The Testosterone Factor

A 2007 study, one of the largest of its kind, tracked testosterone levels of Massachusetts' men in a population-wide research. The results were eye-opening.

Across the board, men had a staggering 17% drop in testosterone concentrations from 1987 to 2004-and it wasn't linked to "normal aging" or other lifestyle factors.

That drop echoed male reproductive health trends, from reduced sperm quality to increased testicular cancer. Both younger and older men showed similar hormonal declines, which diminished faster than normal aging parameters.

What's the big deal? Lowered testosterone levels up a man's risk for early death, morbidity (lowered quality of life) and a number of diseases, not to mention reduced sexual function and performance, libido, mood, inability to maintain muscle mass/ strength, inability to keep body fat off or inability to think clearly.

Losing muscle mass can lead to the insidious sarcopenia, a muscle atrophy condition resulting in frailty and a huge cause of disability, morbidity and mortality in this country.

Andropause. The male equivalent of female menopause, the term "andropause" hasn't been used in traditional medicine until recently-but you'll be hearing much more about it as time goes on.

Unlike the abrupt, distinct onset of menopause, andropause creeps into a man's life beginning in his 40s. Ever so slowly, testosterone levels start to decline, typically in the early 30s.

It could take a few years before most men realize things have changed and their life isn't quite what it used to be.

Here's the point. Testosterone isn't just a sex hormone. It is a much-needed steroidal hormone with receptor sites throughout your whole body:

• brain
• heart
• nerves
• muscles
• sexual organs

Good indicator something's awry. One of the tell-tale questions I ask patients is regarding early morning erections. Most men can't recall the last time they had one-then realize it's not been part of their life any longer the way it was in their teens, 20s, 30s and early 40s.

Those early morning erections have nothing to do with the bladder, but everything to do with testosterone levels. With lowered testosterone, not only do early morning erections disappear, but also erectile performance, libido and sexual thoughts throughout the day.

By the time a patient comes to me with signs (revealed by labs/exams) and symptoms (patient's complaints), the testosterone decline and its effects are well on their way.

Physicians practicing only conventional medicine often write off these signs/ symptoms as part of the aging process- never linking them to testosterone levels and even testing for it. If a test is run, the levels may very well be at the bottom of the "normal" range.

What's normal? The problem is that the so-called normal range is huge, from 90 - 1,000 nanograms per deciliter (ng/dL) for men 20-70. So if your test comes back with a testosterone level in the 100-200 range, a traditional doctor may say, "Well, Joe, you're okay . . . you're in the normal range."

What he doesn't say is that low-range normal is the equivalent of your getting a "D-" or "F" health grade. Now, I don't want to be a low-grade anything. I want to be at the top of my abilities. What about you?

Staying in the upper normal range means having a testosterone level of 900, 1000 or even 1100. Of course, you really need to evaluate both your total and free testosterone levels. The latter is the bioavailable amount that is not bound to anything and is, therefore, more useful and free to travel to all the testosterone receptor sites in your body.

Your free testosterone levels should average approximately 2% of the total, 90-210 picograms per millilitre (pg/ml) for men and 1-10 pg/ml for women. 

Women Aren't Exempt. Gender differences are quantitative, not qualitative. So, ladies, listen up. Testosterone is produced in your ovaries and adrenal glands. A surgical menopause (ovaries removed) costs you a 50% reduction in your natural testosterone levels. After a normal menopause, testosterone levels also decline.

A small amount of testosterone cream can get your levels within the healthy range and deliver similar benefits:

• Improved libido
• Improved sexual function
• Improved clitorital sensitivity
• Improved muscle tissue, tone & strength
• Healthy bone density
• Sharper thinking
• Better ability to stay lean