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).

In one study of 1,532 men in 2002, Travison et al. show a massive decline in Massachusetts’s men’s testosterone levels over the past 20 years that is not related to “normal” aging or other health and lifestyle factors that can effect testosterone levels.

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

Environmental pollution is likely to increase as the world becomes more crowded and new chemicals are created with little understanding of their long-term consequences. The body has a complex system to control testosterone levels and this system can be affected many different ways.

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.