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Introduction to Low Testosterone ("Low T")

Low testosterone, or "Low T," is a condition that affects both men and women. It occurs when the body is unable to produce sufficient quantities of testosterone. Low testosterone is often associated with aging in both men and women – however, it can also be caused by many other factors, including certain genetic conditions, testicular damage or infection, and exposure to toxins, radiation, or chemotherapy. Physicians see more effects from testosterone deficiency as both men and women age, and particularly when a woman approaches and enters menopause.

In women, the ovaries produce the majority of testosterone and estrogens. With the cessation of 80% of hormonal production, a perimenopausal woman suffers from estrogen, progesterone, and testosterone deficiency. The replacement of estrogen alone does not correct an absent sex drive, loss of muscle tone, and general lack of mental “get-up-and-go”. The decrease in sex drive in women is often due to oral contraceptives which suppress all sex hormone production (testosterone, estrogens and progesterone). The treatment is relatively simple: add back some testosterone.

Men and women with low testosterone may experience symptoms such as fatigue or low energy, a decrease in sex drive and sexual function, and increased irritability or depression. Men with low testosterone may also notice a loss in muscle mass, decreased strength, and more fat around their abdomen. Longstanding low testosterone can cause a decrease in bone mineral density, increasing the risk for osteoporosis (loss of bone mass).

These symptoms are often explained away as "I'm just getting older." However, the real problem may be low testosterone. Because the symptoms of low testosterone are often subtle and similar to those caused by other medical conditions, Low T often goes untreated.

Testosterone is an important male hormone produced mainly in the testicles. While testosterone helps the body develop male characteristics during puberty, it also plays a central role in maintaining healthy sexual function, energy, mood, and body composition in adult males.

male testosterone decline with age

Testosterone is also produced in females. It is produced in the ovaries. Testosterone helps promote bone growth, and it can help relieve mild depression, some vasomotor symptoms, and vaginal atrophy and dryness. It is the precursor to estrogen. Without testosterone, there would be no "woman."

female testosterone decline with age

Low T and Erectile Dysfunction

Erectile Dysfunction (E.D.) can be caused by physical and/or emotional factors. It has been estimated that the prevalence of E.D. in U.S. men could be up to 30 million. E.D. has been associated with age, with a prevalence of 52% in men aged 40 to 70 years old. According to a recent study, one out of five men with E.D. had low testosterone. Low testosterone is often associated with a loss of sexual desire, as well as a number of other symptoms.

Symptoms of Low T

Low testosterone, or "Low T," is a condition that affects as many as 13 million American men. It occurs when the body is unable to produce sufficient quantities of testosterone. The medical name for low testosterone in men is hypogonadism. It can be caused by many factors, including certain genetic conditions, testicular damage or infection, and exposure to toxins, radiation, or chemotherapy.

Low testosterone is often associated with aging for both men and women. Yes, women also suffer from low T levels. Women have many of the same symptoms as men: obesity, diabetes, or hypertension may be twice as likely to have low testosterone levels.

Physicians see more effects from testosterone deficiency as a woman approaches and enters menopause. The ovaries produce the majority of testosterone and estrogens. With the cessation of 80% of hormonal production, a peri- menopausal woman suffers from estrogen, progesterone and testosterone deficiency. The replacement of estrogen alone does not correct an absent sex drive, loss of muscle tone and general lack of mental get-up-and-go. The decrease in sex drive in women is often due to oral contraceptives which suppress all sex hormone production (testosterone, estrogens and progesterone). The treatment is relatively simple: add back some testosterone.

Men and women with low testosterone may experience symptoms such as fatigue or low energy, a decrease in sex drive and sexual function, and increased irritability or depression. Men with low testosterone may also notice a loss in muscle mass, decreased strength, and more fat around their abdomen. Longstanding low testosterone can cause a decrease in bone mineral density, increasing the risk for osteoporosis (loss of bone mass).

