As men age past 40 or sometimes earlier, hormonal changes occur that inhibit physical, sexual cognitive function.
The outward appearance of a typical middle-aged male shows increased abdominal fat and shrinkage of muscles, a hallmark effect of hormone imbalance. Loss of feeling of wellbeing sometimes manifesting as depression, is a
common psychological complication of hormone imbalance.
Until recently, these changes were attributed to “growing old”, and men were expected to accept the fact that their bodies were entering into a long degenerative process that would someday result in their death.
A remarkable amount of data has been compiled indicating that many of the diseases that middle-aged men experience including depression, fatigue, abdominal weight gain, alterations in mood, cognition, decreased libido,
erectile dysfunction, prostate disease, heart disease, high blood pressure and elevated cholesterol are directly related to hormone imbalances. The onset of these symptoms usually appear in the early 50s, although it can appear earlier.
Some doctors are constantly prescribing drugs to treat depression, elevated cholesterol, angina, blood pressure, and a host of other diseases that might be caused by hormonal imbalance.
TOO MUCH ESTROGEN
The most significant of hormone imbalance in men is a decrease in free testosterone while estrogen levels remain the same or increased. As men grow older, they experience a variety of disorders relating to the dual effect of
having too little testosterone and an excess amount of estrogen.
A result is a testosterone-estrogen imbalance that directly causes many debilitating health problems.
One cause of hormone imbalance in men is that their testosterone is increasingly converted to estrogen. One report showed that estrogen level in an average 54-year-old male are higher than those of an average 59-year-old
white female. The reason that testosterone replacement does not work by itself for many men is that exogenously administered testosterone may convert – that is, aromatize – into even more estrogen, thus potentially worsening the hormone imbalance problem in aging males – that is, too much estrogen and not enough free testosterone.
Estrogen is an essential hormone for men, but too much of it causes a wide range of health problems. The most dangerous acute effect of excess estrogen and too little testosterone is an increased risk of heart disease or
stroke. High levels of estrogen has also been implicated in the cause of benign prostatic hypertrophy (BPH). One of the mechanisms by which nettle root extract works is to block the binding of growth-stimulating estrogen to the prostate cell.
When there is too little testosterone present, estrogen attaches to testosterone cell receptors throughout the body and creates many problems for aging men. As estrogen levels increase in age, testosterone cell stimulation
may be “locked in the off position” thus reducing sexual arousal and sensation, and causing the loss of libido so common in aging men. High serum estrogens also trick the brain into thinking that enough testosterone is being
produced, further slowing the natural production of testosterone.
This happens when estrogen saturates testosterone receptors in the hypothalamus region of the brain. High estrogen can shut down the normal testicular production of testosterone. Another complication of excess estrogen
that increases the body’s production of sex hormone binding globulin (SHBG), which binds more free testosterone. Based on multiple effects of excess estrogen in men, action should be taken to reduce the estrogen to a safe range.
THE CRITICAL IMPORTANCE OF FREE TESTOSTERONE
Testosterone is much more than a sex hormone. There are testosterone receptor cells throughout the body, most notably in the brain and heart. Useful protein synthesis for maintaining muscle mass and bone formation requires testosterone.
Testosterone improves oxygen uptake throughout the body, helps control blood sugar, regulates cholesterol, and maintains immunity.
The body requires testosterone in maintaining beautiful cardiac output and neurologic function. Testosterone is also a critical hormone in the maintenance of healthy bone density, muscle mass or red blood cell production.
There are also studies showing that depressed men have lower levels of testosterone than do controls.
For some men, elevating free testosterone could prove to be an effective antidepressant. I measure free and total testosterone in all my patients, and only use Bio-identical natural hormones.
Numerous studies have shown that maintaining youthful levels of free testosterone can enable the aging man to restore strength, stamina, cognition, heart function, sexuality; and outlook on life, that is, to alleviate depression .
THE EFFECTS OF TESTOSTERONE ON LIBIDO
Sexual stimulation and erection begin in the brain. When neuronal testosterone receptors sites are prompted to ignite, a cascade of bio-chemical events that involves testosterone receptor sites in the nerves, blood vessels and muscles.
