Men’s Health - Hypogonadism (Low Testosterone ) in the Aging Male
A New Paradigm In Medicine
Conventional medicine has typically held the belief that aging is inevitable and that it is a progressive process which cannot be altered. Fortunately, there is an exciting revolution in science and medicine that identifies aging as a disease. We are now entering a new era in mainstream medicine that focuses on disease prevention, rather than simply the treatment of aging symptoms.
One element of this new paradigm of care is hormone replacement therapy. Because many physicians assume that age-related hormonal declines are natural, the medical community as a whole has been very slow to offer hormone replacement therapy to the aging community. However, researchers from around the world have now shown that a hormonal deficiency associated with aging is no different from that of a younger person with a hormonal imbalance, and should be treated as other hormone -related complications and diseases.
At Serenity Rejuvenation Center, we offer cutting edge tools steeped in evidence based medicine in our quest to improve the quality of life of our patients. Our Men’s Health Program includes evaluation & assessment, analysis & recommendations, and ongoing support and management encompassing hormone optimization, nutrition, physical exercise, and lifestyle which are all key ingredients in the mosaic of healthy aging.
How and why we age
Over the last 50 years, research in the fields of endocrinology and immunology have improved our knowledge as to how and why we age. Communication between the nervous, endocrine and immune systems makes it possible for us to adapt and survive in our environment, and hormones are the messengers between these symptoms. Hormones are molecules that are released into the blood stream and exert biochemical effects on receptor sites to regulate our body’s temperature, reproduction, growth, aging and immune functions. As messengers of the central nervous system, hormones instruct our internal organs on how to function. Unfortunately, both men and women experience a drop in these life-sustaining hormones as we age. In addition, the specific hormone receptor sites in the cells tend to change with age and become less sensitive and more resistant to hormone stimulation, resulting in a decrease in cellular function, cellular repair, protein synthesis, and cell reproduction.
Impact on Men’s Health
As the levels of our hormones decrease and the receptor sensitivities decline, so do our physical and mental capabilities. We lose our energy, vitality, strength, physique and health. The deterioration seen in normal aging results in osteoporosis, coronary artery disease, muscle atrophy, sleep disorders, depression, mood disorders and decreased sociability.
This slow cascade of change can contribute to an increasingly sedentary lifestyle which further contributes to chronic debilitating diseases which are all important factors in the process of frailty.
Physical frailty leads to falls, fractures, impairment in activities of daily living, and loss of independence.
Hypogonadism (Low Testosterone ) in the Aging Male
Low levels of testosterone have been shown to negatively impacts the quality of life of males. It can present with a wide spectrum of symptoms including:
- decreased libido and sexual activity
- decreased muscle bulk
- decreased explosive motor strength
- low trauma fracture
- decreased energy
- unable to concentrate
- difficulty at workplace
- increased body fat
- insulin resistance
- degenerative diseases (diabetes, cancer, heart disease, osteoporosis)
Research studies have also shown an association with opiod medication usage, and/ or chronic pain syndromes with hypogonadism.
Testosterone and Prostate Cancer
Multiple medical studies have proven that testosterone does not cause prostate cancer. In fact, low levels of testosterone are associated with more aggressive tumors. Prostate cancer is the most common cancer in men. It can often be detected by an annual PSA test.
A summary article appeared in the New England Journal of Medicine, The authors concluded, “We reviewed decades of research and found no evidence that testosterone therapy causes prostate cancer”. In fact, prostate cancer became more prevalent later in life when testosterone levels decline. The authors found no connection between higher testosterone levels and prostate cancer or any evidence that testosterone treatment provokes cancers. Research found no evidence that testosterone therapy causes prostate enlargement (BPH).
Definition of Problem
According to the 2010 Endocrine Society Clinical Practice Guidelines:
Definition of hypogonadism: Hypogonadism in men is a clinical syndrome that results from failure of the testis to produce physiological levels of testosterone (androgen deficiency) and a normal number of spermatozoa due to disruption of one or more levels of the hypothalamic-pituitary-testicular axis.
The age-related decline in testosterone levels, confirmed in several cross-sectional and longitudinal studies results from defects in both testicular and hypothalamic-pituitary function.
A significant fraction of older men have levels below the lower limit of the normal range for healthy, young men.
How Do You determine whether a man is a candidate for testosterone replacement therapy?
- Evaluation/Lifestyle Assessment
An in-depth evaluation reviewing your intake questionnaire, current health concerns and goals, as well as looking at your past medical history, family history, medications, and current lifestyle habits.
- Physical Examination & Comprehensive Laboratory Testing
A complete physical exam as well as comprehensive baseline laboratory testing determining your current health status, key hormone levels, and specific disease risk markers.
- Analysis & Implementation
Your personalized, proactive treatment plan consisting of appropriate medications, nutritional recommendations, exercise recommendations, lifestyle management, and any other appropriate medical interventions.
- Ongoing Support & Monitoring
Periodic lab testing and consultations to maintain gains and adjust treatment plan as needed. We continue to work with you to keep you looking and feeling your best.
How to Get Started
This Men’s Health program is designed to help you feel, function, and live your best while minimizing age-related decline in health. The focus is on a healthy quality of life for years to come.
If you feel that you may benefit from testosterone replacement therapy feel free to call Serenity Rejuvenation Center in Bellevue, WA to discuss whether you may be a candidate for a consultation with Dr. O’Connell.