Hormone Replacement Therapy for Men
Women have long received hormone replacement therapy to treat symptoms of peri-menoapuse and menopause. Men, too, can suffer symptoms related to declining sex hormones. Fortunately more attention finally has been give to men to alleviate the symptoms of male menopause, sometimes called andropause. Hormone replacement therapy for men is now being prescribed more often.
The main sex hormone in men is testosterone, but other hormones also decline especially levels of DHEA. Observational studies have shown that mortality rates for heart disease, cancer, and all-cause mortality in men with testosterone levels in the upper third of the reference are lower than in men whose testosterone levels are normal, but in the lower third of the reference range. So it’s important to recognize there is a difference between having a normal testosterone level and having an optimal level.
Benefits of Testosterone Therapy
There are two categories of benefits from testosterone therapy, sexual and non-sexual benefits.
Sexual Benefits of Testosterone Therapy
There are many factors that affect sexual desire and performance, so having low testosterone may not be the only issue if you suffer in the sexual arena. Stress, medications, and substance abuse (primarily alcohol and narcotic pain medications) can reduce both libido and sexual performance.
When it comes to erectile dysfunction testosterone can certainly help, and it can help in even men who have tried maximum doses of drugs like Viagra, Levitra, and Cialis with less than desirable results. Â In one study of 211 men receiving testosterone replacement therapy 60% reported improved erections regardless of age. Testosterone improves arterial blood flow and better blood flow means better erections.
Non-Sexual Benefits of Testosterone Therapy
Testosterone increases muscle mass especially when combined with a resistance or strength training exercise program. More muscle mass and strength means better metabolism and higher quality of life. Most men report better recovery from their workouts and find that they can workout more intensely once started on testosterone replacement.
The increased metabolism resulting from increased muscle reduces fat and improves overall body composition. By reducing fat the risks of diabetes, hypertension, cancer, and heart disease go down.
A high concentration of testosterone receptors exists in the brain. Testosterone is essential for healthy brain function and can improve mood swings and irritability that many men experience as well as depression. Men sometimes display indecisiveness and loss of confidence with aging, both of which can be improved with testosterone therapy.
Testosterone has many cardiovascular benefits, too.  The highest concentration of testosterone receptors is in the heart. Which makes sense since the heart is a muscle that is contracting roughly every second. Testosterone improves blood flow by acting as a vasodilator and helps to repair damaged endothelium or inner lining of blood vessels. Testosterone can help lower blood pressure.
A higher level of well-being and a life brimming with more energy is commonly seen after testosterone replacement therapy. If all this sounds good to you, be evaluated to see if you might benefit from hormone replacement therapy for men.
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“Diabetes and Low Testosterone”
Many of you report to my office with a complaint of being hypothyroid only to have been told by your primary care provider that you are normal on testing. Guess what? They are correct!! But, so are you. However, they have not gone far enough to document what you know to be true. Your thyroid gland most of the time is producing adequate amounts of thyroid. However, after it leaves the gland, the brain takes over and it responds to environmental cues, sleep, stress, exercise, etc. This response changes the activity of enzymes that control the conversion of your thyroid hormone to its more active form known as T3. This has to be assessed to adequately determine your true thyroid activity. I have included a feedback chart below of this physiology.