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Jul 4

Low Testosterone – WebMD: Symptoms, Health Effects, and …

In recent years, Spyros Mezitis, MD, PhD, has found himself talking to a lot more male patients about low testosterone, a diagnosis he says is becoming increasingly common.

"More men are getting older, and men are more open about talking about erectile dysfunction," Mezitis, an endocrinologist at Lenox Hill Hospital in New York City, tells WebMD.

On the one hand, increased diagnosis of low testosterone is driven by an aging population, less stigma, and more precise tests. But there's another big reason why men come to Mezitis' office for a testosterone test.

"Men are bombarded by media, by advertising campaigns -- 'Don't feel well? Ask your doctor about low testosterone,'" he says.

They come in saying they feel excessively fatigued, weaker, depressed, and that they have lost their sex drive -- all common symptoms of a drop in testosterone.

"As an endocrinologist, I'm thinking hormones," says Mezitis, who estimates that about a quarter to a third of the men he tests for low testosterone have levels below normal. "Sometimes it is testosterone, sometimes it is the thyroid, and sometimes it's something unrelated to hormones."

Testosterone is a hormone. It's what puts hair on a man's chest. It's the force behind his sex drive.

During puberty, testosterone helps build a man's muscles, deepens his voice, and boosts the size of his penis and testes. In adulthood, it keeps a man's muscles and bones strong and maintains his interest in sex. In short, it's what makes a man a man (at least physically).

After age 30, most men begin to experience a gradual decline in testosterone. A decrease in sex drive sometimes accompanies the drop in testosterone, leading many men to mistakenly believe that their loss of interest in sex is simply due to getting older.

"Some say it's just a part of aging, but that's a misconception," says Jason Hedges, MD, PhD, a urologist at Oregon Health and Science University in Portland. A gradual decline in testosterone can't explain a near-total lack of interest in sex, for example. And for Hedges' patients who are in their 20s, 30s, and early 40s and having erectile problems, other health problems may be a bigger issue than aging.

"A lot of the symptoms are mirrored by other medical problems," Hedges says. "And for a long time, we were not attributing them to low testosterone, but to diabetes, depression, high blood pressure, and coronary artery disease. But awareness and appreciation of low testosterone has risen. We recognize now that low testosterone may be at the root of problems."

Doctors will want to rule out any such possible explanations for symptoms before blaming them on low testosterone. They will also want to order a specific blood test to determine a man's testosterone level.

"The blood test is really the thing," Mezitis says.

The bottom of a man's normal total testosterone range is about 300 nanograms per deciliter (ng/dL). The upper limit is about 800ng/dL depending on the lab. A lower-than-normal score on a blood test can be caused by a number of conditions, including:

Some medicines and genetic conditions can also lower a man's testosterone score. Aging does contribute to low scores. In some cases, the cause is unknown.

A low score does not always translate to symptoms, Mezitis says, "but we often find something that's off when we see scores of 200 or 100 ng/dL."

Hedges agrees and warns that even if a man does not have symptoms, he may be well advised to seek treatment. Low testosterone scores often lead to drops in bone density, meaning that bones become more fragile and increasingly prone to breaks.

"That's something I would want to have a conversation about," Hedges says. "Bone density issues are not always apparent."

Having a gradual decline in your testosterone level as you age is to be expected. Treatment is sometimes considered if you're experiencing symptoms related to low testosterone.

If a young man's low testosterone is a problem for a couple trying to get pregnant, gonadotropin injections may be an option in some cases. These are hormones that signal the body to produce more testosterone. This may increase the sperm count. Hedges also describes implantable testosterone pellets, a relatively new form of treatment in which several pellets are placed under the skin of the buttocks, where they release testosterone over the course of about three to four months. Injections and nasal gels may be other options for some men.

"If their symptoms are truly due to low testosterone, patients tell me that within a few weeks they notice a significant difference, though sometimes it is not too dramatic," Hedges says. "Sex is better, depression is better -- you can see it directly and quickly."

There are also risks. Testosterone treatment can raise a man's red blood cell count as well as enlarge his breasts. It can also accelerate prostate growth. Men with breast cancer should not receive testosterone treatment.

Testosterone treatment usually is not advised for men with prostate cancer. Hedges says some of the associations between testosterone replacement therapy and prostate health are currently being challenged. In his practice, he does offer testosterone treatment to men who have been treated for prostate cancer.

"The take-home [message] is treatment is safe as long as you get careful monitoring," Hedges says. "If there are known issues, patients should be treated by a specialist."

SOURCES:

Spyros Mezitis, MD, PhD, endocrinologist, Lenox Hill Hospital, New York.

Jason Hedges, MD, PhD, urologist, Oregon Health and Science University, Portland, Ore.

The Hormone Foundation: "Low Testosterone and Men's Health."

The Hormone Foundation: "Patient Guide to Androgen Deficiency Syndromes in Adult Men."

Patient Education Institute: "Low Testosterone Reference Summary."

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Low Testosterone - WebMD: Symptoms, Health Effects, and ...


Jul 4

Study: Women with more naturally occurring testosterone have competitive advantage – ESPN

A scientific paper published Monday found that women who produce higher-than-normal amounts of testosterone have up to a 4.5 percent advantage over their competition on the track, evidence the sport's governing body will use to potentially sideline Olympic gold medalist Caster Semenya and others with so-called intersex conditions.

The International Association of Athletics Federations will use the new study in its appeal to the Court of Arbitration for Sport, which suspended an IAAF rule that enforced a limit on female athletes' naturally occurring testosterone levels. The appeal will not affect this year's world championships, where Semenya is expected to go for her third title at 800 meters.

The study, funded by IAAF and the World Anti-Doping Agency, and published in the British Journal of Sports Medicine, analyzed more than 2,100 androgen samples from athletes participating in the 2011 and 2013 world championships.

It found females with higher testosterone levels received a competitive advantage of 1.8 percent to 4.5 percent over female athletes with lower testosterone levels in 400- and 800-meter races, hammer throw and pole vault.

"If, as the study shows, in certain events female athletes with higher testosterone levels can have a competitive advantage of between 1.8 to 4.5 percent over female athletes with lower testosterone levels, imagine the magnitude of the advantage for female athletes with testosterone levels in the normal male range," said one of the study's authors, Stephane Bermon.

In 2011, the IAAF enacted a rule to force athletes with hyperandrogenism to artificially lower their testosterone levels to be eligible to compete.

Dutee Chand of India contested the rule and CAS overturned it in time for last year's Olympics. CAS gave the IAAF two years to produce evidence that hyperandrogenism led to an unfair advantage. IAAF will submit the paper, but said it would have no further comment until the case is concluded.

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Study: Women with more naturally occurring testosterone have competitive advantage - ESPN


Jul 4

Dear Dr. Roach: Testosterone treatment reserved for men with symptoms – Herald & Review

Dear Dr. Roach: I am a 70-year-old male. I receive testosterone injections (in the butt) from my provider every three weeks, and have been receiving these injections for roughly five years. My provider reviews my blood work every six months before he writes a prescription renewal for testosterone, which I then take to his office for safekeeping and the regular injections. My latest bloodwork indicates that my testosterone serum is low at 310, and free testosterone is low at 4.9. After five years of injections, I continue to have low T; it does not seem to be improving. At my most recent visit, the doctor increased the injection dosage from 2 ml to 3 ml. I am concerned because of the heart, prostate and other risk factors I read about. Any advice or cause for concern?

A: Testosterone treatment is indicated for men with symptoms of low testosterone levels and confirmed by blood testing. It is not a "tonic" to be used without due consideration.

