Testosterone is a vitally important hormone for men from conception to very last days of life. In addition to maintaining muscle mass and energy, testosterone plays a central role in maintaining sex drive, maximizing erectile function and stabilizing bone density.
Andropause is the term given to lowered testosterone levels that some men experience as they age.
Andropause can begin to affect men in their mid-forties and is estimated to affect more than 25 million men in the United States. Despite its frequency, however, less than 10% of symptomatic men seek or receive treatment. Andropause can have a slow onset and most men believe that its symptoms are a normal part of aging.
The most common symptoms of ANDROPAUSE or Low Testosterone include:
• Decreased sexual desire
• Erectile dysfunction
• Decline in energy
• Diminished strength
• Abnormal Semen Analysis
• Decreased lean muscle mass
• Altered mood
• Hot Flashes
Understanding when and how to treat symptoms of low testosterone should involve an experienced and thorough physician. Diagnosing and treating andropause is about more than making men ‘feel better’ as they age. It can also have an impact on how long a man lives. Andropause has been identified as a contributing factor in cardiovascular disease, Alzheimer’s disease, diabetes and metabolic syndrome.
Early identification of men with andropause can lessen the heath impacts of these associated diseases. Replacing testosterone in patients with andropause has been shown to improve their overall sense of well-being, improve the symptoms of Alzheimer’s, improve control of blood sugar in diabetics, improve control of cholesterol levels, and improve overall metabolism.
At North Austin Urology, we see patients with low testosterone levels at all ages and for a number of different reasons. In addition to conducting blood tests for absolute testosterone levels, we will also measure a more sensitive form of testosterone called the ‘free-testosterone’ level. There is no known ‘normal’ range that applies to all men and some men benefit from treatment even after being told that their levels were ‘normal.’
Your initial evaluation will also include looking for other problems whose symptoms can mimick those of low testosterone. In addition, a physical exam will look for evidence of testicular or prostate disease that could impact treatment.
Treatment for low testosterone can take several forms that all require close follow-up and should begin with a thorough understanding of possible risks and side effects.
Topical gels are a common and popular choice for testosterone replacement and many are covered by most insurance plans.
Injection therapy can be a minimally invasive way for testosterone supplementation and can be administered in our office or by self injection.
In fact, weekly self-injection can relieve patients of widely varying peak and trough levels of testosterone and will be allowed in proper patients.
Some patients may be eligible for implantation of subcutaneous testosterone pellets that only need to be replaced every 6 months, making supplementation nearly worry free.
NO MAN THAT INTENDS TO HAVE CHILDREN SHOULD BE PLACED ON TESTOSTERONE THERAPY WITHOUT UNDERSTANDING THE NEGATIVE EFFECTS ON SPERM PRODUCTION THAT ARE LIKELY.
For men that are still interested in having children we will often utilize other medications that can ‘over-drive’ the testicles to produce more testosterone without sacrificing sperm production. These men will often need the more specialized care of a urologist and male fertility specialist and will be well tended-to in our practice.
If you feel that you may be experiencing symptoms of andropause talk to your primary care doctor or urologist. The following self-test can help identify men with symptoms of low testosterone. Hopefully, more men and physicians will become familiar with this condition to help men enjoy life to its fullest as they grow older.