Does Lower Testosterone Lead To More Problems?
Education and Advocacy Understanding testosterone deficiency in men.
estosterone. It’s the hormone secreted by the testicles that basically tells the body to be a man. It’s responsible for increased muscle mass, body hair, aggression, and myriad other characteristics of maleness, both physical and psychological. And, when testosterone levels drop, the impact on a man’s physical and mental health can be profound.
“As men age, our bodies change,” says Dr. Gerald Brock, President-Elect of the Canadian Urological Association. “And, one of the things that changes is our production of testosterone. We think that it’s probably normal for a man’s testosterone level to decrease as he gets older.” On average, men lose between 1–2 percent of their testosterone every year and remain healthy, but when testosterone levels decrease too far or too quickly, there are a host of potential complications including depression, loss of muscle strength and bone density, cardiovascular disease, and erectile dysfunction. When these symptoms occur, the condition is known as late-onset hypogonadism or simply testosterone deficiency.
All adult men at risk
It’s a condition that primarily begins to affect men in their mid-50s, but both older and younger men do come to their physicians with symptoms. “It’s a bell-shaped curve,” says Dr. Brock. “While the majority of my patients are in their late 40s to late 60s, men as old as 85 have come in to my office and asked about their testosterone levels, as have men in their 20s and 30s.
With testosterone deficiency, only about a quarter of all affected men are currently seeking treatment
There is no definitive statistic for the prevalence of testosterone deficiency in Canada, but estimates have suggested it could be affecting as many 40 percent of all men over the age of 45. And, among those men, the ones who are coming into a doctor’s office for help are in the minority. “I believe that with testosterone deficiency, only about a quarter of all affected men are currently seeking treatment,” says Dr. Brock. “Men in general aren’t very good with our health care.
Men need to bite the bullet and talk to their doctor. Testosterone deficiency can affect every aspect of a man’s life, sapping him of energy, clouding his mind, killing his libido, and putting him at risk for other illnesses. And, there is no need to keep living that way, when a very effective treatment now exists in the form of testosterone supplementation. With six months of therapy, 75 percent of testosterone deficient men see significant improvement.
But is it safe?
For many years, testosterone supplementation was considered controversial, but there has been a tidal shift in the opinion of the medical community. “Historically, testosterone was seen as a dangerous drug, especially for men who have or are at risk for prostate cancer. It was seen as throwing fuel on the fire,” explains Dr. Brock. “However, much of the literature over the last two decades has really been very reassuring. More research needs to be done, but there’s a general consensus in the medical community now that testosterone does not cause prostate cancer and that it may in fact uncover undiagnosed prostate cancer at an earlier phase.”
“We do have alternate treatments that can stimulate the body to produce more testosterone without turning off sperm production.”
The other major concern with testosterone supplementation has been that it may increase the risk of cardiovascular disease. Studies have been mixed on the matter, with some implying an increased risk, while others suggest that testosterone supplementation may in fact be protective against some forms of cardiovascular disease. But, one thing almost everyone agrees on is that men with low levels of testosterone are at an increased risk for cardiovascular disease. So treatment is a trade-off.
The one downside to testosterone supplementation that does bear paying attention to is lowered sperm count. “If a man is young and still interested in having a family, it’s very important for him not to get testosterone supplementation,” cautions Dr. Brock. “We do have alternate treatments that can stimulate the body to produce more testosterone without turning off sperm production.”
Regardless of your age, if you are experiencing symptoms, you should talk to your doctor. You might be very happy you did.