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The findings are a boost for proponents of testosterone therapy, but still aren’t likely to settle the long-standing debate over testosterone safety any time soon.
Sales of testosterone products have tripled in the last decade, to over $2 billion in 2012, and manufacturers such as Eli Lilly LLY & Co. and AbbVie, ABBV formerly part of Abbott Laboratories, ABT have spent millions advertising the benefits of restoring “low T,” including boosting sexual function and muscle tone.
Thanks to pervasive drug company advertising, erectile dysfunction as a sexual disorder is now common knowledge.
What’s less appreciated, experts say, is the role that low testosterone, a contributing factor for erectile dysfunction, can play in other serious diseases, including some of the biggest killers of men: heart problems such as high blood pressure and cholesterol, obesity-related illnesses and diabetes.
“We also found that increasing muscle weakness—possibly due to decreasing testosterone concentration in the blood—could explain most of this relationship,” said Benjumin Hsu, MPH, the study’s principal investigator and a PhD candidate at the University of Sydney.
Dr. Saad: There are two ongoing registry studies in men with testosterone deficiency (hypogonadism, defined by two separate measures of low serum testosterone and the presence of symptoms which are typical for testosterone deficiency). The studies are being conducted by office urologists. The total number of men who have been treated for a maximum duration of six years is 561, mean age just under 60 years. All men received three-monthly intra-muscular injections of a long-acting testosterone depot preparation.
The main findings were that at baseline only five per cent of these men had normal weight, some 25 per cent were overweight and the majority obese. Both overweight and obese men showed reductions in weight and waist circumference. The more obese men were, the more they lost. Men in the highest obesity category grade III (BMI ≥ 40 kg/m2), had a mean weight loss of 26 kg and a reduction of waist size by 12 cm.
Low testosterone can make you feel like you’re aging all too quickly. Just ask Ed Childs, 44, of Scottsdale, Ariz. Childs said that two years ago, he felt like an old man. “I had difficulty concentrating, like my brain was in a fog,” he said. He was also depressed and gaining belly fat.
Childs, a former professional power lifter, at first attributed his lack of energy to arthritis, related hip operations, and even age. “I figured that it was just the norm for approaching 50,” he said.
It wasn’t until he visited local physician Angela DeRosa, DO, MBA, in 2012 that he realized his symptoms shouldn’t be just an accepted part of aging. Exams showed that he had a low testosterone level, and Dr. DeRosa prescribed testosterone pellets. “The treatment saved my life,” Childs said.
He’s now back to exercising and everyday activities, and he’s advanced twice in his job in the past year. His sex life has improved, and feelings of depression have gone away.
“There is increasing evidence that low testosterone is associated with obesity, high blood pressure, high cholesterol, and diabetes,” says David Fenig, MD, associate director of male fertility and sexuality at Chesapeake Urology Associates in Baltimore, Md.
When comparing event rates for myocardial infarction (MI) and stroke with those seen in the general population, testosterone therapy patients had a seven-fold lower risk of heart attack and a nine-fold lower risk of stroke, reported Robert Tan, MD, of OPAL Medical Clinic in Houston, and colleagues during a late-breaking session at the American Association of Clinical Endocrinologists meeting here.
Dr. Tan: Our findings¹ are similar to that of an early study by Shores et al ² and other studies on endogenous testosterone that found testosterone lowered mortality. In the analysis of 39,937 patients at the Low T Centers up to 5 years, the rate ratios of new MI and strokes on testosterone as compared to general community based data sets (3,4) was 0.12 (C.I. 0.08-0.18, p<0.0001) and 0.05 (C.I 0.02-0.13, p<0.0001) respectively. Thus, there appears to be a lower risk of heart attacks and strokes with patients on testosterone.
Think of testosterone and you probably conjure images of Rocky Balboa, cavemen, or Christian Bale — and with good reason. The most potent male hormone is responsible for big muscles and a hearty sex drive. But testosterone plays a bigger role than its macho reputation suggests. Here are 6 ways it impacts your everyday actions.
