Low Testosterone: Causes and Treatments
Low testosterone is an unfortunate consequence of aging that currently affects about five million men. Secreted in the testes, testosterone peaks during puberty.
Testosterone plays a role in hair growth as well as the development of the penis and testes. It also causes the voice to deepen and contributes to muscle development. It helps produce sperm and maintains sex drive, too. (Women also make a small amount of testosterone in their ovaries.)
Low testosterone, which is also called hypogonadism can cause undesirable changes such as:
- Reduced sex drive
- Erection difficulties (impotence or erectile dysfunction)
- Low sperm count
- Smaller testes
- Loss of body hair, muscle bulk, and overall energy
- Enlarged breasts
- Accumulation of body fat
At the age of 30, most men start gradually losing their supply of testosterone—about one percent a year. Certain factors such as being a vegetarian, diabetic, a heavy drinker, or having a pituitary-gland disorder may contribute to a greater loss of testosterone. Heredity, obesity, physical trauma, radiation, chemotherapy, and medication side effects can impact testosterone as well as medical problems like a testicular infection, pituitary tumors or diseases, type 2 diabetes, HIV, and chronic liver and kidney disease.
Some men have a lower than normal testosterone level without symptoms. A blood test—usually taken in the morning when testosterone is highest—is the only way to diagnose low testosterone. Normal testosterone levels range from 300 to 1,200 nanograms per deciliter (ng/dl). Because doctors and health experts still don't know enough about how age relates to a decline in testosterone, diagnosing and treating low T is somewhat controversial—unless a definitive medical diagnosis is made.
We do know that low testosterone can make your bones brittle so your doctor may prescribe a bone density test. Low T can also be indicative of a tumor in the pituitary or hypothalamus in which case, a CT scan or MRI may be prescribed. We also know that many acute and chronic diseases produce low testosterone levels, which often normalize when the underlying condition is improved.
Testosterone Therapy: Risky Business or the Ultimate Anti-Aging Formula?
Widely available since the 1930s, testosterone has been used for decades to treat symptoms of an impaired libido. According to research published in the Journal of Clinical Endocrinology and Metabolism (January 2011), regulatory agencies continue to debate whether therapeutic intervention is medically necessary or rather a lifestyle drug.
Testosterone replacement therapy may increase sex drive by promoting more frequent erections, maintain facial hair, decrease depression and fatigue, increase muscle mass, and improve bone density. But as with all medication, risks are involved. The National Institutes of Health (NIH) advise men considering testosterone treatment therapy to understand the possible risks:
- High red blood cell count
- Sleep apnea (breathing that stops intermittently during sleep)
- An increase in prostate cancer in all men over 50—especially in African American men
- Fluid buildup in the body
- Breast or prostate enlargement
There are several forms of testosterone replacement therapy: pills, injections, gel, and patches—each have down sides including adversely affecting the liver. The newest form of hormone replacement therapy—gum tablets which are placed between the gum and upper lip every 12 hours—has side effects including mouth irritation, bitter taste, pain or tenderness in the gums, and headache, but these problems usually disappear within 14 days.
National Institutes of Health
The Hormone Foundation
National Aids Treatment Advocacy Project
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