Testosterone Deficiency Syndrome (Hypogonadism)
Testosterone Deficiency Syndrome, or Hypogonadism, is a disorder in which a man’s body does not produce sufficient testosterone, the main male hormone. This disorder generally affects older men, but younger patients can also be affected for a variety of reasons.
While the term “andropause” is sometimes used for this condition, it is inaccurate. Unlike menopause, testosterone deficiency syndrome is not an inevitable result of aging.
Testosterone plays a key role in a man’s sex drive, muscle mass, as well as mental and physical energy.
There are several symptoms that are associated with a deficiency in testosterone in men:
- Reduced sex drive
- Difficulty getting or maintaining an erection
- Difficulty concentrating or making decisions
- Poor results from exercise programs
- Increase in body fat
- Loss of lean body (muscle) mass
- Loss of bone density
- Poor work performance
- Unfavorable changes in cholesterol profile
Sometimes, a particular cause for testosterone deficiency might be identified. An example would be excess secretion of one or more pituitary hormones that then disrupt testosterone production or availability.
In most people, however, no cause for testosterone deficiency can be identified. In these cases, testosterone replacement therapy is generally an effective treatment.
Beyond the symptoms that many men experience, testosterone deficiency syndrome can also contribute to the beginning or worsening of various illnesses:
- Increased risk of cardiovascular disease
- Increased risk of death from a cardiovascular event
- Increased risk of metabolic syndrome: high blood pressure, elevated insulin levels, excess belly fat and abnormal cholesterol levels
- Strong association with diabetes
- Strong association with atherosclerotic disease of the aorta
- Higher incidence of prostate cancer
- Association with more aggressive variations of cancer
Testosterone deficiency is usually diagnosed with a basic blood test.
When a specific cause for testosterone deficiency can be identified, treatment can be focused on that cause. When it comes to excess pituitary secretion of hormones, for example, medicine or surgery may be used to correct the underlying problem.
In cases where no specific cause can be determined, testosterone replacement therapy is the most common treatment option.
Testosterone replacement therapy increases the body’s testosterone levels with regular administration of testosterone. This therapy can take several forms:
- Testosterone patches give a specified amount of testosterone daily but must be replaced each day.
- Testosterone gels work in much the same way as testosterone patches, requiring daily application.
- Intramuscular testosterone supplementation is an injection that is given every one to four weeks.
- Testosterone “pellets” are implanted beneath the skin, providing a stable level of testosterone for 4-6 months.
There are two other forms of testosterone therapy that are either not available in the United States or not recommended:
- The testosterone wafer dissolves between the lip and the gum. It is not commonly used because it must be taken twice each day and causes gum irritation in many individuals.
- A long-lasting oral preparation of testosterone is currently available outside the United States, however, it has not yet been approved by the FDA for sale in this country.
Before starting testosterone therapy, patients need to recognize that it is a life-long commitment. Testosterone supplementation causes a drop in the amount of testosterone that is naturally produced by the body.
Testosterone replacement therapy can also raise an individual’s red blood cell mass, shown in a test called the hematocrit. As a result, careful tracking of hematocrit levels is essential.
For further information about Dr. Stengler’s practice and his clinic in Encinitas, California, please visit our website at MarkStengler.com or give us a call at (760) 274-2377.