As the lifespan of mankind has increased, modern medicine faces new challenges. For men over the age of 65 various symptoms such as weight gain, sleep disorders, mood swings, erectile dysfunction, difficulty with memory functions, loss of bone density, muscle and hair due to decline in testosterone are referred to as “Aging Male Syndrome”. If unnoticed causes a profound decrease in quality of life.
Testosterone hormone is essential not just for sexual functions but for many other systems such as heart and muscular functions, bone and muscle density and more importantly the brain functioning. Unlike women, there is no sudden drop in testosterone at a certain age range. It is therefore not easy to relate “Aging Male Syndrome” to menopause. The effects of testosterone are not just dependent on the circulating levels of it, but also to the receptors that bind the hormone to result in its actions. A combination of decreased receptor number or binding sites might contribute to symptoms mentioned before with only a slight decrease in testosterone levels. We, medical professionals, specializing in Men’s Health have to make decisions of treatment depends not only on the blood levels of testosterone but the accompanying symptoms of the patients. It is crucial that some of these symptoms may be mistaken as part of aging, but with proper treatment plans almost all respond well and the person may experience a much better quality of life.
There are various methods to increase testosterone levels as well as its efficiency. When a male patient comes with symptoms of “Aging Male Syndrome”, actually against what the name implies, we need to check the serum testosterone levels as well as other parameters associated with its effects. Even in younger men, testosterone drops may occur and present with the same symptoms. Once the symptoms are evaluated as relevant to testosterone decrease or loss of efficiency, a stepwise approach is mandated. We do not prescribe hormone replacement right away.
A lifestyle change is an initial step, especially the drop in serum testosterone levels is not dramatic. Lifestyle change includes exercising, a good and balanced diet, stopping smoking and decreasing alcohol intake. Exercise is a well known and proven way to increase testosterone levels. Fat tissue is a storage unit for testosterone hormone. The more fat there is in the body content, the more is stored instead of being used. Exercise increases the availability of testosterone and reverses the symptoms of the syndrome. In diet, most nuts contain essential fatty acids for production. High sugar content does not increase men’s power but actually might even decrease it. A healthy diet especially an organic diet without preservatives is essential to regain functions.
The second step is medical therapy. This is reserved for patients with significantly low serum testosterone levels and to those whose symptoms don’t improve with conservative measures. Testosterone replacement therapy means giving testosterone through injections, pills or dermally. This can decrease the symptoms very quickly, but then the symptoms will come back after cessation of the medications. In modern medicine, the aim is to avoid life-long testosterone replacement. Medical therapy aimed at increasing the production of the hormone in a patient’s own body and increasing the efficacy of the hormones. Therefore, I can’t emphasize enough, how important it is that testosterone replacement should only be managed by trained doctors and people should not use exogenous supplements without a doctor’s advice and control. Here is what happens if a man takes extra testosterone replacement: there is a control mechanism ( a feed-back system) to promote or suppress testicles to produce testosterone according to the circulating hormone level. If the sensors measure that there is enough testosterone, the system will suppress the testicles and already decreased production will diminish more. Once the circulating hormone is used up by the body the testosterone levels will drop even more than the initial level requiring higher doses of replacement.
If you feel tired and depressed, putting on weight while losing muscle mass, lack of energy and experience decreased sexual desire and performance, please feel free to contact us. You do not need to live with such disturbing symptoms. With a team effort of andrologists, endocrinologists, dietitians we can make you enjoy life better and live a healthier life.
By Prof.Dr. Haluk Kulaksizoglu