Usually when people talk about hormonal changes, the spotlight is on women and menopause. However, as men age, they experience a “male menopause” or “andropause” – a decline in their testosterone hormone levels. Beginning at age 30, men lose testosterone at a rate of 1% per year. Even though this is gradual, by about age 70, a man’s testosterone level may be 50 percent less.
Why is this change significant? Testosterone plays a crucial role in almost every major male body function. The symptoms of lower testosterone are usually subtle and painless, but sometimes men need to consult a physician to find relief from symptoms.
Testosterone is a major player in men’s health
Produced in the testes and known as the “male sex hormone,” testosterone helps men maintain bone density, fat distribution, muscle mass, sex drive, sperm production, and red blood cell production. Testosterone levels differ from person to person, but they peak during adolescence and early adulthood and decrease as a man ages.
Because the symptoms of low testosterone can mirror normal signs of aging, they are frequently ignored or misinterpreted, which can be dangerous. For example, if a man says that he is feeling depressed and has loss of libido, his doctor may treat the depression. However, some antidepressant medications used for treating depression impede sexual function and may aggravate the symptom of lower sex drive.
According to the Mayo Clinic, some common signs of low testosterone are:
- Changes in sexual function – reduced sexual desire, fewer spontaneous erections, and infertility.
- Changes in sleep patterns – insomnia or other sleep disturbances.
- Physical changes – increased body fat (often times in the abdominal area), reduced muscle bulk and strength, decreased bone density, swollen or tender breasts, and hair loss. Men may experience hot flashes and have less energy than they used to.
- Emotional changes – decreased motivation or self-confidence, increased feelings of sadness or depression, trouble concentrating or remembering things.
Understand that some of these symptoms are a normal part of aging and others may be caused by numerous underlying factors, including side effects from medication, thyroid problems, depression, and excessive alcohol use. A blood test is the only way to diagnose low testosterone.
Men should talk with their doctors about their symptoms so they can diagnose the causes and determine treatment options.
Testosterone production cannot be improved by lifestyle changes, but men can take steps to proactively deal with what they are feeling. The Mayo Clinic recommends:
- Be honest with your doctor. Tell your doctor about all the signs and symptoms you are experiencing. Help the doctor identify and treat any health issues that might be causing or contributing to what you are feeling, including – side effects from other medications, erectile dysfunction, lack of sleep, etc.
- Make healthy lifestyle choices. Eat a healthy diet and exercise daily. Healthy choices will help you preserve your strength, energy, and lean muscle mass. Regular physical activity can even improve your mood and promote better sleep.
- Seek help if you feel down. You might have depression if you feel irritable, isolated, and withdrawn. Other signs of depression common in men include working excessively, drinking too much alcohol, using illicit drugs, or seeking thrills from risky activities.
- Be wary of herbal supplements. Herbal supplements haven’t been approved as safe and effective for aging-related low testosterone. Some supplements might even be dangerous. Long-term use of DHEA, for example, has no proven benefits and might increase the risk of prostate cancer.
Dr. David Thomas, a professor of geriatrics at St. Louis University School of Medicine, says one in every ten men between age 40 and 60 has low testosterone. Among men over the age of 60, the numbers increase to one in every five men. Thomas adds that only 5 percent of the estimated 4 to 5 million American men with low testosterone are being treated.
Why testosterone replacement therapy is not for everyone
If you have low testosterone, your doctor may put you on replacement therapy. However, few studies have been done, so it is unclear whether testosterone therapy benefits older men who are otherwise healthy (Mayo Clinic). It may relieve symptoms but patients increase their risk of prostate cancer, stroke and other health problems (Mayo Clinic). Specialists recommend that men who have testosterone replacement therapy of any kind get their PSA (prostate-specific antigen) levels checked regularly to identify and monitor their risk for prostate cancer.
Testosterone treatment methods include injections, patches, pills, creams, or gels. If you wonder whether testosterone therapy treatments might be right for you, work with your doctor to weigh the pros and cons for your specific situation.
Some questions you should ask your doctor are (WebMD):
- Are my symptoms definitely from low testosterone, or could they be caused by some other problem?
- What are the possible benefits of testosterone supplements?
- What are the side effects and risks of testosterone replacement therapy?
- How long would my treatment with testosterone replacement therapy be?
What kind of lifestyle changes – like exercise or diet – could I try before testosterone treatment that might help alleviate the symptoms?
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