TESTOSTERONE
& MALE AGING
“Low-T” is also known as low testosterone or andropause.
As men age, their bodies produce less and less testosterone. Andropause is often referred to as “male menopause.” This lack of testosterone can lead to a number of symptoms that many men just accept as the “normal aging process” and do not realize that these symptoms can be significantly reduced or nearly eliminated through testosterone replacement therapy (TRT).
Numerous changes associated with an age-related decline in testosterone can occur quickly, with a sudden change, or more typically, slowly over a period of time, with a gradual hormone decline. Male aging begins much earlier than most men realize. Testosterone levels start to decline in the late twenties and continue well into our seventies. This decline in testosterone levels becomes more evident in middle-age when some men experience troubling symptoms, such as fatigue, muscle loss, increased body fat, and erectile dysfunction, among many others.
Understanding Low Testosterone
There are many factors that contribute to low testosterone levels which include:
Natural Aging
Low physical activity
Exposure to heavy metals, pesticides, and other pollutants
Stress
High blood sugar
Excess body fat
There are many other signs and symptoms that men experience due to andropause which include:
Loss of muscle mass
Decline in bone density
Enlarged or tender breasts
Greater body fat
Lower self-confidence
Motivation problem
Poor concentration
Memory issues
It is important to be aware that some of these symptoms could be linked with other disorders such as hypothyroidism, diabetes, cardiovascular disease just to name a few.
Am I a Good Candidate for Testosterone Therapy?
The first steps we take at CoastalT to determine if you can benefit from testosterone therapy are to discuss your concerns during a consultation and run a comprehensive blood analysis. This enables us to determine your baseline, what you need to supplement, and how much you need to take. Blood test results are usually available within a week of your appointment.
WHAT YOU SHOULD KNOW:
Important information to consider in preparation for your appointment at CoastalT:
If you are currently on treatment, blood draws must be scheduled on your injection date for the most accurate results.
When doing a full blood panel, you are recommended to start fasting 8 hours before your blood is drawn.
Do NOT inject testosterone or apply the cream directly prior to a blood draw.
Please hydrate!
MALE HORMONE THERAPY OVERVIEW
Since the drop of male hormone is the likely issue in andropause, Testosterone replacement therapy is used to combat the symptoms. Treatment normally involves any of the following:
PILLS
There are products you can take orally to boost the levels of testosterone in your body. Pills need to be taken with food 2-3 times daily and are only advisable for short-term use.
GELS
Along with pills, there are also topical solutions that can be used to combat andropause symptoms. Testosterone gels are applied after showering on the upper arm or shoulder. You are to leave them on for several hours for proper absorption. Extra caution is essential when using these products, though.
INJECTIONS
These are the most effective means of testosterone replacement. Injections are taken less often. But the potency of testosterone injections also makes them, perhaps, more likely to cause side effects.
Men typically get relief from andropause symptoms following testosterone replacement therapy as it improves energy levels, enhances sexual drive and desire, and relieves depression.
What To Expect After Starting Testosterone Replacement Therapy
Most men begin to see improvements in symptoms within weeks. Injections tend to work more quickly than other administration routes such as pellets or patches, the information below gives you a general idea of what to expect after testosterone replacement therapy begins.
1 WEEK
Insulin sensitivity improves.
3 WEEKS
Interest in sex returns, quality of life increases, inflammation declines, and mood begins to improve.
3 MONTHS
Fat mass begins to decrease, and lean muscle mass increases. Total cholesterol decreases, with maximum improvement achieved at about 12 months.
1 MONTH
Sexual performance and satisfaction start to increase but may take up to 6 months.
12 MONTHS
Glycemic control and lumbar bone density increase. Bone mass can continue to improve for up to 3 years.
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• Testosterone makes a man look and feel like a man. In a man, this hormone helps:
• Keep bones and muscles strong
• Determine hair growth and where fat is on the body
• Make sperm, maintain sex drive and erections
• Make red blood cells
•Boost energy and mood
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Beginning in the late 20s and extending into mens’ golden years, to 40, testosterone levels may start to slowly decrease. This occurs naturally.
Other causes of low testosterone include:
• Medicine side effects, such as from chemotherapy.
• Testicle injury or cancer.
