ANdropause Doctors Offer Hormone Replacement for Men

Andropause, or male menopause, is the result of an age-related drop in testosterone. Symptoms of andropause include irritability, weight gain, sleeping problems, night sweats, memory loss, decreased sexual desire and erectile dysfunction, hair loss, hot flashes, muscle loss, depression, and fatigue. Age-related low testosterone levels can also put men at risk for heart disease and osteoporosis (a weakening of the bones).

Testosterone is a male hormone that serves many different functions, including protein production, bone formation, liver function, prostate gland growth, and the production of blood cells. This hormone is also responsible for sexual desire, and producing and maintaining erections. When testosterone levels decrease, men experience a related increase in Sex Binding Hormone Globulin (SHBG). SHBG captures a portion of the testosterone that is circulating in the body, and prevents it from working, further lowering the amount of available testosterone.

Andropause can be successfully treated using hormone replacement therapy. Bio-identical (“natural”) hormones are an ideal treatment for aging-related hormone declines, because these hormones precisely match hormones that are synthesized by the body. Bio-identical hormone preparations are often custom-tailored (“compounded”) and specifically designed for each individual, reducing the likelihood of negative side effects. Traditional or “synthetic” hormones are derived from animals or synthesized in labs and are similar (but not identical) to the body’s natural hormones.

The best candidates for testosterone replacement therapy are otherwise healthy men (of any age) who have undergone a thorough physical examination (with associated lab tests) that indicates a significant decline in testosterone levels. Men with breast or prostate cancer are not appropriate for testosterone replacement therapy. Individuals with liver, heart, or kidney disease, edema (swelling of the face, hands, feet, or legs), diabetes, or an enlarged prostate will need to be evaluated carefully by a doctor to determine if they are suitable candidates for hormone replacement therapy.

Bio-identical testosterone replacement therapy can be delivered in several different forms, including pills, injections, creams/gels, skin patches, tablets that are dissolved under the tongue, and pellets that are inserted under the skin. Intramuscular injections and pellets are the most commonly used forms of testosterone. The specific delivery method used will depend on the particular patient’s needs, medical history, and personal preference.
Men interested in bio-identical hormone replacement therapy should consult with an experienced physician and obtain a prescription for the appropriate testosterone dose and delivery method. Advertised products that are available without a prescription may not actually contain testosterone, and have not been thoroughly tested for safety and effectiveness.

Once bio-identical hormone replacement therapy has been initiated, periodic screenings will be necessary to monitor the effects of treatment on the prostate. Repeat lab tests will also enable the doctor to ensure that therapy is resulting in an overall increase in circulating testosterone.