These symptoms are often explained away as "I'm just getting older." However, the real problem may be low testosterone. Because the symptoms of low testosterone are often subtle, and similar to those caused by other medical conditions, Low T often goes untreated, with only 1 in 20 men (and even less in women) with the condition receiving treatment.

On the brain:

  • Sex drive and performance decrease
  • Energy levels decrease
  • Irritability and depression increases

On the body:

  • Lean body mass (muscle) decreases
  • Fat mass - abdominal fat increases
  • Bone mineral density decreases

Expert Opinion

Dr Gold

Low testosterone is a major problem in both men and women approaching their forties and fifties. Testosterone is an important hormone that is produced in both men and women for physical growth and support such as maintaining muscle mass, muscle growth, fat loss, energy, stamina, and sexual health. A number of studies show a fairly significant percentage of diabetics have low testosterone. And low testosterone is linked to insulin resistance.

Testosterone is a dominant hormone in men, so when it decreases drastically, it causes major problems. By the time men reach their seventies, most of them have 30 to 50 percent less testosterone than they had when they were young. This causes muscle weakness, reduced libido, depression, mood swings and loss of mental acuity. Researchers found nothing wrong with the men's testes. Instead, they found evidence that the men's pituitary glands weren't making enough luteinizing hormone. That's the hormone that tells the testes to make testosterone. These symptoms are reversible with testosterone therapy and millions of men over age 50 are now using testosterone for this reason.

Women have a tenth of the testosterone that a man does, so when it starts to diminish it can have a big impact. Low testosterone causes problems including depression, decreased bone density, low sex drive, lack of vaginal moisture, lack of orgasm and loss of energy and strength. Between 45 and 55 years of age, women begin to experience menopausal symptoms and premenopausal symptoms can occur as early as 35. This causes an imbalance in hormones. A youthful balance is a primary key to slowing down and even reversing the effects of aging.

Low Testosterone in Men is Linked to Earlier Death

The recent news is frightening. Studies are being released showing that the lower a man's testosterone level, the higher his risk of death.

The research is becoming jaw-dropping and yet most men have no idea how serious the situation really is.

Please take note...

According to just released findings in the Journal of Clinical Endocrinology & Metabolism, Dr. Gail A. Laughlin and her University of California, San Diego colleagues showed that older men with low levels of testosterone may die sooner than other men their age with normal testosterone levels.

This particular study included 794 men between 50 and 91 years old who were followed for an average of 11.6 years. In general, the one quarter with the lowest testosterone levels at the beginning of the study were 40% more likely to die over the course of the study than the men with higher levels of the hormone.

Another study was carried out by University of Cambridge gerontologist Kay-Tee Khaw, MBBCh, and colleagues. They studied 12,000 British men aged 40 to 79 who enrolled in a long-term study from 1993 -1997.

More than 800 of the men died by 2003; Khaw compared the testosterone levels of these men to those of some 1,500 living study participants.

After adjusting for factors that might affect risk of death - including age, weight, smoking, alcohol use, unstable blood pressure, blood sugar problems, physical activity and social class— the link between low testosterone and earlier death remained.

Low T Risk Factors

The causes for low testosterone that occur in men can be a result of one's lifestyle. Lack of exercise, unhealthy diet, smoking, and excessive drinking are all causes of low testosterone that can be modified by changing one's living habits. These factors are responsible for damage of the pituitary gland hypothalamus.

Other reasons men may be low on testosterone include poor circulation, and hypertension. Use of prescription or non-prescription medications may also be a cause of low testosterone. Psychological problems, too, it is believed in some circles might cause a man to suffer low testosterone although there is no consensus on this.

chart 1

Low T and Diabetes

Men with type 2 diabetes may be at an increased risk for low testosterone. Recent research shows that Low T affects 33-45% of men with type 2 diabetes.

While the exact reasons for this are still unclear, research suggests that the problem lies in the body's ability to stimulate testosterone production in the testes.

