Testosterone Deficiency Syndrome Treatment

Testosterone Deficiency Syndrome Treatment

WHAT IS THE ‘ANDROPAUSE’?

Andropause is a decline in the male hormone testosterone. This drop in testosterone level is considered to lead in some cases to loss of energy and concentration, depression, and mood swings.

While andropause does not cause a man’s reproductive system to stop working altogether, many experience bouts of impotence. Andropause is usually caused by a very gradual testosterone deficiency and an increase in sex hormone-binding globulin (SHBG) that occurs from age 35 onwards.

TESTOSTERONE DEFICIENCY SYNDROME 

How common is Testosterone Deficiency Syndrome (TDS)?

Testosterone Deficiency is common in older men, so if you do suffer from low testosterone don’t worry, you are not alone! In fact, it has been estimated that up to 1 in 10 men over the age of 50 – increasing to 1 in 5 over 60 – have TDS and have testosterone levels below normal.

As we age, our bodies do not function as well as they did when we were younger, and in men, it is expected that testosterone levels will decline with age. However, it is important to note that this is different from TDS where testosterone levels fall below normal. So do remember that TDS is a recognized medical condition and should NOT be considered as an inevitable consequence of ageing.

It is particularly common in type 2 Diabetes with approximately 1 in 3 men suffering from it.

Testosterone plays a number of important roles in men. For example, this hormone influences aspects of our short-term health like mood and sex drive, as well as being important to our long-term health by helping to maintain strong bones and a healthy body shape.

How do I know if I have Testosterone Deficiency Syndrome (TDS)?

It is important to remember that there are many different signs and symptoms associated with testosterone deficiency and these can vary between different men. The list below shows examples of the signs and symptoms commonly associated with it.

Again, please remember that if you do suffer from one, or some of these symptoms, it does not mean that you definitely have TDS – other illnesses can cause the symptoms. Our doctor is the best person to confirm whether you have low levels of testosterone by measuring it. When talking to your doctor or nurse it is important to remind them of all your current and previous illnesses and medications – because these may be related to low testosterone levels.

How is my testosterone level measured?

Measuring your testosterone level is quick and simple. You will have to give a small blood sample (usually in the morning) from which your testosterone level can be measured.

Will I need any other tests?

This will depend upon your doctor, your symptoms and your medical history. For example, as well as measuring your testosterone levels, some doctors may also use a questionnaire to help assess whether you are suffering from TDS. Additionally, there may be other aspects of your health that may need further examination – like the health of your bones or prostate (a small gland near your bladder).

What treatments are available for TDS?

There are now many different treatments available for TDS. Treatment that replaces the body’s levels of testosterone is referred to as Testosterone Replacement Therapy (TRT) and the different ways in which TRT can be administered currently include oral, inject able and topical therapy. The most popular being a gel which you apply once a day to your skin. This gel can be purchased or prescribed by the clinic.

If you are suffering from health problems as a result of low testosterone, then restoring your level to normal will improve your short-term and long-term health.

Clomiphene Citrate (Clomid)

Very effective in increasing levels of testosterone in the younger patient without reducing sperm production or causing shrinkage of the testicles.

How does it work?

Clomid is a weak oestrogen receptor antagonist, it blocks the normal negative feedback mechanism of circulating oestradiol on the hypothalamus, preventing oestrogen from limiting the production of GnRH. The increase in GnRH level then stimulates the pituitary gland to release more FSH and LH, resulting in an increase in sperm and testosterone production by the testes.

Results
Most patients respond to the treatment. A recent study from Brazil showed a response rate of 68% with the only side effect being nipple tenderness in 5% of patients. In this study, the average age of the patient was 62. It is clear that the best responses occur in the younger patients.

Side effects
Occasionally nipple tenderness.
Very rarely visual changes may occur which are reversible with discontinuation.
Is Testosterone Replacement Treatment completely safe?

No medication can be said to be 100% safe and effective. However, provided certain precautions are taken, like checking that your Prostate Specific Antigen (PSA) is normal then Testosterone Replacement Therapy is very safe and well-tolerated.
I have heard that Testosterone treatment can cause cancer of the prostate. Is this true?

No, testosterone treatments do NOT cause cancer of the prostate or of anything else for that matter. Prostate cancer occurs in older men with very low testosterone levels and is rare in younger men with high levels. But where prostate cancer already exists, giving testosterone in this situation might serve to accelerate its growth. This is why keeping a close eye on PSA is essential for any many on TRT.

Are there any ‘fringe benefits’ to taking TRT apart from the sexual ones?

Yes. Apart from improving you sexually, there are a number of potential benefits that are now beginning to emerge for men who have been taking TRT long-term. Among these are:

    Improvements to your cardiovascular system

    Improvements to your cognitive function and memory

    Increased mineral bone density to help against fractures

    Increased muscle mass and decreased body fat.

    All that said it is a mistake to expect miracles. The benefits from TRT are often subtle and mild and not life-transforming but rather life-enhancing.