As many as 43 percent of women and 31 percent of men have experienced sexual dysfunction, and one of the most common problems is low libido, or a low sex drive.
Missing the spark that makes you want to enjoy sexual activity is a prevalent type of sexual dysfunction, but it is also one of the trickiest to solve.
Recognizing Low Libido
For some people, low libido is a new problem that has a physical or emotional cause. Others may have had low sexual desire their entire lives, and that may be a result of the way their brains are hardwired, says Carolyn Nemec, MD, a women’s health specialist at Cleveland Clinic Willoughby Hills Family Health Center in Willoughby Hills, Ohio. When it’s an ongoing problem, doctors call it hypoactive sexual desire disorder.
Testosterone is a hormone that is produced primarily in the testicles and is essential to the development of male growth and masculine characteristics. Testosterone production peaks during adolescence and early adulthood. After that, it’s natural for levels to drop slightly each year.
Testosterone plays a key role in the creation of muscle mass and strong bones. It’s also responsible for the development of men’s deeper voices, and it contributes to sex drive too. Low testosterone levels in a man is called hypogonadism.
The research was presented at the Society for Neuroscience annual meeting in San Diego this week.
Previous studies have shown memory loss to be common in men with prostate cancer (search) who have had treatment with testosterone deprivation therapy (search). The therapy involves reducing the body’s production of testosterone and is a common treatment for prostate cancer. However, it wipes out most of the male hormones in the body.
Associate Clinical Professor of Urology Abraham Morgentaler, MD, of Harvard Medical School, and chairman of the Androgen Study Group said, “To have several professional societies and so many of the most accomplished experts in the field unite in this action indicates the seriousness of the article’s errors, and the magnitude of damage this article has caused to the public’s perception of testosterone therapy.”
In the male body, testosterone is the most important sex hormone. Testosterone is responsible for development of male characteristics such as body and facial hair, muscle growth and strength, and a deep voice. Normal levels of testosterone also influence the production of sperm, promote sexual function and promote sex drive.
We now know that some men’s bodies do not make enough testosterone. These men may experience uncomfortable and sometimes distressing symptoms. The U.S. Food and Drug Administration (FDA) estimates that 4 to 5 million American men may suffer from low testosterone, but only 5 percent are currently treated.
•Primary. This type of hypogonadism — also known as primary testicular failure — originates from a problem in the testicles.
•Secondary. This type of hypogonadism indicates a problem in the hypothalamus or the pituitary gland — parts of the brain that signal the testicles to produce testosterone. The hypothalamus produces gonadotropin-releasing hormone, which signals the pituitary gland to make follicle-stimulating hormone (FSH) and luteinizing hormone (LH). Luteinizing hormone then signals the testes to produce testosterone.
Testosterone is a hormone made in the male body by the testes, under the direction of other hormones produced by glands in the brain. Low testosterone levels can interfere with sexual function and even your moods. Yet low testosterone itself can be a side effect of another, potentially more serious, condition — one that you may not know you have. Low testosterone and type 2 diabetes have been linked, and associations with low testosterone have also been noted for high cholesterol, excess weight, and metabolic syndrome (often a precursor to diabetes), although the direct connection is still under investigation. For instance, in a recent study in the Journal of Endocrinological Investigation, researchers explain that science hasn’t yet clarified whether metabolic syndrome causes low testosterone or if low testosterone contributes to the development of metabolic syndrome. Similarly, although there seems to be a connection between low testosterone and heart problems, it’s unclear if low testosterone causes or worsens heart disease.
In the United States alone, perhaps as many as 30 million men will at some time suffer from erectile dysfunction, the most recognized male menopause symptom. And if the other symptoms are added in, it’s clear that tens of millions of men in their 40’s and older may need treatment.
As such, many doctors prefer to use the term andropause, or more accurately, Androgen Decline in the Aging Male (ADAM), to describe age-related low testosterone in men. ADAM is often responsible for changes in sexual function, energy level or mood, which can be subtle and go on unnoticed for years.