Men with low testosterone may be more likely to develop type 2 diabetes than men who have normal testosterone levels.

Women with NIDDM (Non-Insulin-Dependent Diabetes Mellitus), also known as Diabetes mellitus type 2 or type 2 diabetes, have high levels of free testosterone and low levels of sex hormone binding globulin (SHBG). Insulin resistance is closely correlated with these signs of hyperandrogenicity as well as with obesity. Men with NIDDM also have low levels of SHBG and, in contrast to women, low testosterone values.

Testosterone treatment is very efficient to reduce insulin resistance without digestive problems (a very common side effect of other anti-diabetes drugs).

Men and women with type 2 diabetes should have their testosterone levels tested, so be sure to remind your doctor during your next appointment.

Low T and Chronic Pain

If you're using prescription medicine to treat your chronic pain, you may be at higher risk for having low testosterone. Use of pain medications (known as opioids) may have a negative effect on the production of testosterone. In fact, recent research shows that up to 74% of men using opioids for treatment of chronic pain have testosterone levels below the normal range.

Restoring and maintaining normal testosterone levels can lead to a number of positive changes, such as:

  • Reduced fat
  • Increased muscle mass
  • Improved sexual desire
  • Improved sexual performance
  • Increased bone mineral density

Common Questions

What is the average age that men begin Andropause?

By the time men are between the ages of 40 and 55, they can experience a phenomenon similar to the female menopause, called andropause. Unlike women, men do not have a clear-cut signpost such as the ending of menstruation to mark this transition. Both, however, are distinguished by a drop in hormone levels. Estrogen in the female, testosterone in the male. The bodily changes occur very gradually in men and may be accompanied by changes in attitudes and moods, fatigue, a loss of energy, sex drive and physical agility.

Andropause is often underdiagnosed because symptoms can be vague and can vary a lot among individuals. Some men find it difficult to admit that there's even a problem. And often physicians didn't always think of low-testosterone levels as a possible cause. But testosterone is usually the cause, so you should get your testosterone levels checked to see if that is what is causing your possible andropausal symptoms.

Does taking testosterone cause manly features in women?

If a woman is using more than the prescribed dosage of testosterone for her diagnosis, she will start to acquire masculine features. These features may include thicker facial and/or body hair, a deeper voice, and masculine-like facial features. Just be careful when using it and do what your doctor suggests.

Will it improve my sex life?

If you are experiencing low testosterone levels, it might be the cause of the low libido. Be sure to check with the doctor first to find out if that is the reason for the decreased sex drive because there could be other reasons. If your test results do show low T levels, then it would be a good idea to get started on a hormone replacement therapy for testosterone and possibly estrogen, according to your tests.

What is DHEA? What does it do for you?

Dehydroepiandrosterone (DHEA) is produced by the adrenal glands. The body converts DHEA to male and female sex hormones, such as estrogen and testosterone. DHEA levels typically peak by the time people are in their 20s and decline with age, which is why there has been considerable interest in DHEA and its role in aging. DHEA is manufactured naturally in the body, but DHEA supplements can also be made in a laboratory from a substance called diosgenin, found in soybeans and wild yam. Wild yam cream and supplements are often promoted as being a natural source of DHEA, but the body can't convert wild yam to DHEA on its own -- the conversion must be done in a laboratory.

Testosterone Test

If you have experienced any 4 of the following, you may be a candidate for further testing and possible hormone (including testosterone) replacement.

  1. Decrease in sex drive
  2. Orgasm less strong
  3. Lack of energy
  4. Decrease in strength or endurance
  5. Lost height
  6. Decreased "enjoyment of life"
  7. Sad and/or grumpy
  8. Deterioration in sports ability
  9. Falling asleep after dinner
  10. Decreased work performance

If you have symptoms of low testosterone, a simple saliva test can confirm if your testosterone levels are low.

 

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