As men age, they experience a psychological, emotional, physical and behavioral change which is popularly known as andropause. This condition is also known by many other terms which include; late onset of hypogonadism, low testosterone condition, male climacteric andropause, andropause syndrome and ADAN (androgen decline in the aging male). Most medics have described this condition as the male version of menopause and though according to some aspects, this might be accurate the fact is that this condition is rather different. Similarly, both of these conditions are related to old age and declining levels of primary hormones, if these conditions are left untreated, they may result in a variety of negative symptoms and effects.
Andropause is associated with old age and the aging process, but many of the effects that men experience at their old age are as a result of a substantial decrease in the testosterone levels in their bodies. Men who are going through andropause experience a gradual but noticeable loss of energy, decline in mental focus, reduced stamina, an increase in body fat, a decrease in muscle mass, a reduction in sexual desire, reduced libido and declined sexual functioning.
Testosterone is present in both men and women but since it is the principal primary sexual hormone in a man’s body, it is produced in quantities that are up to ten times more in men than in women. Testosterone is an essential hormone that facilitates the development of male masculine characteristics from birth to death. It is responsible for determining gender at conception, maintaining the male sexual functions, libido, fat distribution, partitioning of body muscles and moderation of pubertal changes. It also lays a foundation to a man’s sense of well-being, psychology, sexual health and biological health. It influences sperm production, stress coping capacity, production of red blood cells, bone density, it supports the immune system and mental health which includes memory, focus, clarity, recall, and concentration. With all these responsibilities, decreasing levels of testosterone will affect very many elements of an individual’s health, this leads to a general deterioration of health as this condition progresses.
One major difference between andropause and menopause is the action time frame. Whereas menopause occurs suddenly in a more defined manner and at specific ages, andropause begins at ages above thirty and progresses at an average rate of 1% every year. Even though all men go through andropause, not all of them experience hypogonadotropic symptoms which are severe enough to seek medical help. According to a Census bureau in the U.S, close to 15 million men suffer from the effects of low testosterone levels but only 5 – 10 % seek medical treatment. This is mainly because most of them don’t realize that this condition is correctable.
Andropause has symptoms that are similar to those of non-age related testosterone deficiency. Some of these symptoms are characterized by;
– Reduced body mass and declining strength.
– Mild anemia and low hemoglobin levels.
– Increased body fat.
– Low energy levels and a reduced interest in tiresome activities.
– Thinning and loss of hair.
– Atypical lipid and cholesterol values.
– An irritable male syndrome which is characterized by mood swings, depression, irritability. anger and fatigue.
– A decrease in libido and sexual functioning.
Routine physical examinations should expose the symptoms of andropause but when old age is also a factor to consider, physicians can be surer by employing a simple blood test examination to measure an individual’s testosterone levels. The lower limit of testosterone in a human body should be about 350 nanograms/deciliter of blood plasma. A testosterone deficiency is diagnosed when tests return a testosterone level in the serum level that is below this. All tests should be administered between 8:00 am to 9:00 am when the concentration of testosterone in the blood serum should be at its peak. Other hormones which should also be considered and tested together with testosterone are Follicle stimulating hormones (FSH), Luteinizing Hormones (LH), Estradiol and DHEA.
Testosterone replacement treatment should theoretically balance and approximate the natural endogenously produced hormone levels in a patient’s body. Averagely, men produce 4 to 7 mg of testosterone daily in a circadian pattern. Maximum levels of testosterone in the blood plasma are attained early in the morning and this diminishes to a minimum later in the evening. An ideal testosterone replacement treatment provides and maintains a normal physiologic concentration of this hormone in the serum without posing any risks and negative side effects. There are various forms of testosterone preparations which can be used in a testosterone replacement therapy. Each form of testosterone has its unique properties and mechanisms of action. The most commonly requested forms of testosterone preparations from our pharmacy are injectables and transdermal forms.
Intramuscular injections (IM). This form of preparation is shot directly into a patient’s muscles where it is immediately absorbed into the bloodstream through the blood capillaries. This form of testosterone preparation is the most preferred form by physicians because it enables them to administer highly accurate dosages, it has timely release qualities and very low hepatotoxicity levels.
Transdermal/topical forms of testosterone preparations can be made as gel or cream. These forms are administered by rubbing onto the skin where testosterone is absorbed into the body system through the skin pores. Transdermal testosterone can be provided in varying strengths which range from 10 – 200 mg/ml. In order to maximize the benefits of testosterone from this form of treatment, it is advisable to administer it in the morning immediately after you wake up and once again later in the day and repeat this application daily at consistent times.
Testosterone ( Propionate, Cypionate, and Enanthate) plus testosterone creams and gel have been approved by the U.S FDA for treating hypogonadism. Various tests on this medication have proved that it can; Improve moods, enhance libido, erectile functions and memory. It also increases body energy, strength, bone density and reduces subcutaneous fat deposits, adipose fat, and visceral.
Some possible side effects from the administration of this medication include; abnormal functioning of the liver, gynecomastia, acne, vivid dreaming, sweating at night and an increase in appetite.
Patients who are currently on a testosterone replacement treatment should be monitored very closely to ensure that the levels of this hormone in their body system are within the normal ranges. A physician should continuously look out for any changes in a patient’s hypogonadism symptoms. All side effects as a result of this treatment should be addressed and the level of testosterone in a patient’s plasma inspected at least 5 to 7 hours after a transdermal application.
Men who are over 40 years should have a PSA test before they are enrolled for a testosterone replacement therapy. This test should be repeated after 3 to 6 months then examined every year after this. A confirmed case of PSA which is more than 2 ng/mg or a total of above 4 ng/mg calls for a urologic examination. Hematocrit levels should also be tested at their baseline after 3 to 6 months then examined annually.
Hematocrit levels which are below 55% justify an evaluation for sleep apnea and hypoxia. This should be accompanied by a reduction in the testosterone dosage. Hypogonadal men with osteopenia should have an examination done to establish their bone mineral density especially in the lumbar spine and at the femoral necks. This should also be done annually.
From this, it is very clear that living with andropause is not a downhill spiral as it used to be in the past. Because researchers and scientists have acquired more knowledge and a better understanding of this condition and its causes, Physicians have had the ability to develop tools and medications which can combat this situation. With these, your golden years will be so much more lively and enjoyable.
Together with your health service provider, we can work to compound and tailor a customized prescription in specific and exact strengths that your body requires, and in any form which is easiest for you to apply. This will transform this phase of your life into one full of virility, verve, and continuous activity. For More Information, feel free to contact our pharmacy.