Men's Hormones

testosterone doctors portland oregon

“Men never have a Viagra deficiency, but they often do have a testosterone deficiency!” Dr. Kathryn Retzler

Many men think hormone problems are only found in women. Unfortunately, hormone imbalance, especially low or suboptimal testosterone, can cause significant, progressive symptoms in men. Because testosterone production declines gradually, symptoms of low tesosterone are often unnoticed, or are dismissed as signs of “just getting older.”

Testosterone production begins to decrease after the age of 30 or 35. In addition to aging, low or sub-optimal testosterone levels are often the result of poor diet and lifestyle choices, unmanaged stress, and lack of exercise. Recent studies suggest the prevalence of low testosterone in men over 35 years may be as high as 38.7% (1), with more than 50% of men having low testosterone by age 70 (2), and 86% of men by age 80. The prevalence may be even higher if free testosterone levels (the amount that's available to the body's tissues) are used for diagnosis.

Andropause – The Male Menopause

The term "andropause" is often referred to as "male menopause". The medical community acknowledges the existence of "androgen decline in the aging male, or "ADAM," although some old-school physicians may not believe in treating low testosterone levels in men.

Symptoms of andropause usually arise gradually due to the progressive decline in testosterone, often coupled with an increase in estrogen production. Symptoms of andropause include:

  • Accelerated aging
  • Decreased athletic or work performance
  • Lower sex drive  
  • Erectile dysfunction
  • Diminished strength or muscle mass
  • Memory problems
  • Lower competitive edge and motivation
  • Decreased energy and stamina
  • Declining mental clarity
  • Irritability or depression
  • Prostate enlargement
  • Weight gain (especially in the waist or breasts)

Treatment

Besides testosterone supplementation, treating contributing causes of suboptimal or low testosterone is fundamental. This may include diet and lifestyle changes, nutrient supplementation, stress management, and increasing the amount or type of exercise.

Low Testosterone levels can be enhanced by maintaining a healthy diet high in good-quality protein and low in simple carbohydrates, and keeping alcohol intake to a minimum. In addition, exercising for 30-45 minutes at least 4 days per week can enhance testosterone production. Avoiding environmental toxins in plastics and pesticides may help, as can reducing stress levels. Supplements such as zinc and selenium, and herbs, such as saw palmetto and nettles, can improve hormone balance in men. Lastly, since the aromatase enzyme responsible for converting testosterone into estrogen is found in fat tissue, maintaining a healthy weight helps optimize testosterone production.

If testosterone levels are low and symptoms exist, there are many options to restore testosterone to youthful levels. Choosing a specific form of testosterone supplementation depends on effectiveness, preference of a particular delivery system, cost, and potential insurance reimbursement. It's important to perform follow-up lab testing with supplementation, in order to minimize risks and keep levels safe and effective.

Not all men need or desire testosterone replacement therapy and we believe it is every man's right and responsibility to educate himself as to all benefits as well as potential risks before choosing any hormone replacement. Some men do not need testosterone replacement therapy and only want treatment for ED or Erectile Dysfunction.

Dr. Retzler will thoroughly discuss symptoms, health history, benefits and risk factors with you at your first appointment allowing you to make an informed decision as to whether or not testosterone replacement therapy is right for you.

For additional information about testosterone supplementation including the latest information on testosterone and cardiovascular health please see  the free "Testosterone Supplementation Options" and "Testosterone and Cardiovascular Health" on the Resources page.

(1) Mulligan T, Frick MF, Zuraw QC, et al. Prevalence of hypogonadism in males aged at least 45 years: the HIM study. Int J Clin Pract. 2006 July 1;60(7):762-769.
(2) Harman SM, Tsitouras PD. Reproductive hormones in aging men I. Measurement of sex steroids, basal luteinizing hormone and Leydig cell response to human chorionic gonadotropin. J Clin Endocrinol Metab 1980;51:35-41.