Low testosterone in men: erasing the stigma

Reduced sex drive is a small part of the condition.Getting proactive with an often-unaddressed issue.

It’s an issue most men are reluctant and embarrassed to talk about, leaving them feeling like if they do raise the topic they might as well check their man-card at the door. This uneasy feeling is probably due in part to the fact that, until recently, low testosterone has only been thought of in connection with a decrease in sex drive.

“It is only natural that most men feel uncomfortable discussing any condition which reflects on their masculinity. For most men our sexuality and virility are inter-twinned and any hint that this is waning is frightening and may contribute to a diminished sense of self worth,” said Dr. Christopher Lauricella, DO, Family Medicine of Vandalia. “When confronted with a seemingly inevitable problem such as decreasing testosterone as a part of aging, people very often would rather not talk about it and simply wish to sweep it under the rug.”

Making matters worse is the fact that low testosterone is not something that has not been typically addressed as part of preventative care.

“Physicians and other health practitioners have a responsibility to take a more proactive approach and help their patients identify the problem and get to a sense of health and wellness. If you don’t ask the questions, the patients may not be willing to provide the information or they may be embarrassed,” said Dr. Dale Block, a Premier HealthNet Physician who practices at Premier Family Care of Mason. “A low sex drive is just a very small piece of it.”

Just as woman’s body goes through significant changes with menopause, a man’s body can also go through many major changes when his testosterone levels get too low due to aging. According to the National Institute of Health, symptoms such as low libido, loss of body hair and muscle bulk, increase in body fat, joint pain or erectile dysfunction can all be attributed to low testosterone levels. In fact, if left untreated, chronic low testosterone can cause weak bones (osteoporosis), mood changes and a decrease in energy.

According to the American Diabetes Association, low testosterone is a common condition that often goes undiagnosed because its symptoms masquerade as other conditions. As many as 13 million men in American may have low testosterone levels and more than 90 percent of them remain untreated. In addition, research has shown that preexisting conditions such as diabetes can increase a man’s risk for low testosterone.

Dr. Blocks says that men can begin seeing symptoms of low testosterone as early as their mid-40s, but most being experiencing symptoms in their 50s and 60s. In a typical male, their testosterone level at the age of 70 is 50 percent of what is was at the age of 20. According to Dr. Block, this time in a man’s physical health is often referred to as andropause.

The good news is that testosterone levels can be determined through a simple blood test. If levels are low, treatment is typically through the use of hormone replacement therapy. Since, according to the National Institute of Health, there are risk factors involved with hormone replacement, such as prostate cancer and sleep apnea, Dr. Block recommends that men discuss their options with their primary care physician and encourages men to not rule out a diagnosis or treatment because of the potential risks of therapy.

Dr. Block says that once men start on hormone replacement therapy, many see significant improvements in their sexual performance and fat burning, as well as other issues they may have, such as headaches, night sweats, depression and overall health.

“I have patients who will come in with this constellation of symptoms and they are on all these (prescription) drugs treating the symptoms and all it really comes down to is that they need a balanced hormonal approach and as soon as I present that to them and they get started on therapy, they see an improvement in their overall well-being,” said Dr. Block.

As for getting the initial conversation started between doctor and patient, Dr. Lauricella said, “I would like to encourage patients to be straight forward and honest with their physicians; as a group we are difficult to shock. That being said, if patient finds it difficult to simply come out and say ‘Gee doc, I think I might have low testosterone’, simply describing the common symptoms of fatigue, loss of muscle mass and decreased libido will certainly send most physicians down the right diagnostic path.”

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