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We have known for a long time that as men age, their testosterone levels decline. This was just considered a normal part of aging. Today, we have discovered that there are a number of symptoms that are directly related to the androgen decline. Further, a number of small studies have shown that there can be some significant benefits to elevating testosterone levels.

 

Androgen deficiency in the aging male, also known as Andropause or Hypogonadism, affects an estimated 1 in 200 men. Symptoms of testosterone deficiency may include: depression, weakness, fatigue, decreased sex drive, erectile dysfunction, loss of muscle mass, gynecomastia (breast enlargement), and osteoporosis.

 

A man may be considered hypogonadal at any age if his total testosterone is less than 200 ng/dl, or bioavailable testosterone is less than 60 ng/dl. Basaria and Dobs of Johns Hopkins University recommend that elderly men with symptoms of hypogonadism and a total testosterone level <300ng/dl should be started on hormone replacement therapy. However, caution must be used before initiating androgen replacement. Particularly, if the man has a history of benign prostatic hypertrophy (BPH), an enlarged prostate, or elevated PSA levels. Hormone Replacement Therapy for this group of men is not contraindicated, however they must be watched closely for any progression to prostate cancer.

 

Goals of Testosterone Replacement Therapy in adult hypogonadal men are:

 

Improvement in psychological well-being and mood Improvement in erectile dysfunction Improvement in libido Increased muscle mass Increased strength and stature Preservation of bone mass Possible decrease in cardiovascular risk