Free testosterone promotes sexual desire and facilitates performance, sensation and the ultimate degree of fulfillment. Without adequate levels of free testosterone, the quality of men’s life is adversely effected and the genitals atrophy. This can be reversed with testosterone.
TESTOSTERONE AND THE HEART
Normal aging results in the gradual weakening of the heart, even in the absence of significant coronary artery disease. Testosterone is a muscle-building hormone, and there are many testosterone receptors in the heart. This
can be reversed at times, by hormones. Testosterone is also a promoter of coronary dilatation and helps maintain healthy cholesterol levels. There is an increasing number of studies indicating association between high
testosterone and low cardiovascular events in men. The following events represent the negative effects of a LOW testosterone in cardiovascular disease.
- Cholesterol, fibrinogen, triglycerides and insulin increase.
- Coronary artery elasticity diminishes.
- Blood pressure rises.
- Human growth hormone declines, weakening the heart muscle.
- Abdominal fat increases.
Those with cardiovascular disease should have blood tests for their hormones, especially testosterone.
TESTOSTERONE AND THE PROSTATE GLAND
Many doctors will tell you that testosterone causes prostate disease. The published scientific literature indicates otherwise.
Actually, prostate cancer is more prevalent in men with low testosterone and high estrogen levels. I refer patients to read a book, Testosterone for Life, written by Morgantaler, who is an M.D. and Professor of Urology at Harvard, for further information. Before starting testosterone therapy,
I check all men with a PSA test to rule out existing prostate cancer. I use natural substances to inhibit estradiol and dihydrotestosteron to protect the prostate. I also use substances to prevent prostate cancer by stimulating the beta estrogen receptor
TESTOSTERONE AND DEPRESSION AS WELL AS MENTAL DECLINE
A consistent finding in the scientific literature is that testosterone replacement produces increased feeling of wellbeing.
Low testosterone is associated with symptoms of depression and other psychological disorders. A common side effect of prescription antidepressants is suppressed libido and many patients welcome testosterone and withdrawal of their drug, or tapering it.
Other research has explored the mechanism by which testosterone exerts its a protective effect in Alzheimer’s.
The research shows that testosterone decreases the harmful secretion of beta-amyloid, indicating that testosterone supplementation of the endocrine system may be beneficial in treatment of Alzheimer’s.
OBESITY AND TESTOSTERONE DEFICIENCY
A consistent finding in the scientific literature is that obese men have low testosterone and high estrogen levels. Central or visceral obesity, that pot belly, is recognized as a risk factor for cardiovascular disease and type 2 diabetes.
Research has shed light that hormone imbalances are often the cause.
Boosting testosterone levels decreases the abdominal fat, reverses glucose intolerance, and reduces lipoprotein and cholesterol abnormalities. One study showed that serum estrogen levels were elevated two-fold in one group of morbid obese men. Fat cells synthesize aromatase enzymes causing male hormones to convert to estrogen.
The fat tissue, especially in the abdomen, has been shown to aromatize this testosterone into potent estrogen, causing more problems.
PROGESTERONE FOR MEN
When many of us think of progesterone, we think of it as a hormone for women; however, men need it too.
Progesterone inhibits the conversion of testosterone to dihydrotestosterone and also blocks the conversion of testosterone to estradiol. I have been using progesterone in men along with testosterone, to protect their prostates.
At times, I use progesterone separately in treatment of elevated PSA, along with other natural substances. Progesterone protects the heart, the brain, and the prostate. In the brain, it has been shown to increase dopamine as well as serotonin.
Mood has increased and weight loss has been found in most patients.
HORMONAL TESTING
Every patient has a thorough consultation regarding his problems.
Blood testing, urine or salivary tests are performed to measure hormone values, and natural hormones, always Bio-identical and always natural, are used in synergy together. All patients are placed on prostate protection as well as a detoxification protocol. Antioxidants, minerals as well as vitamins are also utilized.
I USED IM TESTOSTERONE AS WELL AS BY INJECTION IF INDICATED. OTHER HORMONES ARE USED AS TRANSDERMAL.
If your would like further information about andropause or male hormone replacement or prostate protection, please call my office for an in-depth consultation.
DEAN R. SILVER, M.D.