• Problems with glands in the brain (hypothalamus and pituitary) that control hormone production.
• Low thyroid function.
• Too much body fat (obesity).
• Other disorders, chronic diseases, treatments, or infection.
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Some men with low testosterone do not have any symptoms. Others may have:
• Low sex drive
• Problems having an erection
• Low sperm count
• Sleep problems such as insomnia
• Decrease in muscle size and strength
• Bone loss
• Increase in body fat
• Depression
• Lower self-confidence, low motivation, Poor concentration, Depression. Mental fog
• Fatigue
• Aging skin
• Enlarged or tender breasts
Some symptoms may be a normal part of aging. For example, it is normal to feel less interested in sex as you get older. But, it is not usually normal to have no interest in sex.
If any of these symptoms are bothering you, talk with your provider. It is important to be aware that some of these symptoms could be linked with other disorders such as hypothyroidism, diabetes, cardiovascular disease just to name a few. At CoastalT, we help determine the root cause of your symptoms and get you the correct treatment.
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If you have Low T, hormone therapy may help. The medicine used is man-made testosterone. This treatment is called testosterone replacement therapy, or TRT. TRT can be given as a pill, gel, patch, injection, or implant. At CoastalT, we prefer gels and injections as they are better absorbed and easier to adjust when needed.
Gels are self-administered at home. They are applied daily to the upper arms, shoulders, and abdomen, as these regions have thinner skin that enhances absorption while minimizing potential side effects. Because it is absorbed through the skin, certain precautions are necessary to prevent accidental exposure to others you may touch, especially women and children.
Injections can be given at CoastalT or self-administered at home. These intramuscular injections are administered 1-2 times per week into the buttock or thigh. If you choose this type of administration, CoastalT will instruct you on the process. Be sure to store new and used syringes and needles out of the reach of children and pets. You will need to dispose of the used needles properly. There are no other special precautions.
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TRT has several known risks and side effects. These may include:
• Testicular shrinkage and Low sperm count, infertility
• Enlarged prostate leading to difficulty urinating
• Worsening cardiovascular disease
• Sleep problems
• Cholesterol problems
• Increased risk of blood clots, heart attack, and stroke
• Breast size increase
• Acne
• Fluid retention
It’s important to talk with your hormone specialist and carefully weigh these potential risks and benefits before beginning treatment. Side effects are not uncommon with any type of hormonal treatments, and not just limited to testosterone replacement therapy. This is why regular blood analysis and followup appointments are vital. There are medications that can treat and offset these effects.
It should be noted that some men may not benefit much, if at all, from the therapy. If you do not notice any change in symptoms after treatment for 3 months, it is less likely that TRT treatment will benefit you.
Most men over the age of 40 show some signs of low testosterone. If your symptoms are becoming bothersome or you simply want to feel better, discuss treatment options with the team at CoastalT.
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Men with a history of enlarged prostate, blood clots or certain blood disorders are NOT candidates for TRT. The long-term risks of the therapy aren’t completely known. But it is believed that it can promote cancerous growth and worsen prostate cancer.
TRT can also increase your risk of suffering from heart disease and stroke. This is in connection with how testosterone can promote the formation of clots in your veins which is why periodic monitoring is essential.
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You can continue testosterone replacement therapy for as long as you’re benefiting from it. At CoastalT we monitor your symptoms periodically and make adjustments as needed.
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There is no specific age at which it’s best to begin testosterone replacement therapy. Even though low T can occur at any age, it typically occurs some time after age 40. Unlike menopause, which involves rapidly declining levels of estrogen, andropause involves the gradual loss of testosterone.
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You can effectively boost testosterone naturally by consuming a diet rich in protein, vitamin D, and zinc, exercising regularly, minimizing stress, and getting enough sleep. Men with low T, however, often feel fatigued and have trouble sleeping, which leads to less exercise. Testosterone replacement therapy can effectively treat those and other symptoms of low T.
In addition, if you are a person who prefers to use herbal supplements that may help, you do have options. The problem with herbal supplements, though, is that many in the medical community doubt their efficacy due to lack of evidence in research. However, there are also reports of people noticing an increase in their testosterone levels using herbs. If you are interested in learning more, this can be discussed in your consultation.
