of comprehensive hormone evaluations are we routinely order these tests for our patients in order to increase safety as well as benefits of the treatment. On our standard follow up labs for testosterone therapy we check about 30 different markers.
We understand you may have some questions after reading this and we’re happy to help. Please call 425-455-1700 for your FREE phone consult to see how we can help you get the “old” you back.
References
“A Population-Level Decline in Serum Testosterone Levels in American Men” Thomas G. Travison et al. The Journal of Clinical Endocrinology & Metabolism January 1, 2007 vol. 92 no. 1 196-202
{ 4 comments… read them below or add one }
My recent blood test showed my hormone level to be just a little on the low side. I have erectile dysfunction. My GP has suggested medication. But I would really like to get my erection back naturally. I’m a young sixtyish.
Hi John,
Determining the cause of your ED is very important. Without knowing your entire medical history it is difficult to comment on what that cause may be but certainly low testosterone levels can have a major impact on erections.
Having erections problems puts you at a much higher risk for a heart attack or related health problem. When we treat the cause of an erection problem we can help reduce the risks of other health problems.
For example, a man with diabetes is likely to over-convert his testosterone to estrogen and this can lead to lower testosterone levels. Some doctors may prescribe testosterone injections or topical cream to treat the low testosterone level and never even check estrogen levels. This is very risky because when we increase testosterone levels the estrogen levels are likely to increase as well and if you read the side effects of testosterone injections or cream they are almost all related to excess estrogen (ie breast enlargement and prostate problems). Thus, to get the most benefit and truly treat the cause safely and effectively, estrogen levels must be addressed and monitored as well.
Hopefully, your doctor is aware of the fact that testosterone can convert to estrogen and what to do improve testosterone levels and estrogen levels. Excess estrogen is bad for erections and can cause you to get too in touch with your “feminine side”.
The above comments are for information purposes only and all treatments should be supervised by a licensed physician.
Cheers,
Dr. Barry
I AM 79, MY TESTOSTERONA LEVELS IS 243, I AM TAKING PROSCAR 5 mg. since one year ago due BPH, my libido has decreased and my semen amount too, I need take Viagra 50 mg. for have sex. May I take Testofen to improve my libido?
Thanks,
Juan
Hi Juan,
First, let me apologize if the following is too technical. The answer to your question is rather complex.
The problem with Proscar® is that it decreases DHT (dihydrotestosterone) levels too much in many men and then they get symptoms of low testosterone (ie low libido) despite having “normal” testosterone levels. Proscar® is made of the drug finasteride. Finasteride is linked to increased risk of more aggressive prostate cancer. While it can reduce prostate size, and this can be an emergency in some men, there are alternatives.
5mg finasteride per day is, in my opinion, a dangerously high dose due to the risk of more aggressive prostate cancer. Of course, your doctor made his decision based on your medical history and the standard of care that many doctors follow in terms of BPH. Flomax® is another medication that is likely to help with BPH but unfortunately also is likely to cause ED.
Some doctors are concerned about the use of testosterone in men with prostate problems. For sure, if you have prostate cancer you cannot receive testosterone therapy and your oncologist may actually want to reduce your testosterone level in some situations. However, in the case of benign prostate enlargement, it is much more likely that you have elevated levels of estrogen in your prostate causing enlargement. Estradiol, a form of estrogen, stimulates growth and differentiation in the prostate through estrogen receptors.
Testosterone can help “flush” the estrogen out of the prostate and reverse its effects. In men who convert too much of their testosterone to estrogen or have low progesterone levels, testosterone therapy without the use of anti-estrogen treatments and/or treatments to increase progesterone can lead to prostate size increases indirectly. There is NO evidence testosterone causes prostate cancer.
Read more about testosterone therapy and its side effects and benefits
In some of my patients with low testosterone who take Proscar®, when we treat their low testosterone their libido improves. Finasteride seems to have long lasting effects in some men but for most these eventually improve based on my observations and reading the forums where guys talk about Propecia%reg; side effects. Propecia® is the lower dose version of Proscar® used for hair loss treatment. You need to ask your doctor about testosterone therapy but it certainly may help your libido because higher levels of testosterone can sometimes compensate for the lower levels of DHT.
In Europe, many doctors use an herb, saw palmetto, to treat BPH and in my opinion is a safer and potentially equally as effective approach. I suggest you ask your doctor about saw palmetto.
Another newer approach to BPH is daily low dose Cialis®. Some men can’t take Cialis® due to heart conditions or other health problems so ask your doctor first. A low dose of 2.5mg to 5mg daily can improve urination problems related to enlarged prostates AND it improves erections! The more sex you have the longer you’ll live! It’s true.
Read about sex and longevity here
My opinions are NOT medical advice and you should discuss this with your doctor before making any changes to your treatment.
Cheers,
Dr. Barry