What they are, and what to do about them!
The Significance of Testosterone
The primary hormone that we think about in association with men is testosterone. This poor hormone gets some bad publicity as it seems to drive a lot of men’s thoughts and decisions for several years of their life (and from a woman’s perspective, not always in a good way!). Differences in testosterone and estrogen balance do account for many differences between men and women, and sometimes it seems to create a disconnect. But testosterone is such an important hormone for men, and too much of it or too little of it can certainly have far-reaching effects.
We joke about men in their 20’s and 30’s and how testosterone drives them. Not just sexually either – it fuels their energy, their strength, their ambition. Testosterone is truly a whole-body hormone with highly complex and comprehensive roles in the body. This is true in women too but the amounts are much smaller and women have other more dominant hormones that “drive” us (and we confess, not always in a good way either!). Men, by design, are providers and protectors – they have to go out hunting the deer to bring home for dinner; they have to fight off the wild animals and the boogie-men, they have to keep everyone safe and well-protected. Testosterone is one of the major hormones that allow them to be that way. It is a well-designed system.
Testosterone is vital to a man’s health. It bolsters muscle strength, energy, libido, lean muscle mass, mood and outlook, plus a range of other effects. Men have estrogen too, it’s just in much smaller quantities than women, so it plays less of a role.
How Male Hormones Change Over Time
As a man ages, naturally his levels of testosterone will drop. Subsequently men can experience unwanted changes such as weight gain, especially around the abdomen, difficulty gaining and retaining lean muscle mass, depressed mood and outlook on life and drop in sex drive. Further, changes in male hormone levels have been associated with a range of significant degenerative diseases, including heart disease, stroke, diabetes, arthritis, osteoporosis and hypertension. Benign Prostatic Hyperplasia (BPH) may be due to increased estrogen in men, and research shows that men with prostate cancer often have low levels of testosterone.
Unfortunately, there is a triple-whammy in the hormone pool of men. Along with testosterone levels dropping, there is a rise in Sex Hormone Binding Globulin (SHBG). This means that more testosterone is bound to proteins and not available to bind with cells to exert its normal effect. And as if that’s not enough, estrogen levels rise in men around middle age as more testosterone is converted to estrogen, so that they experience more of the estrogen-like effects such as being more emotional (‘softer’ emotionally and physically). This can be helpful for their mates as at this stage in their life, men can sometimes bond more deeply, be more committed and less controlled by powerful sex drives of earlier years. But for many men, the changes are hard to deal with, and there is a feeling of loss around them. Losing hair, losing muscle, losing libido, gaining weight and feeling weaker physically – that doesn’t sound like a set up for feeling on top of the world and like a mighty provider and protector.
What Can Men Do To Balance Hormones?
Fortunately, there is something that can be done. With a simple saliva or blood test, we can assess a man’s testosterone levels. We can also measure the SHBG and estrogen levels, to see what the conversion to estrogen looks like. Along with that, and equally important, is to check cortisol and DHEA levels, which reflect adrenal status, and can influence both estrogen and testosterone.
From there, with evidence of low or low-normal testosterone levels, we can give testosterone supplementation in either a transdermal (on the skin) gel form, or in an injectible form. Typically the injections would be done weekly, and can be combined with B-12 for a further boost in energy levels. Some men prefer the transdermal form as they use it every day, it is convenient to do at home, and it gives a more steady state rather than the ebbs and flows of weekly injections.
The goal of testosterone therapy is not to falsely elevate testosterone out of the safe range. It is to boost testosterone levels to the higher end of normal range on the lab test. Translated to real terms, this means we are trying to optimize testosterone levels for a 30-40 year old man, not create a twenty-one year old monster again!!! The goal is to bring a man back to the feelings of strength, empowerment, sexuality and good health that he has known throughout his life, bearing in mind the natural changes that are built in by design with age.
In chronic illness, I have also seen many men benefit from testosterone therapy. For example, many of my male Lyme disease patients show low testosterone. This is partly because chronic disease takes so much out of the adrenal glands, decreasing the cortisol levels which further decreases the testosterone levels. Chronic infections can also play havoc on the pituitary gland, which filters down to the testes to reduce testosterone production there.
Men do not have to go through their 40’s, 50’s, 60’s and beyond feeling disempowered in their health, giving up their sex life, struggling to stay in shape, and being depressed about the whole scenario. Testosterone therapy, carried out safely using lab testing and moderate dosing schedules, is a safe and effective way to return to men their zest for life.
If you are a man who has experienced these effects with age, or if you suffer from a chronic illness that involves major fatigue, muscle weakness and/ or depression, you might benefit from testosterone therapy. Call us today at 619-546-4065 to schedule an appointment and get started on the road back to great health.