Testosterone is the primary male hormone responsible for keeping a man’s muscles and bones strong, and maintaining his interest in sex. In the normal developing male, testosterone peaks during early adulthood, and once he reaches age 30, it is common for testosterone levels to slowly decline by approximately one percent a year. While testosterone levels vary greatly among men, older men generally have lower testosterone levels than younger men. In fact, low testosterone affects roughly 39 percent of all men over the age of 45.
Want to experience serious information overload? Google “male menopause.” Within seconds, you’ll be faced with reams of advice, from acupuncturists, news outlets—even Dr. Oz.
As you dig deeper, you’ll learn that the condition is quite controversial. Health experts argue about every aspect of “male menopause:” what it is, what to call it, and even whether the condition exists at all.
So what is male menopause, anyway? If it does exist, how can you tell if you have it?
The incidence of low libido dropped from 64% to 10% after treatment.
The study was conducted on men with medically deficient levels of testosterone, known as hypogonadism. Experts believe the findings could be relevant to the far larger group of ageing men whose testosterone has simply dropped to low levels.
No matter how much they exercise or how little they eat, these men are unable to shed this excess weight that accumulates in their belly. Published studies have shown that low testosterone and obesity reinforce each other, trapping men in a spiral of weight gain and hormonal imbalance.1-5
In spite of this widespread threat to men’s health, most physicians do not test for testosterone levels in their obese male patients. If they did, millions of men could be protected against the scourge of metabolic syndrome, type 2 diabetes, high blood pressure, atherosclerosis, and cancer.
If you happen to be one of these plagued men, please have your testosterone blood levels measured and share the results with your doctor.
This article describes the science linking testosterone insufficiency to weight gain and its deadly cousin, the metabolic syndrome. You’ll learn how testosterone determines body composition and fat accumulation. You’ll read why experts now recommend testosterone testing for most men of middle age and beyond. And you’ll see compelling evidence for the role of testosterone therapy as a means of promoting weight loss.
Hormone changes are a natural part of aging. Unlike the more dramatic reproductive hormone plunge that occurs in women during menopause, however, sex hormone changes in men occur gradually — over a period of many years. Here’s what to expect, and what you can do about it.
The term “male menopause” is sometimes used to describe decreasing testosterone levels or a reduction in the bioavailability of testosterone related to aging. Female menopause and so-called male menopause are two different situations, however. In women, ovulation ends and hormone production plummets during a relatively short period of time. In men, hormone production and testosterone bioavailability decline more gradually. The effects — such as changes in sexual function, energy level or mood — tend to be subtle and might go unnoticed for years.
In older men, it’s low testosterone that has captured attention. Testosterone, the male hormone, plays a vital role in many body functions, and low testosterone levels can leave men tired, uninterested in sex, infertile and with thinning bones, according to the U.S. National Library of Medicine.
It’s also a fairly common problem in older men. As many as four in 10 men older than 45 have lower than normal levels of testosterone, according to the American Urological Association.
The free testosterone range is from 25.0 – 80.0pmol/L (for men)
When asking a doctor to test testosterone, it is important that the doctor check for free testosterone. Total testosterone includes testosterone that is bound to sex-binding globulin hormone and albumin; this is not biologically available testosterone, meaning any bound testosterone is useless.
The Free testosterone range is very wide. The individual with a free test of 30pmol/L, and the individual with a free test of 75pmol/L should not both be considered normal. A free test of 30pmol/L is considered a “low normal” and a free test of 75pmol/L is considered a “high normal”. An adult male with a free test of 75pmol/L would be 2.5 times more likely to add muscle, have a fulfilling sex life and a heightened sense of well-being. Equating the two individuals with normal testosterone levels is a disadvantage to the individual with a testosterone of 30pmol/L. That individual with a “low normal” free testosterone deserves the same positive effects as the individual with the high normal level.