In recent years, as many as 2.4 million prescriptions were filled for testosterone therapy products. For men, over the age of 40, the use of testosterone therapy has become main stream in the health approach of what men refer to as the male “menopause”. While it is true testosterone levels decrease in men as they age, it is questionable whether these levels constitute a testosterone replacement therapy in this many cases. For men, understanding the normal healthy levels of testosterone, the impact testosterone plays on the aging process, the conditions for which testosterone therapy is appropriate and the contraindications, may provide for a more healthy and aging process.
As men age, the testosterone levels gradually decrease. This is in contrast to the experience many women face, in terms of a menopausal condition, in which hormone levels cease to even exist. In men, testosterone never completely ceases to produce. In fact, as men age, in most cases, the testosterone levels decrease but never decrease to a level considered below the normal range. For men, the slight change in testosterone levels may be seen through loss of muscle mass and strength, loss of sex drive, some symptoms of depression and loss of memory or cognitive ability. Because these are characteristics considered abnormal for healthy men, many are seeking testosterone replacement therapy when blood levels exhibit testosterone levels are slightly declining. So, what does this mean in terms of the aging man?
Testosterone therapy, in men with a family history of breast cancer or prostate cancer, may increase the likelihood of development either condition. Because of this, before beginning a testosterone therapy program, the prescribing physician should complete a full family history and diagnostic work up to ensure the testosterone therapy has not placed the patient at a greater risk for other diseases. In addition to an increased likelihood of breast cancer and prostate cancer, testosterone therapy side effects may include insomnia, infertility and excessive blood production which can lead to stroke. For these reasons, alone, the use of testosterone therapy should be a serious consideration before beginning treatment.
Not all aging men enjoy the slow decline in testosterone. For these men, fortunately, the testosterone therapy is a life sustaining method to ensure consistent maintenance of the necessary muscles needed to sustain organ function. Such patients may include men who have suffered testicular related disease or injury resulting in failure of the testes to produce the necessary levels of testosterone needed to sustain life. Contrary to popular belief, however, these conditions are rare, resulting in a questionable practice of prescribing testosterone therapy by the medical community.
For those men seeking testosterone replacement therapy, once a medical practitioner agrees to write the prescription, the next challenge is determining the method of dosing. For most men, the most consistent and successful administration is provided through an oral, gum and cheek method in which the testosterone substance is placed at the gum line and absorbed into the body through deterioration by saliva. Other dosing methods, including gels, oral tablets, patches and injections.
As an aging man, the loss of muscle mass, decrease in sex drive and minor symptoms of depression are to be expected. Before considering a testosterone replacement therapy, discuss alternative medical approaches including diet, exercise and discuss health history including family history of breast and prostate cancer, as these factors will play in important role in determining the true medical necessity of a testosterone hormone replacement program.