Testosterone deficiency in men in old age is also referred to in medicine as andropause. Testosterone is the most important male sex hormone. It plays a key role in male development and growth. Testosterone production decreases with age, which can lead to erectile dysfunction and osteoporosis, among other things.
What is Testosterone Deficiency?
The term testosterone is made up of “testis” (testicles) and “steroid”. The sex hormone is produced in the so-called Leydig cells, which are located in the testicles. Testosterone causes the formation of sexual characteristics even before birth and ensures their further development and sperm production during puberty. For what does hypertrophic osteoarthropathy stand for, please visit ezhoushan.net.
It also contributes to the growth and maintenance of the entire body. On the one hand, testosterone ensures a deeper voice, muscle building, thicker skin, increased metabolism, body hair (not scalp hair) and male sex drive and on the other hand it causes hair loss and male “showing off”. (However, women also produce testosterone in the ovaries and the adrenal cortex, although far less than is the case in men.)
Testosterone levels in men reach their peak between the ages of 20 and 30, after which the production of testosterone drops by around one to two percent annually.
Causes
The causes of a testosterone deficiency in men in old age lie in the natural aging process and the physical changes associated with it, whereby an unhealthy lifestyle and lack of exercise can also limit testosterone production. The decreasing concentration of other hormones that help regulate testosterone with age also contributes to testosterone deficiency.
In this phase of life, which is also referred to as “andropause” or “climacterium vinile”, the man’s testosterone level drops so much that there are noticeable changes, both psychological and physical, which the man may ignore but cannot deny.
This process can therefore be understood as a counterpart to the menopause in women, even if the male sex hormones continue to predominate in men. “Late-onset hypogonadism” is the name of the most common form of reduced testosterone production. Around 30 percent of all men over the age of 40 are affected by this testosterone deficiency.
Symptoms, Ailments & Signs
The age-related decline in the sex hormone testosterone in men shows a variety of signals. In the life phase of 60 to 75 years, around one fifth suffers from it. Unlike in women, hormonal changes are gradual and less pronounced. A general sign of the deficiency is physical endurance, which decreases noticeably. Psychologically, the decreasing motivation is noticeable, which is evident in a wide variety of topics. Overall, life satisfaction is declining significantly.
Three symptoms in particular are typical of the andropause. They directly affect sex life and do not remain hidden from the partner. The previously rapid erection and its strength are reduced. In addition, the physical desire weakens. The third sign of dwindling virility is the previously regular morning penis swelling. Overall, the psyche suffers enormously.
A number of those affected develop further symptoms that are different for every man. The physique changes due to the decrease in muscle mass and the increase in fat tissue. The hair on the head is slowly thinning and the growth of the beard is weaker. Some of the patients suffer from persistent nervousness, inner restlessness and sleep disorders.
Previously unknown attacks of sweat and heat occur less frequently. Some find it difficult to concentrate for long periods of time. There are also signs of poor memory. In some cases, depression is inevitable.
Diagnosis & History
In order to determine the testosterone deficiency in men in old age, the blood serum is usually examined. In order to achieve a reliable diagnosis, the blood must be taken in the morning, since the testosterone level is subject to strong fluctuations during the day. It reaches its highest value early in the morning, while it drops to a minimum in the afternoon.
Signs of reduced testosterone production can be erectile dysfunction and a general decrease in potency and libido. Osteoporosis, reduced physical and mental performance, palpitations and sleep disorders are also among the consequences of testosterone deficiency.
Complications
A lack of testosterone in men in old age can lead to various complications. Those affected primarily suffer from a very pronounced muscle weakness. This also leads to weight gain, so that those affected are dissatisfied with their weight and often also with their appearance and are ashamed of it. Permanent tiredness and exhaustion also occur and cannot be compensated for by sleep.
Most of those affected also develop depression or inner unrest due to the lack of testosterone in men in old age. In children, the lack of testosterone in men can lead to severe limitations in growth and development in old age. The children are often tired and cannot concentrate. The complaint can also have a very negative effect on sexual desire, so that there may be problems with your partner.
Treatment of the disease in most cases is carried out with the help of hormones. There are no complications. However, those affected are usually dependent on lifelong intake. If the testosterone deficiency in men in old age is triggered by an underlying disease, this must also be treated.
When should you go to the doctor?
