Men’s Hormone Decline Can Be Subtle: Many Treatment Options are Available
May 24, 2013 11:04AM
● By Dr. Josie Tenore, M.D., and Dr. Ryan Lombardo, DAOM
Men are being increasingly targeted by advertising for pharmaceutical remedies to treat low testosterone levels, or “Low T”. Whether the reason is that we are in the midst of an epidemic, pharmaceutical companies are exercising their right to advertise, or it is simply a matter of recognizing that men are living longer today than in prior generations, it is clear that men are becoming more aware of this health issue and are looking for solutions.
Symptoms of Low T can include fatty deposits around the midsection that do not respond to exercise and diet (beer belly), reduced libido, erectile dysfunction, loss of muscle mass and strength, low bone mass, decreased energy and vitality and a depressed mood. Not all symptoms need to be present to be affected by Low T.
Low T is a very real condition. In a 2013 study published by the European Journal of Endocrinology, testosterone levels in men were shown to decrease as they age. According to the National Institute on Aging’s ongoing Baltimore Longitudinal Study on Aging, 19 percent of men over the age of 60 have been found to have low testosterone levels, while another study found the overall prevalence to be a whopping 39 percent in males 45 years old or more. However, age alone is not the only cause of low testosterone. In addition to aging, low testosterone levels can be brought on by trauma, infection, tumors, genetic factors, chemotherapy, radiation, medications, poor sleep, poor diet, stress, illness and alcohol abuse.
Some studies link the combined loss of muscle mass and strength, along with increased fatty deposits, with degenerative diseases such as cardiovascular disease, osteoporosis and diabetes. Combine these symptoms with other causative factors and it becomes obvious why Low T needs attention. While it is not clear whether low testosterone is the cause or the result of these conditions, treating it may be helpful in improving men’s quality of life.
A physician will typically make the diagnosis of andropause (similar to menopause in women) when there is a combination of consistent symptoms and low testosterone levels. However, a controversy revolves around what actually constitutes “low” levels of testosterone. A low level for one man may be perfectly fine for another, and vise versa. The only way to possibly know what level is considered normal for any individual is to perform lab tests on the individual in their early 20s and then again in later life to restore testosterone levels to that level, something that practitioners do not do. Instead, they must rely on men to subjectively rate their symptoms, quality of life, desire for symptom relief and improved vitality. This type of care is commonly referred to as “anti-aging”, “longevity” or “age management” medicine.
Treatment options for low testosterone can include bio-identical or commercially derived hormone replacement, nutritional supplements and herbal medicine. While some methods literally replace testosterone, other options include replacing precursor hormones such as DHEA, which the body uses to produce testosterone. Additionally, nutritional supplements and herbal medicine are aimed at helping the body increase its own hormone production and prevent the potential causes of low testosterone.
Once normal hormone levels have been restored, libido, sexual function, energy and mood generally improve early in the course of treatment. Restoration of muscle mass and decreases in fat deposits is a more gradual process, and usually takes at least six months to show measurable results.
All of these options are generally safe and viable treatment methods when directed by trained practitioners. A healthcare provider should review the history and screen for potential risks that may be present and perform baseline tests to monitor prostate health, as well as measure a baseline bone density and body composition. Once treatments begin, expect to have testosterone levels checked after three months, and then annually.
Dr. Josie Tenore, M.D. is the owner of FreshSkin, 806 Central Ave., in Highland Park, which specializes in hormone replacement therapies for men and women and aesthetic medicine. Dr. Ryan Lombardo is board certified in acupuncture, anti-aging and integrative medicine. He has joined forces with Tenore to help provide care to men and women. For more information, call 847-681-8821 or visit MyFreshSkin.com.