There has long been concern about adverse effects of testosterone, especially to the prostate and to the heart. Most prostate cancer is testosterone-sensitive, and removing testosterone was one of the oldest treatments for prostate cancer. However, restoring normal levels of testosterone in a man with low levels is now considered to have low potential for increasing prostate cancer. It has not been definitively proven to be safe, but the many studies that have been done have been reassuring. Authorities recommend more-aggressive prostate cancer screening for men on testosterone treatment.

Athletes using extremely high doses of testosterone (many times greater than the doses you are taking) are at risk for heart attack and stroke. However, these data cannot be used to consider the risk in men who are prescribed testosterone with a low level, where the goal is to get to normal. Testosterone treatment reduces several key risk factors, including cholesterol. Most of the well-done studies show little if any risk from testosterone treatment; some have shown some benefit.

Since the dose you were getting wasn't bringing your blood level up, I think increasing it is appropriate. The usual goal is a blood level of 500-600, but that may not be appropriate for everybody.

Dear Dr. Roach: I am perplexed about use of estrogen ointment. My doctor has prescribed Premarin ointment to be used vaginally for relief of painful intercourse. It is effective, but I am very concerned about side effects. She has assured me that the amount that is used (twice a week) is minimal and does not put users at risk for the side effects of oral estrogen tablets. I do have family history of blood clots and uterine cancer, and I suffer from aura migraines. I am 65 years old and in good general health. I never considered the use of hormones for menopausal symptoms, and although I am using the ointment at present, I still am very hesitant.

A: Because estrogen is poorly absorbed when used topically, the concerns about side effects are greatly reduced. Estrogen blood levels are very nearly the same in women on vaginal estrogen compared with women who do not use estrogen at all. While I would never prescribe vaginal estrogen to a woman with a history of breast cancer without discussing it with her oncologist, I think that the systemic risks of estrogen are very small with the vaginal preparations.

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Dear Dr. Roach: Testosterone treatment reserved for men with symptoms - Herald & Review


Jul 4

What is Testosterone? – Live Science: The Most Interesting …

The chemical structure of testosterone.

Testosterone is a male sex hormone that is important for sexual and reproductive development. The National Institutes of Health regards testosterone as the most important male hormone. Women also produce testosterone, but at lower levels than men.

Testosterone belongs to a class of male hormones called androgens, which are sometimes called steroids or anabolic steroids. In men, testosterone is produced mainly in the testes, with a small amount made in the adrenal glands. The brain's hypothalamus and pituitary gland control testosterone production. The hypothalamus instructs the pituitary gland on how much testosterone to produce, and the pituitary gland passes the message on to the testes. These communications happen through chemicals and hormones in the bloodstream.

Testosterone is involved in the development of male sex organs before birth, and the development of secondary sex characteristics at puberty, such as voice deepening, increased penis and testes size, and growth of facial and body hair.

The hormone also plays a role in sex drive, sperm production, fat distribution, red cell production, and maintenance of muscle strength and mass, according to the Mayo Clinic. For these reasons, testosterone is associated with overall health and well-being in men. One 2008 study published in the journal Frontiers of Hormone Research even linked testosterone to the prevention of osteoporosis in men.

In women, the ovaries and adrenal glands produce testosterone. Women's total testosterone levels are about a tenth to a twentieth of men's levels.

Levels of testosterone naturally decrease with age, but exactly what level constitutes "low T," or hypogonadism, is controversial, Harvard Medical School said. Testosterone levels vary wildly, and can even differ depending on the time of day they're measured (levels tend to be lower in the evenings). The National Institutes of Health includes the following as possible symptoms of low testosterone:

It is important to note, however, that conditions other than low T can cause erectile dysfunction, such as diseases in the nerves or blood.

Doctors typically to treat men for hypogonadism if they have symptoms of low testosterone and their testosterone levels are below 300 nanograms per deciliter.

High testosterone levels can cause problems in women, including irregular menstrual cycles, increases in body hair and acne, and a deepening of the voice. Women with polycystic ovarian syndrome have high levels of male hormones, including testosterone, which can be a cause of infertility.

