Male Hypogonadism – “Low T” – ADAM
June is National Men’s Health Awareness month! It’s a special month dedicated to educating Men about preventable health issues and encouraging health screenings that may detect preventable diseases among men. Physicians and the medical community encourage all men to seek out medical advice and possible treatment they may need for health-related issues.
Did you know that around 20% of men that are greater than the age of 50 years old have either low levels of the male hormone testosterone in their blood or show signs and symptoms of testosterone deficiency? This is because, after the age of 40, the testosterone levels in a man will decline by 1% each year. Testosterone plays an essential role in the men, responsible for masculine growth and development from young adolescent through puberty.
The physiological functions of testosterone are:
- Maintaining reproductive tissues
- Stimulating spermatogenesis
- Stimulating and maintaining sexual function
- Maintaining bone mass
- Stimulating erythropoiesis
- Promoting sebum production, and axillary and body hair growth
- Increasing body weight and nitrogen retention
- Maintaining reproductive tissues
Causes of low testosterone levels:
The primary cause of male hypogonadism, or low T can be related to testicular failure due to and autoimmune disorder, a genetic disorder, chemotherapy or injury to the gonads or liver and kidney disease.
The secondary cause known as Central hypogonadism arises from a problem in the hypothalamus and the pituitary gland in the brain. This may be caused by nutritional deficiencies, inflammatory diseases, medications such as opiates, rapid weight loss, obesity or normal decline of hormones with aging.
Just like the female version of menopause, men go through changes defined as ADAM – Androgen Deficiency of the Aging Male. A decline of testosterone levels and related symptoms begins after the age of 40 leading to sexual dysfunction, slower metabolism and decreased muscle mass. According to the International Journal of Clinical Practice 38.7% of men greater than 45 years old in the United States experience this syndrome. Studies have noted a significant drop in testosterone levels over the last 25 years due to obesity, physical inactivity, diet, pesticides, and stress. When one or more levels of the hypothalamic-pituitary-testicular axis are disturbed, the testis fail to produce the correct hormone levels of testosterone (androgen deficiency). This lack of testosterone can play a factor with health issues including Type 2 diabetes, hypertension, obesity and osteoporosis.
Symptoms of low testosterone in adulthood:
- Erectile dysfunction
- Decrease in beard and body hair growth
- Decrease in muscle mass
- Development of breast tissue (gynecomastia)
- Decreased sex drive
- Difficulty concentrating
- Hot flashes
Health risks associated with ADAM
- Depression and mental decline
- Cardiovascular related issues
- Diabetes (up to 50% of men) and metabolic syndrome
- Decreased muscle strength
When to speak to a Physician
Andropause screenings should be provided to patients experiencing concern or to those who have clinical conditions associated with insulin resistance (like obesity or type 2 diabetes).
A physician will be able to determine the need for further medical attention, including a questionnaire and blood work.
A German Professor developed the Aging Male Symptoms (AMS) questionnaire that is frequently used by doctors to diagnose of Testosterone Deficiency Syndrome and the monitoring of Testosterone Replacement Therapy (TRT) based on the patient’s results. The questions can get personal but are essential to decide on a plan of action, if needed.
Treatment for male hypogonadism
Testosterone Replacement Therapy can be used to improve erectile dysfunction, libido, cognition, muscle strength and mood. Changes can generally be noted in 6 to 9 months. Treatments can be given orally, through patches or topical creams. However, studies show there are risks to using testosterone replacement therapy as a treatment and would suggest that clinicians consider offering the therapy on an individualized basis. Risks include: a decline in prostrate health to include cancer, decreased bone density, risk of cardiovascular disease, breast enlargement, reduced sperm count and worsening of sleep apnea.
Males who suffer from hypogonadism are encouraged to try integrative natural approaches before male hormone replacement therapy occurs.
- Reduce your stress – improve your testosterone levels
- Address your weight and diet – cut out junk food and processed food
- Exercise regularly – light to moderate weight lifting increases serum testosterone levels
- Sleeping – add an hour a day and increase testosterone levels by 12-15%
- Supplement with L-arginine – an amino acid which enhances human growth hormone response, a natural testosterone booster
- Try Ashwagandha – an Ayurvedic herb known to be an aphrodisiac
- Try essential oils – Sandalwood relieves low sex drive, stress, and cognitive issues.
Maintaining healthy testosterone levels as you age can be challenging. Be proactive and visit with your Physician. More information about men’s health and low testosterone levels can also be found at these great websites: