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Just like women, men undergo significant hormonal changes as they age, especially in their testosterone levels. Understanding “male menopause” is key to maintaining health and vitality in the years to come.
Testosterone, which is vital for the development of male sexual characteristics, naturally rises and then declines with age. Testosterone production rises during puberty and can gradually rise until age 30. Levels may begin to decline at a rate of 1% per year after age 30. By age 70, some men may experience up to a 50% drop in testosterone levels compared to when the numbers were At peak levels.
Testosterone affects men and women differently due to its varying levels and gender roles. In men, as it is an essential hormone, its age-related decline greatly affects sexual function and physical traits. Women who naturally have low testosterone experience milder effects from low testosterone as their bodies adapt to hormonal changes during life events such as menstruation and menopause. Although its levels are low, testosterone in women is essential for bone health, muscle maintenance and energy.
Male menopause, or amenorrhea, is not just a myth. About 2 in 10 men over age 60 have low testosterone levels, according to the American Urological Association. This number rises to 3 in 10 men in their 70s and 80s. Symptoms such as decreased libido, fatigue, mood changes, erectile dysfunction and physical changes can significantly affect quality of life.
The new year is the perfect time to do a health checkup. If you’re over 40 and experiencing symptoms such as low energy or low libido, consider getting your testosterone levels checked. Only about 5% of men with low testosterone receive treatment, according to a 2018 study by the New England Research Institutes. This low number is mostly due to the fact that most men do not undergo annual checkups, leading to undertreatment and underdiagnosis of underlying health conditions.
Treatment for low testosterone, also known as testosterone replacement therapy, or TRT, aims to improve symptoms such as low libido, fatigue, and decreased muscle mass. Topical gels and creams are applied to the skin, ensuring stable hormone levels but requiring caution to prevent skin-to-skin transmission. Testosterone injections, taken every few weeks, are effective but can cause fluctuations in the hormone level. The patches provide a fixed daily dose and are an alternative for those who prefer not to use gels or injections. Testosterone pellets, implanted under the skin, provide a long-term solution, releasing steady doses over several months. Newer oral testosterone medications have also recently entered the market as an option to TRT.
Choosing the right type of TRT therapy involves considering individual preferences, medical history, and lifestyle, and should be discussed with your health care provider. Medical supervision is crucial during TRT treatment to adjust doses and monitor potential side effects, which may include acne, sleep apnea, blood clots, and increased risk of heart disease. Men with a history of prostate or breast cancer are usually advised against TRT.
Treatment for low testosterone is not limited to hormone therapy. Lifestyle plays a decisive role. Obesity has been linked to lower testosterone levels. A 2015 review found that overweight men are more likely to suffer from low testosterone, and losing weight can increase testosterone levels.
Regular exercise, a balanced diet and good sleep are not only good for your body. These habits also help maintain healthy testosterone levels. Embrace 2024 with a commitment not only to your fitness goals but also to a holistic approach to your well-being that can start with checking your hormone levels.
Dr. Jamin Brahmbhatt is a urologist and robotic surgeon at Orlando Health and past president of the Florida Urological Society.