Key points:
- Sex drive and sperm production can be affected by decreased testosterone.
- Unlike menopause in women, not all men will experience andropause as a result of a drop in their testosterone levels.
- Testosterone affects various functions such as sugar, fat, lipid, and bone metabolism.
Testosterone is the main male hormone, says Dr. Gerardo Eusebio Ortiz Lara, urologist at ABC Medical Center, which is produced 97% in the testicles and the remaining 3% in the adrenal glands, is considered the main male sex hormone and an anabolic steroid.
Among testosterone’s main functions are sexual desire, producing and maturing sperm, having good erections, reaching orgasm and making it pleasurable; all this in the sexual sphere.
On the other hand, testosterone is involved in many metabolic functions such as hemoglobin production, metabolic control, sugar, fat, and lipid metabolism; as well as bone mineral density. Energy in men is related to the quality of sleep, mood, and muscle mass.
This hormone is only released in the morning, so it is recommended that its measurement be ideally at eight in the morning and fasting, through a blood test. In this way, it will be possible to detect if the testosterone levels in the body are normal or low. Because of the variability in the results, both due to the same characteristics of the hormone and the characteristics of each laboratory, it may be necessary for this type of test to be performed two or three times, to determine if the levels are always the same. It is also recommended that they be interpreted by a specialist since frequently the laboratory reference values are not correct.
Low testosterone levels.
Dr. Ortiz says there are two measurements to consider when detecting low testosterone levels. On the one hand, the European guidelines indicate that a level below 350 ng/dl* is already low, while the American guidelines determine that this is from a 300 ng/dl level, but they also indicate that, if a patient is within normal ranges, but a permanent decrease in testosterone levels has been detected and, in addition, they show symptoms derived from this, a replacement treatment may be indicated to stop this process.
For the ISE (International Society of Endocrinology), the normal lower limit is 246 ng/dl, which is why each doctor must determine the patient’s condition and identify the symptoms that someone with lower levels may have; generally, at 350 ng/dl they already show one or several of the related symptoms.
Age is the main cause of testosterone decrease, as you get older you can experience this situation. But also their general health will have repercussions on this. Diseases such as diabetes, smoking, varicocele, high blood pressure, or obesity are some situations that could result in low testosterone levels.
“The term ‘male menopause’ has been used to describe the decline in testosterone levels associated with aging. But the hormonal changes related to aging in women and men are different.”1
Something to keep in mind, and in contrast to women’s menopause/climacteric, is that while any man can experience a drop in hormone levels, it doesn’t happen for everyone, compared to women who will all reach this stage of life.
What symptoms do low testosterone levels cause?
By decreasing testosterone levels, the man can perceive different changes in his body such as decreased sexual desire, this is the main cause for the patient to see their doctor; but they can also perceive less production of ejaculated semen, loss of muscle mass and strength, hot flashes, increased abdominal circumference, sleep disorders, perception of sadness or depression for no apparent reason, fatigue, irritability, decreased concentration and memory or even drastic mood swings.
If this situation is not treated, it will mean that a man with low testosterone will end up living fewer years compared to a man with normal levels, for which timely diagnosis and treatment will have a very positive impact on daily life.
How to increase testosterone levels?
Since different situations can result in low testosterone levels, Dr. Ortiz recommends that all men should see a doctor from the age of 40, at which time they can begin to lower this hormone to levels from 0.4% to 4% annually. Because of this, every man should perform a testosterone test and a prostate check.
Whether symptoms related to low testosterone are detected, as well as if they have reached 40 years of age, the patient should preferably see an andrologist, which is a urology subspecialty that focuses on men’s sexual and reproductive health.
Once the decrease in this hormone has been determined through tests, the cause should be sought and, if there are risk factors that may affect it, they should be treated for the levels to normalize.
If, on the other hand, it is due to the aging process, a testosterone replacement treatment can be prescribed, which could be every 6, 12, or 14 weeks, varying from patient to patient and seeking to cover their unique needs. This type of treatment will be for life.
For Dr. Ortiz, although testosterone replacement therapy is an effective option, there are different myths regarding this procedure. The main one is that this treatment can cause cancer, but it has been proven that this does not happen, although if there is prostate cancer and treatment is started, it will result in it spreading more quickly. As a result of this, it is optimal that before starting any replacement treatment, specific prostate antigen tests and physical examinations are also performed to rule out the presence of cancer.
A testosterone replacement treatment, although it may have some contraindications, should not cause health problems as long as the doctor and the patient follow the treatment properly.
At ABC Medical Center’s Department of Internal Medicine, we can provide you with specialized care. Contact us!
*Nanograms per deciliters.
Fuente:
Dr. Gerardo Eusebio Ortiz Lara – urologist at ABC Medical Center
1https://www.mayoclinic.org/es/healthy-lifestyle/mens-health/in-depth/male-menopause/art-20048056
