Friends 'R' Family

ResidentInsomniac · Site Admin

Testosterone Replacement Therapy May Improve Health and Happiness in Older Men

Rallie McAllister, M.D., M.P.H.

Women aren't the only ones affected by a midlife hormonal upheaval. A growing body of scientific evidence supports the notion that middle-aged men may experience a phenomenon known as "andropause," the male version of menopause.

In women, drastic reductions in levels of the female hormone estrogen bring about the well-known symptoms of menopause. Likewise, middle-aged men produce smaller quantities of the male hormone, testosterone, than they did in their younger years.

While estrogen production typically takes a hard nosedive in mature women, testosterone levels tend to decline very gradually in aging men. As a result, the emotional and physical changes associated with andropause are generally far less dramatic than those that occur in menopausal women.

In men, testosterone production typically peaks in the late teens and remains relatively stable for the next 10 to 15 years. Around the tender age of 30, however, testosterone levels may begin to drop at a rate of about 1 percent to 1.5 percent per year.

By the time men reach their 60s or 70s, their testosterone levels may have dropped below the normal range, causing subtle signs and symptoms. Like menopausal women, andropausal men can experience hot flashes, depression, irritability and insomnia.

As testosterone production declines, men may notice decreased beard growth, increased body fat and loss of muscularity and strength. In some cases, low testosterone levels can lead to bone loss, increasing the risk for osteoporosis and debilitating bone fractures.

For many men, the most disturbing aspects of andropause are a noticeable decline in libido and diminished sexual function. Fortunately, treatment with supplemental testosterone can bring about dramatic improvements in andropause-related symptoms.

In years past, physicians traditionally reserved hormone replacement therapy for men with severe testosterone deficiencies. But as the male life expectancy continues to increase, many doctors now recognize the potential benefits of prescribing supplemental testosterone to older men with minor hormone deficiencies.

In clinical studies, men treated with testosterone replacement therapy reported enhanced sexual function, better stress-handling capabilities and a greater sense of wellbeing. They exhibited greater strength and stamina as well as significant increases in lean muscle mass and bone density.

Testosterone also appears to affect a man's ability to learn and remember as he grows older. The results of several studies suggest that older men with higher testosterone levels perform better on tests of cognitive function than those with lower levels of the hormone.

Higher testosterone levels in older men may be linked to better overall health and greater longevity. In a study of more than 850 male veterans, researchers at the University of Washington in Seattle discovered that men with low levels of testosterone after age 40 had an 88 percent higher risk of death over a four-year period than those with normal levels of the hormone.

Supplemental testosterone appears to improve some aspects of cardiovascular health. Male hormone replacement therapy has been shown to help lower LDL cholesterol levels, reduce blood pressure and improve blood flow to the heart.

On the downside, some doctors fear that supplemental testosterone may trigger benign prostatic hyperplasia, a nonmalignant enlargement of the prostate, or even worse, that it might increase a man's risk of prostate cancer. More research is needed to fully understand the potential long-term risks of hormone replacement therapy in older men.

In the past, men who needed testosterone replacement therapy had to submit to regular injections or have hormone-impregnated pellets implanted under their skin, but these days, kinder, gentler treatment options are available. Testosterone-containing gels, creams and patches are easy to use and can effectively deliver a steady dosage of the hormone through the skin.

These products are generally well tolerated, although they can cause skin irritation in some men. Care must be taken to avoid transferring the products to other people by skin-to-skin contact.

One of the newest delivery options is a testosterone-containing buccal tablet, designed to be placed in the natural depression in the mouth over one of the upper front teeth. As the tablet dissolves, the testosterone is quickly and easily delivered to the bloodstream through the soft tissue of the mouth.

If you're a mature man and you suspect you might be experiencing andropause, it's time to make an appointment with your physician. After performing a complete physical exam and a few blood tests, your doctor can make the diagnosis.

Together, you can decide if testosterone replacement therapy will help improve your health and happiness.

========

Rallie McAllister is a board-certified family physician, speaker and the author of several books, including "Healthy Lunchbox: The Working Mom's Guide to Keeping You and Your Kids Trim." Her website is www.rallieonhealth.com. To find out more about Rallie McAllister, M.D., and read features by other Creators Syndicate writers and cartoonists, visit the Creators Syndicate Web page at www.creators.com.

Source:
Your Health
ArcaMax Publishing
http://www.arcamax.com