Hormone Replacement Therapy for Men with Low Testosterone

Andropause is the name given to lowered androgen levels (e.g., testosterone, dehydroepiandrosterone, estrogen) or decreased androgen production in aging men. Androgens are hormones produced by the gonads (i.e., testes and ovaries) and is found in both men and women. The most known male androgen is testosterone and many people use the terms androgen and testosterone interchangeably. Lowered testosterone levels are thought to be the main catalyst for the onset of andropause and lower levels of testosterone in both aging men and women is well documented. In men, testosterone is responsible for the changes experienced during puberty. Secondary sex characteristics like the development of muscle, a deepened voice and an increase in body hair are all due to increased testosterone production. In addition, testosterone is responsible for libido (i.e., sex drive) and appropriate sexual functioning. When testosterone levels are low, these functions can become impaired.

What Are the Symptoms of Low Testosterone?
The symptoms of andropause, sometimes referred to as hypogonadism (i.e., low levels of testosterone), are thought to be similar to the symptoms experienced by women during menopause, but to a much lesser extent. Hot flashes, night sweats, depressive mood, aches and pains along with increased irritability and decreased energy are symptoms experienced by women during menopause and men during andropause, though the experience for women is much more drastic and abrupt in comparison to men. Symptoms for men generally occur gradually and may take many years before men begin to notice them, if at all. In contrast, all women experience menopause between their late 40’s and mid 50’s, leading to a steep decline in the production of female sex hormones, which subsequently, induces the ovaries to stop releasing eggs, the cessation of menstruation, and finally infertility. This is not the case for men. Men with adequate testosterone levels can produce sperm and be fertile well into their 80’s or 90’s. Though disputed, andropause or low testosterone levels, is thought to affect between 2 and 5 million men in the U. S. and is usually experienced by men beginning in their 40’s. In addition to the symptoms listed above, loss of body hair, decreased strength, erectile dysfunction, loss of some cognitive abilities, osteoporosis, thinning skin, impotence, gynecomastia (i.e., male breasts) and diabetes have been shown to be associated with low testosterone levels and andropause.
At What Age do Men's Hormone Levels Start to Decline?
Changes or declines in men’s hormone levels generally begin around the age of 40, though some men may experience them earlier. Men are expected to lose 10% of their testosterone every decade or 1% a year, starting anytime between the ages of 40 and 55. Many physicians refer to this timeframe as the mid-life crisis phase, or a time when some men question the direction of their lives and the legacy they’re leaving behind. Some physicians assert that this period of crisis can be attributed to age-related medical, mental or emotional issues that inhibit the production of androgens like testosterone.
What is Hormone Replacement Therapy?
Hormone replacement therapy (HRT) for men is generally the replacement of testosterone. As males age, androgen production slows down and testosterone levels start to decline. Hormone replacement therapy for men is often, but not limited to, testosterone replacement. Many in the medical community refer to the phenomena of low androgen levels in men as low t (low testosterone). Men who believe they have low testosterone levels should consult a physician and schedule and check-up. There could be serious medical conditions associated with symptoms that can be corrected with proper medical treatment. If men are suffering from low levels of testosterone not due to medical issues, then testosterone replacement therapy may be the answer.
What are the Benefits of Testosterone Replacement Therapy?
  • Increased libido (i.e., sex drive)
  • Increase in muscle mass and bone density
  • Increased strength
  • Decrease in body fat
  • Improved mood and positive well-being
  • Improved sleep patterns
  • Reduced risk of Alzheimer’s
  • Reduction in metabolic Syndrome (i.e., abnormal cholesterol levels and high blood pressure)
  • Decrease in erectile dysfunction
  • Increase in energy levels
  • Decreased fatigue
  • Decreased gynecomastia (i.e., male breasts)
  • Improved cognition and memory
  • Improved mood swings- unprovoked, sudden changes in mood
  • BPH (i.e., benign prostatic hyperplasia; an enlargement of the prostate gland, which puts pressure on the urethra and makes urination difficult)
  • Better blood sugar regulation and decreased risk of diabetes
  • More nitric oxide production and more oxygen delivered to cells
Why is it Important to Consult a Doctor About Andropause?
Many of the problems associated with andropause, if left unchecked, can lead to serious chronic illnesses, such as, high blood pressure, type 2 diabetes, heart and cardiovascular disease. Furthermore, it may not be safe to use products not regulated by the FDA or without the care of a physician, for instance, products sold without a prescription or online. It is best to see a physician, preferably one that is familiar with hormones, hormonal levels in men, as well as, the benefits and costs associated with hormone replacement, like endocrinologists, andrologists, and urologists (i.e., doctors who specialize in the urinary tract).

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