Changes in the hormonal balance are normal over the lifespan and are part of the natural process. A doctor is not always needed when they occur. Testosterone depletion occurs in men over the age of 60 or later. It happens slowly and insidiously. Normally, this development does not require a doctor’s visit.
If the person affected suffers from the physical changes, he should consult a doctor. The decrease in libido or sexual activity are considered a natural process. If the person concerned notices that he is not in harmony with this, the changes should be discussed with a doctor. If you experience sleep disorders, night sweats or heat attacks, you should consult a doctor. Changes in hair growth, personality disorders and emotional sensitivity should also be examined more closely by a doctor. Although the symptoms are considered natural in men at an advanced age, it must be clarified whether other diseases are present. An inner restlessness, nervousness and the feeling of imbalance are also among the symptoms of a testosterone deficiency.
If the person concerned is under the age of 60, he should always initiate a doctor’s visit if the symptoms arise. Here, the lack of testosterone points to further discrepancies that should be investigated.
Treatment & Therapy
Various therapies are used to treat testosterone deficiency in older men. In all of them, the testosterone that the body lacks is supplied from the outside.
The oldest form of hormone treatment is called a monthly injection. This takes place at intervals of three to four weeks, although the testosterone level can still be subject to strong fluctuations. A special gel that is applied to the skin every day achieves better results.
The scrotal plaster that is applied to the scrotum every day also keeps the testosterone level relatively constant, but some men find it annoying. The 3-month injection is a new form of treatment with good results. It has the advantage that the lack of testosterone in men can be eliminated over a longer period of time without them having to worry about it.
In some countries it is possible to insert testosterone implants under the skin. With a short, outpatient procedure, the testosterone level can be maintained over a period of six months.
However, little is known about the long-term damage and other risks induced by the external administration of testosterone. There are also numerous possible side effects (such as thrombosis, depression, stroke, damage to the heart muscle or the formation of liver and kidney tumors) that can occur especially when synthetic testosterone is administered.
Prevention
In order to best prevent testosterone deficiency in men in old age, importance should be attached to a healthy lifestyle, a balanced diet and physical activity.
Since stress, obesity, alcohol, drugs and certain medications such as psychotropic drugs or corticosteroids also have a negative effect on testosterone levels, it can be said in summary that testosterone deficiency in older men can at least be alleviated by changing their habits.
Aftercare
During testosterone replacement therapy, it is of great importance to monitor the prostate through regular check-ups in order to detect the development of prostate carcinoma at an early stage. The treatment interval should initially be three to six months and then repeated after a year. The investigations should then be continued annually. The parameters to be controlled are the tumor marker PSA and the rectal examination of the prostate.
Since testosterone leads to increased erythrocyte formation, the hematocrit and hemoglobin value should be determined regularly. Here, the fluidity of the blood is to be monitored in order to counteract thromboembolic events. Studies have shown that starting testosterone replacement therapy is associated with an increased risk of thromboembolism.
The risk of such a serious side effect is highest in the first three months after the start of therapy. In the case of existing cardiological pre-existing conditions, regular check-ups should also be carried out. Therapy successes can be seen over a period of months to sometimes even years.
The fact that the lack of male hormones can also lead to psychological impairments should not be ignored. It is therefore important to consider offering psychotherapeutic support during aftercare. The offer of self-help groups is also an important part of holistic aftercare.
You can do that yourself
Andropause is a natural phenomenon that will subside on its own after a few months. Treatment is only necessary if symptoms occur. Hormone replacement therapy can be useful for symptoms such as hair loss or mood swings. The man should seek treatment at an early stage and ideally talk to his family doctor about the symptoms.
The therapy can be supported at home by changing your diet and various general measures. The diet should be balanced and healthy during this break. It’s also good to spend a lot of time outdoors to stimulate the body’s testosterone production. In addition, sports should be practiced. Physical exercise contributes to a healthy hormone balance and can counteract the typical symptoms of testosterone deficiency. In consultation with the doctor, various potency-enhancing drugs are also available. Which measures make sense in detail must be discussed with the doctor.
Middle-aged men who experience symptoms of andropause are best advised to speak to their GP. The doctor can perform a physical exam and use the results to suggest appropriate therapy. If necessary, other specialists as well as nutritionists and sports physicians can be consulted.
