Portrait of adult male, his head down with sadness.
If you want to remain looking and lusting like a man, you need a steady flow of testosterone, or androgens, as this hormone is responsible for the normal growth and development of male sex organs, and the maintenance of secondary sex characteristics.
Without enough of it, you can feel anxious, depressed, become intellectually muddled, and develop a low sex drive. Also, low levels of testosterone may result in a decline in muscle mass and strength, and an increase in upper body and abdominal fat. A little-known condition called androgen deficiency occurs when bodily tissues do not have enough exposure to androgens, or testosterone, to function normally. There is hope — with testosterone replacement therapy (TRT), lower-than-normal testosterone levels can be regulated and modified.
Who's at risk?
While young males do not typically suffer from a testosterone deficiency, the presence of certain medical conditions that hamper the body's ability to produce testosterone can result in this condition at any age. In fact, approximately one in 200 men under 60 years of age suffers from androgen deficiency.
The testosterone levels in men usually decrease with age. They gradually begin to fall from the age of 40 years and decrease by approximately 0.3 percent per year. It has been estimated that up to 20 percent of men over 60 will experience a decline in androgen production that is significant enough to warrant a diagnosis of androgen deficiency. Some controversy still exists over whether or not older men experience what is known as "andropause," or male menopause, a much more gradual and subtle change of life than female menopause. The question of whether such naturally decreasing levels of testosterone should be remedied, or if TRT should simply be reserved for extreme cases, remains largely unanswered. For now, it is best to assume that unless your doctor diagnoses you with a deficiency, TRT is not the solution.
Diagnosis
To determine whether or not you are experiencing a deficiency and what may be causing it, your doctor can measure the amount of testosterone in your blood with blood tests. In addition to measuring testosterone levels, doctors sometimes measure prolactin levels to make sure your pituitary gland is functioning properly. Further blood tests, such as serum FSH, LH and thyroid tests, may also be necessary.
Normal levels of testosterone fall between 250 and 800 nanograms of testosterone per deciliter of blood. Levels in the same man vary according to time of day, season and exercise; therefore, your doctor must conduct an entire physical examination to determine whether or not you are suffering from the disorder. If you want to measure your testosterone level yourself, there are ways to do so. Testing kits allow you to measure the amount of available testosterone for use in your bloodstream; simply gather a sample of your saliva and mail it to a lab for analysis. Doctors and physicians will then identify any preventable hormone imbalances in your system and recommend solutions to normalize your testosterone level.
Causes
Contributing factors to the development of androgen deficiency include:
- Medications, especially those used to treat depression or mental disorders
- Chemotherapy or radiation treatment for cancer that targets or harms the testicles
- Chronic illness
- Dysfunction of the pituitary gland (a gland in the brain that produces substances that regulate hormone production from the brain to the testis)
- Hemochromatosis (too much iron in the blood)
- Hypogonadism (when the testis is not able to produce high enough levels of testosterone, aka androgen deficiency, or sperm, aka spermatogenesis)
- Inflammatory diseases, such as sarcoidosis (a condition that causes injury to or infection of the testicles)
- Illnesses, such as AIDS, that compromise the immune system
- Excessive stress, which taxes the adrenal system
Symptoms
The diagnosis of testosterone deficiency can only be made through a full medical examination by a doctor. If you suspect you may be suffering from androgen deficiency, please contact your doctor; however, some of the symptoms are as follows:
- Erectile dysfunction (the inability to get or maintain an erection)
- High cholesterol levels (having high cholesterol or high blood pressure causes hardening of the arteries, which can decrease blood flow to the testicles and cause enough damage to lower testosterone)
- Obesity, especially around the waist
- Depression
- Anxiety or mood swings
- Problems with concentration and memory or other cognitive and intellectual functions
- Low sex drive
- Decreased bone density, possibly leading to osteoporosis
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More from AskMen.com:
Andropause: A Testosterone Deficiency ________________________________________________________________________
What is TRT?
There are solutions if you discover that you are suffering from androgen deficiency. Testosterone replacement therapy (TRT) may be administered to men who are not producing high enough levels of testosterone. Such treatment is usually long-term and should only be started when androgen deficiency has been clinically proven, including testing hormone levels in the laboratory and ruling out other possible medical conditions. Testosterone is available in pill form, patches, gels, creams, and intramuscular injections or it can be implanted under the skin. Absorbing testosterone through the skin via a patch or gel or receiving an intramuscular injection (every two weeks) are the best methods of delivering TRT. Testosterone in an oral form is not absorbed very well by the body and may increase the risk of high cholesterol, as well as heart and liver problems.
Understanding androstenedione
Although falsely sold on the market as a way to "naturally" increase testosterone levels, androstenedione is a steroid-like substance — a metabolite of DHEA and a natural precursor of testosterone. It is often taken as a dietary steroidal supplement to purportedly regulate testosterone levels, and when taken in large doses, it may cause effects similar to stronger anabolic steroids like testosterone.
Although it may also function to stimulate androgen production, it should not be seen as a replacement for standard medical treatments; as a supplement, it's not regulated by the FDA. Companies that manufacture steroidal supplements often make claims that are false, and very little is known about the long-term effects on the body of some of these substances. If you require Testosterone Replacement Therapy, stick to the drugs, treatments and recommendations made by your doctor.
Side effects of TRT
Even if the dosage of testosterone received is sufficient, you may experience certain side effects. TRT has yet to be studied long-term, so the jury is still out on all of its potential side effects. Some common side effects of TRT include nausea and vomiting, priapism (an erection that won't go away, which can last longer than four hours and requires immediate medical attention), acne, headaches, a noticeably increased appetite, mood changes, possible liver damage, and swelling of the ankles.
Who shouldn't use TRT?
Due to the popularization of human growth hormone (HGH) and testosterone supplementation on the Internet, the use of synthetic testosterone is widespread. Reported uses include combating infertility, providing an energy increase or enhancing athletic performance, fixing erectile dysfunction, and remedying low sex-drive problems. But TRT can have damaging consequences if not used properly, and like HGH supplementation, it is unnecessary for most healthy men.
TRT may not be right for men who have high cholesterol, heart disease or prostate cancer, or for those who are at risk for prostate cancer. Exposure to testosterone has been known to activate certain types of cancer cells in the prostate gland of susceptible individuals; therefore, it is important for all men considering TRT to undergo a thorough prostate cancer screening prior to starting this therapy.
Myths and questions
In order to clarify the beast that is testosterone, the answers to a few common questions can be found below.
1. Does too much testosterone make you aggressive?
Yes. As we all know from the popular term "'Roid Rage," too much testosterone can make your mood swing, your testicles shrink and your hairline recede.
2. Is testosterone the same thing as sperm?
No. Testosterone is a hormone produced by the testicles and is responsible for the proper development of male sexual characteristics. The testes have two main functions: the formation, development and excretion of sperm (which occurs in seminiferous tubules), and the secretion of testosterone. Sperm is a male gamete, or reproductive cell, whose development is aided by the conversion of hormones that make testosterone. Sperm will make a woman pregnant; testosterone will just make her hot and bothered.
3. Can steroids act as a testosterone replacement? A
Anabolic steroids are artificially produced hormones that are the same as, or similar to, androgens. As mentioned, the most powerful androgen is testosterone (another androgen is aldosterone). However, testosterone replacement therapy uses different types of steroids than those abused by some bodybuilders. Essentially, all substances mimicking hormones are steroids, but not all steroids are created equal or of precise medical-grade quality.
The testosterone test
If you believe you have a low level of testosterone, take the proper steps to do something about it: Get your blood tested and your body examined.
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