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Aging Well
All About TestosteroneThe 'male' hormone naturally declines as you age, but other factors also affect testosterone levelTestosterone surges through the bodies of teen-age boys, propelling them into manhood with deeper voices, rapid growth, and new facial and body hair. This “male” hormone is responsible for a man’s aggression, energy, sex drive, sperm production, and development of muscle and bone mass—in other words, making men look, act and function like men.The hormone is produced in the testicles, says endocrinologist Geraldo Saavedra, M.D., of Lehigh Valley Hospital and Health Network. Men experience a flood of testosterone twice in their lives—first, in the womb about six weeks after conception when their genitals are formed, and again at puberty, usually between ages 14 and 18. Men have between 260 and 1,000 units* of testosterone running through their veins daily, but the level fluctuates. It’s at a natural high in the morning, increases during physical activity or periods of excitement, and decreases during periods of depression or anxiety. “While high testosterone levels often are associated with high- energy, aggressive men, many other physical, psychological and environmental factors affect male behavior,” Saavedra says. Women, too, produce testosterone in their ovaries and adrenal glands, but in much smaller amounts (10-40 units). The hormone still can affect their health, Saavedra says. Elevated levels can contribute to infertility and polycystic ovarian syndrome, a metabolic disorder associated with infertility, diabetes and heart disease. Symptoms include sporadic or absent menstrual periods, excess facial and/or body hair, thinning scalp hair, acne and weight gain, especially in the upper body. Andropause: the “male menopause”“A man’s testosterone level peaks at about age 20 and generally begins to decline very slowly in his 30s,” Saavedra says. “This has been called andropause by some scientists and is a normal part of aging. Men experience a gradual decline in sex drive, energy and muscle mass, but most men can maintain normal levels of testosterone, an active sex life and the ability to father children into their 70s or older.”Men whose testosterone declines more quickly may have such symptoms as impotence, depression, hot flashes, irritability, mood swings, difficulty concentrating, fatigue, breast enlargement, increased fat and loss of muscle mass. Prolonged periods of low testosterone cause hair loss on the head, face and body, and eventually osteoporosis. “The most common symptoms of low testosterone are a diminished sex drive and erectile dysfunction,” says internist Anthony Matejicka, D.O., of Lehigh Valley Hospital and Health Network. “But erectile dysfunction can be caused by other conditions, so it’s important that the man be tested for a correct diagnosis.” What (besides aging) causes testosterone to decline? Possible causes include alcohol abuse, steroid use (see right), obesity and medical treatments such as chemotherapy or hormone therapy for prostate cancer, Matejicka says. “You can help keep testosterone at a healthy level by not overdoing alcohol and staying physically fit,” he says. For men whose hormone levels are too low, there is testosterone replacement therapy (TRT). “TRT restores sexual function and muscle strength, prevents bone loss, and increases energy and overall well-being,” Saavedra says. TRT is most common today as a patch or gel that delivers a steady, low dose of testosterone. Also available are biweekly injections, which cause fluctuations in symptom relief between doses; and tablets, rarely used because they may increase the risk for liver problems.
Want to Know More? For a checklist to help determine whether your testosterone levels should be tested, call 610-402-CARE or click here. This page last updated 4/9/08 04:01 PM
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