Andropause: Low Testosterone
I don’t think it is a “guy” thing to channel surf. My ice dancing coach is a woman, and she channel surfs enough to make the Beach Boys proud. With one billion channels to choose from, both men and women are compelled– no– mandated to surf the tube to see what else is on. God forbid we miss a better movie, important news information, or a VH1’s Sexiest Bodies installment.
My DVR is so fancy that I can even watch 2 channels at once. I can simultaneously record two shows while watch a previously recorded show– even Howie Long couldn’t do that in Radio Shack commercial! I can speed things up, slow them down, and put things on pause to answer the phone– only to find out it is an evil telemarketer. The only thing my remote controls can’t do is menopause and andropause.
First of all, why is menopause a term for women? Shouldn’t it be gynopause? Andropause is now the hot term for older men who don’t have as much testosterone as they used to. About half of men over the age of 65 have low free testosterone, which can lead to things like erectile dysfunction, loss of muscle mass, depressed mood and thinking, osteoporosis, anemia, and infertility (but then again, should grandpa really be reproducing? Billy Crystal said about Charlie Chaplin’s having a baby at the age of 70, “Yeah, but he was too old to hold the kid.”)
We have been looking for the Fountain of Youth since the days of Ponce de Leon. Since we haven’t found the Fountain, Botox and collagen injections have found us (well, if you want to look like Nancy Sinatra, who looks more like the Bride of Chuckie.)
However, considering there are health problems that can develop from low testosterone, treatment can have its benefits. I have been treating a lot of men with low testosterone, and the results have been interesting to say the least. Some spouses have said to me, “Thank you, thank you, thank you for getting my man back!” Others have said, “Lord Jesus! He has never acted like a grown up, and now things are even worse. He is chasing me around like a teenage boy—the difference being I have arthritis now and it isn’t so fun.”
Estrogen has a small associated risk of breast and ovarian cancer. Testosterone replacement, too, has a risk of prostate cancer. Some of my patients choose to use saw palmetto or Avodart to reduce this risk. It can also worsen the cholesterol profile to some degree.
Blood tests are used to detect low testosterone. In general a “total testosterone” level is checked; this consists of both Bound testosterone and Free testosterone. This is important to understand because you might have low testosterone but get a normal reading with a total testosterone. The older you get, the more SHBG (sex hormone-binding globulin) you have so testosterone gets Bound. But it is the Free testosterone that counts—this is what is “active” in the body. So if you have a bunch of Bound testosterone on SHBG but very little Free testosterone, it might be down periscope for you!
On the other hand, obese men have less SHBG and might have a false finding of low testosterone. Therefore, a free testosterone, FSH, and LH are worth checking at times. (FSH and LH are pituitary gland hormone that tell the testicles to perk up.)
Getting older is fun because you have more insight and wisdom (we hope!). On the other hand, it can be no fun because it is “one thing after another.” But we should be thankful because we live longer than most animals, including our best friends, dogs. I wonder if an older male dog goes through andropaws as well?
© Dr. John Hong, Inc