For people who are worried about low or high testosterone, a doctor may perform a blood test to measure the amount of the hormone in the patient's blood. When doctors find low-T, they may prescribe testosterone therapy, in which the patient takes an artificial version of the hormone. This is available in the following forms: a gel to be applied to the upper arms, shoulders or abdomen daily; a skin patch put on the body or scrotum twice a day; a solution applied to the armpit; injections every two or three weeks; a patch put on the gums twice a day; or implants that last four to six months.

Men using testosterone gels must take precautions, such as washing hands and covering areas where the gel is applied, according to the U.S. Food and Drug Administration. Women and children should not touch the gel or the skin where the gel or patch is applied.

In older men with true testosterone deficiencies, testosterone treatment has been shown to increase strength and sex drive, experts say. But sometimes, symptoms of erectile dysfunction are due to other conditions, including diabetes and depression, according to the Mayo Clinic. Treating these men with testosterone hormone won't improve symptoms.

There are a lot of other claims about what testosterone therapy can do, but are also still being tested. For instance, it was thought that maybe it would help with age-related memory loss. A 2017 placebo-controlled study published in JAMA, found that in the 788 older men tested, testosterone treatment did not help with age-related memory loss.

It may also become a treatment for anemia, bone density and strength problems. In a 2017 study published in the journal of the American Medical Association (JAMA), testosterone treatments corrected anemia in older men with low testosterone levels better than a placebo. Another 2017 study published in JAMA found that older men with low testosterone had increased bone strength and density after treatment when compared with a placebo.

The safety of testosterone treatment is still being researched. It has several possible side effects and some possible long-term effects, as well.

For example, testosterone treatment lowers sperm count, so Michael A. Werner, a specialist in andropause, or "male menopause," recommends that men who desire future fertility avoid testosterone treatments.

Other side effects include increased risk of heart problems in older men with poor mobility, according to a 2009 study at Boston Medical Center. A 2017 study published in JAMA found that treatments increase coronary artery plaque volume. Additionally, the Food and Drug Administration (FDA) requires manufactures to include a notice on the labeling that states taking testosterone treatments can lead to possible increased risk of heart attacks and strokes. The FDA recommends that patients using testosterone should seek medical attention right away if they have these symptoms:

The treatment can also increase the risk of sleep apnea, promote prostate and breast growth, and even encourage the development of prostate cancer, according to the Mayo Clinic.

This article is for informational purposes only and is not meant to offer medical advice.

Additional reporting by Jessie Szalay and Alina Bradford, Live Science contributors.

Additional resources

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What is Testosterone? - Live Science: The Most Interesting ...


Jul 4

Male testosterone dropping more rapidly – UpperMichigansSource.com

MARQUETTE, Mich. (WLUC) - It's natural for men to lose some of their testosterone as they age, but studies show men are losing their testosterone quicker these days than ever before.

"Male menopause is really the feminization of males. It's men becoming females," said Motions Fitness Owner Mike Koskiniemi.

All men over the age of 30 lose their testosterone as they age. However, today some experts are warning that men are quickly losing their masculinity, biologically speaking, faster than ever before.

"The 20-year-old males of today have half the testosterone their fathers had when they were 20. It's getting severe, said Koskiniemi. It's been happening like that generation over generation. But now we're at the worst state that men have been at."

Some symptoms of male menopause are excessive fatigue, loss of strength and vitality, and being overweight with male breast tissue.

"Apparently my body was creating the correct amount of testosterone, but it was creating more than necessary estrogen, said Motions Client Ty Hartung. My body was retaining more estrogen, which is the female hormone."

This excessive amount of estrogen is coming from multiple sources: lack of proper sleep, overconsumption of alcohol, especially beer, and high carbohydrate intake.

"Another big one is nutrient deficiency, Koskiniemi said. No one is getting any of the nutrients they need these days. Specifically, D3, Vitamin A, Zinc, and Magnesium."

