More and more Ontario Men have questions about Testosterone Treatment and/or Testosterone Therapy. And they wonder whether various symptoms they are experiencing could be related to Andropause, and if they would be improved with Testosterone Treatment.
As men age, the testicles typically begin to produce less testosterone. This occurs in all men to some degree, but men differ in the amount of the drop in testosterone levels. And men differ as well in how their body responds to a given decline in testosterone.
Please Note: There has been increased interest from younger men looking to boost Testosterone levels. Though we evaluate symptoms, and check blood levels of Testosterone accordingly, it is not our typical practice to put younger men with normal or borderline Testosterone, on Testosterone replacement. Sexual symptoms still should be evaluated, and can ususally be managed without hormone therapy. Also, the routine use of HCG and Aromatase Inhibitors is not part of the practice.
Truly low blood levels of testosterone typically result in a constellation of symptoms (a syndrome) which may include low libido (low sex drive), lack of energy, irritability, depression, poor concentration, loss of physical strength and decreased muscle mass. Sometimes erectile dysfunction is present. This syndrome, in conjunction with laboratory findings of low testosterone, is often referred to as Andropause, or Testosterone Deficiency Sydrome (TDS), which is the term we prefer at Ontario Men’s Health in Toronto.
As you can see, the symptoms involved can be quite vague and can overlap with many other conditions. These symptoms often also occur when our lives are too busy or stressful. This can complicate the diagnosis of Testosterone Deficiency / Andropause.
At Ontario Men’s Health in Toronto, the wellness counselors and physicians consider the possibility of Testosterone Deficiency / Andropause when symptoms are present. They will take a complete medical history and perform a complete physical exam, and arrange laboratory testing for blood levels of testosterone.
Note: Men suffering from Low Libido and/or Low Testosterone often have Erectile Dysfunction as well. A New Erectile Dysfunction Treatment (Shock Wave Therapy) that does not involve medication can be of great benefit to these men, as it promotes the growth of new blood vessels in the penis, often resolving ED.
Some recent studies, though criticized by many for data flaws, point to a possible increase in cardiovascular events (heart attack, stroke etc) in older men using testosterone, especially men with prior disease or at risk for disease. This lead to much media attention, and to the following statement :
July 2014: From Health Canada:
Health Canada is advising patients and healthcare professionals of new safety information regarding testosterone hormone replacement products and a risk of serious and possibly life-threatening cardiovascular (heart and blood vessel) problems.
However, a more comprehensive review of the literature in 2015 and again in 2016 showed more evidence of NO increased cardiac risk with Testosterone treatment. And having low testosterone seems more correlated with Higher risk of vascular disease.
For instance a more recent studies give evidence of possible cardiac benefit and LOWER risk with Testosterone Replacement. A recent study of men on Testosterone therapy, showed that over 5 years, they had 7 times lower Heart attack risk, and nine times lower stroke risk. than the general population.
Despite this confusion, the take away message now, while we wait for even more definitive studies to guide both patients and doctors, is that Testosterone therapy is not to be taken lightly. There are certainly benefits to treating low Testosterone, but there may be risks, some of which may come to light more clearly in the future. Patients and doctors must weigh this uncertainty when making decisions.
At Ontario Men’s Health we take the diagnosis and decision making process seriously when it comes to testosterone deficiency.
When appropriate, based on the clinical scenario and lab values, Ontario Men’s Health, in co-operation with patients who meet criteria, can recommend treatment of Testosterone Deficiency / Andropause with testosterone replacement medication, and provide the counseling and follow up needed, at the Toronto office.