National Post

When Testostero­ne Levels Drop, Men Suffer

- D. F. McCourt

Testostero­ne. 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.”

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.”

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.

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