Besides poor diet and lack of sleep, another contributing factor in the rise of estrogen are water bottles and plastics that have been heated. Synthetic estrogens are produced and consumed.

The best way to regain testosterone is to get adequate sleep, decrease alcohol and carbohydrate consumption, and avoid drinking fluids from heated plastics. If you want more information on rebuilding male testosterone, click here.

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Male testosterone dropping more rapidly - UpperMichigansSource.com


Jul 4

Springfield weighted down with testosterone. Where are the women? – Chicago Sun-Times

It was a yard sign, that mundane and overrated weapon of Chicagos pugnacious street politics.

For Celina Villanueva, it became a telling symbol of the challenges women face in politics.

Villanueva, an accomplished, Chicago-based political operative and organizer, has worked the political hustings at the state, county and city levels.

OPINION

One day back when she was managing her first campaign, she was working alone in the office. A precinct captain walked in asked for some yard signs. She told him they were not ready for distribution.

I want them now, he said. She said no.

I am taking them now, he said. She said no.

Im 54, a short little Mexican girl from Little Village, Villanueva told me the other day. The man was a foot taller than me. He got in my face, stared me down.

He thought he would use his machismo, she added, to intimidate me. No one ever prepared me for how to deal with that, as a woman in politics.

Women in politics get little training, mentoring or encouragement, she said. They grapple with sexism, unequal pay and lack access and resources that men enjoy. And now Villanueva and a group of other women in the politics and policy arenas are launching an online campaign for change.

Over a recent dinner, they vented about one big question: Are there any women running for Illinois governor?

They posted the answer No! along with an open letter that is demanding change.

They wrote: We are disturbed that of all the Democratic candidates running for Illinois governor, zero are women. Zero.

The eight aspirants for the gubernatorial nomination are all men. Six are white. None are openly LGBT.

How bad is it? O Thursday, the one women in a leadership position in the state Legislature, Senate Minority Leader Christine Radogno, whose authority repeatedly was undermined by Gov. Bruce Rauner, announced she is quitting the job and the Senate.

Springfield is historically dysfunctional, weighted down with too much testosterone. Illinois politics desperately needs a womans touch.

Its about more than the governors race, Villanueva said. This is a bigger, systemic issue, she argues. Its a problem overall, particularly that not enough women of color are involved in the political process.

The group wants to send a message to the leadership, across the board, but also to the base of the Democratic Party, said Joanna Klonsky, a political communications consultant who primarily works with progressive Democrats.

They want a concerted effort to recruit, train and engage women in electoral politics at all levels.

President Donald Trumps election has activated Democratic women as never before, shows a new study sponsored by Politico, American University and Loyola Marymount University. Yet, the authors report, women in both parties remain significantly less likely than men to have thought about running for office even after Trumps victory.

Their study states that it uncovered a large gender gap in political ambition. For example, when asked if they had ever considered running for office, 23 percent of women had, compared to 38 percent of men.

Unlike other states, Illinois has no formal pipeline or training ground for candidates and political professionals, Klonsky said. Unlike men, women are not encouraged to consider politics at a young age.

No offense to supportive male politicos, but women are the best judges of gender-based issues like reproductive choice and pay equity, she added. We need women in leadership and in every room where decisions are being made about us. We need to be at the table.

Women who want to join them can go to: arethereanywomenrunningforilgovernor.com

I asked Villanueva: Did the precinct captain get his yard signs?

No!

Send letters to: letters@suntimes.com.

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Springfield weighted down with testosterone. Where are the women? - Chicago Sun-Times


Jul 4

Testosterone Injections: How To Inject Testosterone

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Testosterone Injections: How To Inject Testosterone


Jul 4

How to Inject Testosterone Safely

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How to Inject Testosterone Safely


Jul 4

How Not To Inject 200mg of Testosterone!

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How Not To Inject 200mg of Testosterone!


Jul 4

How to do a Testosterone Shot Injection

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How to do a Testosterone Shot Injection



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