As a man ages, there is a general decline in testosterone. Because this decline occurs gradually, it goes relatively unnoticed. Usually changes manifest in middle-aged men, but can begin for men as early as in their mid-twenties. Since testosterone imbalances may develop for reasons other than low hormone production, it is important to diagnose what form of testosterone disparity exists and the reasons behind it. This syndrome is termed andropause.
It becomes critical to identify the signs and symptoms of andropause. The following are the most common occurrences:
- Decrease or loss of morning erections
- Decrease in libido or sex drive
- Difficulty starting, maintaining, or decreased fullness of erection
- Muscle loss or soreness
- Tendency to depression, mental fatigue, difficulty with concentration
- Lack/decrease of initiative and/or physical stamina
- Weight gain around the mid-abdomen area
- Fat increase around the hips and breast areas
These changes may be accompanied by increases in cholesterol or triglycerides, increased blood glucose levels and possible elevation in blood pressure.
One or two of these changes do not necessarily indicate andropause, but an overview of decreased vitality and/or sexual function may be good indicators that this process has started.
Other factors may come into play and directly impact testosterone physiology. Genetics, autoimmune illness, enzyme imbalances, and tumors may be part of the picture, but they are relatively uncommon.
FIRST VISIT: 3-4 hours
History and physical
Cognitive testing
DEXA scan: bone density, muscle mass and fat content for the entire body
Diet and exercise counseling
Discussion of blood test
Discussion of a program directed to the patient’s specific needs.
Hormone replacement therapy when appropriate
FOLLOW UP VISIT: 1 -2 hours
repeat blood test after 2 months, if on hormone replacement,
discussion on how successful the program is for the patient.
modifications to the current medication, supplements, diet and exercise protocol
may repeat both cognitive and dexa testing to check on progress
