What Senior Men Can Do About
"Male Menopause"
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.
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One
Senior’s Testosterone Replacement Story
"I felt like I didn't want to move," says Cecil Dorsey of Vernon,
Connecticut. The 68-year-old retired truck driver, who discovered via a
blood test nearly four years ago that his testosterone levels dropped,
said, "I just didn't want to be bothered by anything." Dorsey used to
get testosterone shots monthly, but in the last year his doctor has
prescribed a pill form, after Dorsey complained that the injections
would make him feel uneven – great at first but three weeks after the
shot, "I'd feel like crap." Although some doctors warn against oral
medication, Dorsey says the treatments increase his energy level, and
he generally feels better. Doctors check his hormone and PSA levels
monthly.
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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?
How
does testosterone replacement therapy affect a man?
| PROs |
CONs |
|
Relieves
symptoms of:
|
Increases
risk of prostate cancer
|
|
-
Fatigue/loss of sleep
|
Increases risk of stroke |
|
-
Loss of libido/sexual function
|
Increases liver toxicity |
|
-
Sadness/depression
|
Increases chance of breast development |
| Increases
bone density
|
Shuts down the production of sperm |
| Maintains
body composition and muscle
|
Increases chance of sleep apnea |
|
Increases chance of acne and other skin
problems |
Sources: Livestrong.com,
Mayo Clinic, Urologyhealth.org
To
help relieve the side effects of testosterone therapy and make a
difference in how you feel, change your lifestyle. For example, reduce
stress, get plenty of rest, exercise regularly, and eat a healthy diet.
All will help improve strength, resiliency, and better overall health.
If
you are concerned that you have low testosterone, consult a physician
for an accurate diagnosis. It is possible that other health conditions
are causing your symptoms. If you need treatment for low testosterone,
ask your doctor about all your options and their possible side effects.
Other health conditions may prevent testosterone replacement therapy
from being a viable option for you. If you and your doctor decide that
testosterone replacement therapy is a good choice, communicate with
your doctor throughout the treatment process.
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