Hormone Replacement- Is It Right for You?

Hormone replacement therapy is a bit of a misnomer. It’s natural for men’s testosterone levels to decrease as they get older. So, hormone therapy doesn’t replace anything that is naturally missing.

Testosterone is required for:

  • male sexual development
  • reproductive function
  • building muscle bulk
  • maintaining healthy levels of red blood cells
  • maintaining bone density

Could you survive without replacing lost testosterone? Probably yes, but we don’t want to simply survive- we want to live! The Economist recently published an article on what they refer to as “a silver tsunami” as baby boomers approach age 65. These boomers don’t consider 65 old, many view it as a new chapter in life and want to embrace it.

For these men the symptoms of low testosterone such as lower sex drive and sense of vitality, erectile dysfunction, decreased energy, reduced muscle mass and bone density, and anemia are issues they want to deal with to fully live an active lifestyle. Over time, the testicular “machinery” that makes testosterone gradually becomes less effective, and testosterone levels start to fall, by about 1% a year. According to WebMD testosterone levels begin to drop in their 30’s and as men get into their 50s, 60s, and beyond, they may start to have signs and symptoms of low testosterone such as lower sex drive and sense of vitality, erectile dysfunction, decreased energy, reduced muscle mass and bone density, and anemia. Taken together, these signs and symptoms are often called hypogonadism (“hypo” meaning low functioning and “gonadism” referring to the testicles). Researchers estimate that the condition affects anywhere from two to six million men in the United States. Yet it is an underdiagnosed problem, with only about 5% of those affected receiving treatment.

Studies have shown that testosterone-replacement therapy may offer a wide range of benefits for men with hypogonadism, including improved libido, mood, cognition, muscle mass, bone density, and red blood cell production. But little consensus exists on what constitutes low testosterone, when testosterone supplementation makes sense, or what risks patients face. Much of the current debate focuses on the long-held belief that testosterone may stimulate prostate cancer.

Testosterone and Erectile Dysfunction

“It’s well established that testosterone by itself, for men with sexual dysfunction that includes erectile dysfunction, can improve erections in the majority of men who take it,” says Dr. Abraham Morgentaler, an associate clinical professor of urology at Harvard-affiliated Beth Israel Deaconess Medical Center. Before asking for that blue pill you may want to build your testosterone to see if your problems can be corrected. Factors such as exercise, stress and diet can impact your testosterone level.

What is the correct level?

Low testosterone is diagnosed by measuring the amount of testosterone in the blood with a blood test. It may take several measurements to determine if a patient has low testosterone, since levels tend to change throughout the day. The highest levels of testosterone are generally in the morning, near 8:00 a.m. This is why doctors prefer to measure testosterone levels in the early morning.

Low testosterone is treated with testosterone replacement therapy, which can be given in several different ways; including intramuscular injections (into a muscle), usually every 10 to 14 days; testosterone patches, testosterone gels, and pellets that are implanted under the skin every two months. Currently oral testosterone is not approved in the United States.

A testosterone shortage could cost you your life. As if losing muscle mass, bone density, and your sex drive to low testosterone levels wasn’t bad enough, new research shows the decline can also increase your risk of prostate cancer, heart disease, and even death. So if you want to fully live your life, consider hormone testing to insure your testosterone level is at an appropriate level.

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