Is It Possible to Slow Down The Aging Process?
Posted By: Dr. Gary Bellman
Testosterone affects the function of many organs in the body. In the brain, it influences libido or sex drive, mood and thinking. Testosterone can also improve verbal memory and visual-spatial skills. It as also been shown to decrease fatigue and depression in men with low levels. It is responsible for muscle strength and growth, and stimulates stem cells and blood cells in bones and kidneys. Penile growth, erections, sperm production, and prostatic growth and function all depend on testosterone. It also causes body hair growth, balding, and drives beard growth. Thus, testosterone makes us who we are, and influences how we look.
Advantages of Testosterone Replacement Therapy
In men with low testosterone levels, testosterone can improve bone mineral density and reduce bone fractures, an effect similar to that found in postmenopausal women on estrogen replacement. Importantly, hip fractures are 2-3 times as likely to kill an older man as a woman of the same age, and 40% of older male patients with hip fractures die within 1 year of the injury.
Testosterone results in increases in lean body mass, possibly strength and can decrease fat mass. By stimulating erythropoietin, testosterone increases blood counts. It appears to improve lipid profiles and dilates blood vessels in the heart but no data has yet shown that it reduces heart attacks or strokes. It appears not to alter LDL or total cholesterol levels. In recent work, it has been shown that men with chronically low testosterone levels have 2-3 fold higher risk of developing metabolic syndrome and have up to a 40% greater risk of death than men with normal testosterone levels.
Better Sexual Health
Sexual function also improves with testosterone. Most studies agree that sexual drive is improved by testosterone. Penile erections may be improved with testosterone, but only in men with low testosterone levels. Important, isolated low testosterone is an unusual (6%) cause of erectile problems in older men as lower sex drive and age-related changes to the penis are far more common.
Low Testosterone Symptoms and Diagnosis
To make an accurate diagnosis of low testosterone, symptoms or findings must accompany a blood draw showing a low testosterone level. This combination makes treatment worthwhile to pursue. Symptoms include decreased sexual desire and erectile dysfunction, changes in mood associated with fatigue, depression and anger and decreases in memory.
On examination, there may be decreased lean body mass with reduced muscle volume and strength, and increases in abdominal girth. Decreased or thinning of facial and chest hair and skin alterations such as increases in facial wrinkling and pale-appearing skin suggestive of anemia may also be noted. Testicles that have become smaller or softer may also be present. Finally, low bone mineral density with osteopenia or osteoporosis may also suggest a problem.
Not all of these findings need to be present at the same time to diagnose the problem. In fact, many of these symptoms can be attributed simply to the natural aging. For example, frailty may be due to many causes, some of which include loss of muscle strength, bone fractures, decreased mood, and impaired cognition, symptoms typical of testosterone deficiency. However, the association of such symptoms along with a low testosterone certainly implicates this as a problem. By these criteria, it is estimated that only 10% of men with low testosterone levels are currently being diagnosed.