Dr. Andre Guay, a clinical assistant professor at Harvard Medical School and director of the Center for Sexual Function at Lahey Clinic Northshore, says that up to 5 million American men suffer from low testosterone levels, but only 5 percent seek treatment. Anything below 300 nanograms of testosterone per deciliter is low.
Definition
Andropause is the most accepted cause of decreasing testosterone levels in men and it is age-related, according to Dr. Jacob Rajfer in "Reviews in Urology." Alternatively, doctors and health care professionals might use the acronym ADAM -- androgen deficiency in the aging male -- to describe this condition. MayoClinic.com says that calling the decrease of testosterone "male menopause" is inaccurate because unlike female menopause, which occurs within a defined period of time, andropause is a gradual change in male physiology. Guay refers to the condition as Low T.
History
The "Journal of the American Medical Association" first addressed symptoms and treatment of andropause in 1944, according to the website Seek Wellness. The website indicates that limited progress has been made since then because men are reluctant to acknowledge their symptoms and because treatment options and theories about the condition are so divergent.
Causes
Rajfer blames decreased production of testosterone on the hypothalamic pituitary gonadal axis and indicates that this is a byproduct of aging. The website Mens Hormonal Health also cites accident-induced trauma to the brain, as well as heart attack, stroke or anything else that deprives the brain of oxygen long enough for the hypothalamic pituitary gonadal axis to suffer damage. Vasectomies and testicular injury might also affect testosterone production. Vasectomies can result in an autoimmune disorder that targets testicular tissue. The hypothalamic pituitary gonadal axis prompts the testicles to produce testosterone, so a decrease can result when either end of the equation malfunctions.
Time Frames
According to Seek Wellness, age-related andropause can begin as young as your 30s. Symptoms become most recognizable between the ages of 50 and 55. Testosterone levels are highest in the morning, Guay says, regardless of what may be causing a decline.
Effects
Rajfer says that low testosterone levels can result in erectile dysfunction and a change in desire. It can also affect cognitive abilities, muscle mass and bone density. Seek Wellness suggests that insomnia and mood disturbances, such as irritability and depression, can also result. You may gain weight in the form of fat. Guay says that some research links low testosterone levels to coronary heart disease, Type 2 diabetes and metabolic syndrome.
Solutions
Guay says that a routine blood test can identify your testosterone level. If a problem is established, Rajfer says there are a variety of androgen replacement therapies available to treat it, including gels, patches and injections. He cites the gel Testim, manufactured by Auxilium Pharmaceuticals, which does not promote prostate cancer as some topical treatments can. Guay warns that these products can cause liver damage. You should have your doctor perform a prostate cancer exam before prescribing because men with a history of either prostate or breast cancer should not use these products.
References
- "Reviews in Urology"; Decreased Testosterone in the Aging Male; Jacob Rajfer, M.D.; 2003
- Seek Wellness: Overview of Andropause
- The Washington Post: Low Testosterone -- The Potential Link to Osteoporosis, Diabetes, Cardiovascular Disease, and Depression
- Mens Hormonal Health: The Cause of Low Testosterone
- MayoClinic.com: Male Menopause: Myth or Reality?
