“One should strengthen himself like a lion to get up in the morning to serve his Creator.”
What is andropause?
Andropause, also known as male androgen deficiency syndrome, is the male equivalent of female menopause. It results from diminished levels of testosterone in the body, and exhibits a symptom complex similar to female menopause. Testosterone levels decline with age beginning in the 30s, and by the 80s, are one-fifth the level of adolescents. Compared to menopause, which results in a relatively abrupt drop in hormone levels, andropause is a more gradual process with symptoms more insidious.
As we approach our 50s, we may notice tiring a little earlier and not having quite as much energy as we had when we were in our 20s. This may progress gradually and even lead to significant intolerance of any activity or exercise. One may notice gradual weight gain even without an obvious change in diet. Another subtle symptom could be waking up more slowly without feeling refreshed.
What is testosterone?
Testosterone is the primary male sex hormone, responsible for male sexual development and critical in maintaining erectile function, libido, normal energy levels and mood. Testosterone also controls a whole range of physiological functions throughout the body.
Is testosterone decline the primary cause of aging?
With aging, there is increased cardiovascular disease, decline in bone density, decline in cognition with onset of dementia, reduced muscle mass, fatigue and decreased libido. Obviously, decreased testosterone is not the only cause of all these conditions. Men with low testosterone are predisposed to all of these conditions. On the other hand, testosterone replacement improves all of these conditions. So while testosterone decline may not be the primary cause of all these age-related conditions, low testosterone is associated with these conditions and testosterone replacement improves these conditions.
What are the benefits of testosterone?
Testosterone is most known for its positive sexual effects and based on all of the advertisements of which this is the focus, that seems to be a popular benefit. Yet there are many more benefits of testosterone for both the present and the future. Testosterone improves energy and mood and overall feeling of well-being. Over the longer term, men who replace testosterone have improved cardiac health. They have fewer heart attacks and fewer cardiac deaths. Men who replace testosterone have improved cognitive ability with less dementia. Osteoporosis is more common in women but also occurs in aging men. Men who replace testosterone have improved bone density and fewer fractures. Reduced cardiac disease and reduced dementia are both associated with increased longevity.
Will testosterone replacement make me younger?
No, but based on multiple studies, testosterone replacement will help you feel more energetic with associated improved self-confidence and improved mood. Also, testosterone replacement builds muscle mass. Testosterone can also help reduce visceral fat, which is a factor in many illnesses associated with aging such as Type 2 diabetes mellitus, heart disease and many cancers. So you will not be younger with testosterone replacement but you just may feel younger.
Does testosterone replacement cause prostate cancer?
No. When testosterone replacement was initially described, a concern was expressed that testosterone could stimulate prostate cells, predisposing one to cancer. However, multiple studies have demonstrated that testosterone replacement does not cause an increased incidence of prostate cancer. There have also been studies that demonstrate that those with low testosterone levels have a higher incidence of prostate cancer. The idea that testosterone replacement causes prostate cancer has been debunked.
What about the heart?
Multiple studies have shown cardiac benefit from testosterone replacement. Testosterone can improve lipids, raising the good HDL cholesterol while lowering the bad LDL cholesterol. Also, testosterone can reduce visceral fat and reduce blood sugar. All of these effects lead to improved cardiovascular health. There have been a few studies that have suggested increased incidence of heart attacks when starting testosterone but the vast majority of studies have demonstrated positive cardiac benefit. Testosterone replacement has been shown to increase cardiac output in some men with congestive heart failure. This positive benefit translates to increased longevity, which is also supported by the preponderance of the studies of testosterone replacement.
Does testosterone replacement promote weight loss?
Studies suggest that testosterone replacement will help with a modest weight loss. More important, body composition is improved. There is reduced visceral fat and increased muscle mass. Furthermore, with increased muscle mass and improved energy, one who has not exercised may get more motivated to initiate an exercise program. One who already exercises will have increased capacity to increase his exercise regimen. As someone starts to feel better, he becomes more motivated to take better care of himself and eat better. All of these factors lead to a better lifestyle and improved fitness. Thus, in addition to helping weight loss, testosterone replacement can promote the kind of lifestyle changes that lead to the healthiest long-term type of weight loss.
What’s the bottom line?
Andropause, the decline in testosterone with age, is associated with many age-related conditions as described above. Fortunately, many of these conditions can be prevented with testosterone replacement. Instead of declining energy, one feels increased energy to help fulfill the first halacha in the Shulchan Aruch, “One should strengthen himself like a lion to get up in the morning to serve his Creator.”
To find out if you are experiencing andropause and learn more, set up an appointment to diagnose and treat this common condition.
By Warren Slaten, M.D.
Dr. Slaten is a wellness physician specializing in regenerative pain treatments and lifestyle counseling. He is certified in advanced bioidentical hormone replacement.
