Testosterone Deficiency Syndrome (Hypogonadism)

Testosterone Deficiency Syndrome, or Hypogonadism, is a disorder in which a man's body does not make sufficient testosterone, the primary male hormone. This condition generally affects older men, but younger individuals can also be affected for a variety of reasons.

While the term "andropause" is sometimes used for this condition, it is inaccurate. Unlike menopause, testosterone deficiency syndrome is not an inevitable result of aging.

Testosterone plays a major role in a man's libido, muscle mass, along with mental and physical energy.

Symptoms

There are a number of symptoms that are linked to a deficiency in testosterone in men:

• Reduced libido
• Difficulty getting or maintaining an erection
• Trouble concentrating or making decisions
• Poor results from exercise programs
• Increase in body fat
• Loss of lean body (muscle) mass
• Loss of bone density
• Depression
• Poor work performance
• Negative changes in cholesterol profile

Causes

Sometimes, a certain cause for testosterone deficiency might be identified. An example would be excess secretion of one or more pituitary hormones that then interfere with testosterone production or availability.

In most individuals, though, no cause for testosterone deficiency can be identified. In these circumstances, testosterone replacement therapy is often an effective treatment.

Effects

Beyond the symptoms that many men experience, testosterone deficiency syndrome can also contribute to the beginning or worsening of various illnesses:

• Increased risk of heart disease.
• Increased risk of death from a cardiovascular event.
• Increased risk of metabolic syndrome: high blood pressure, high insulin levels, excess belly fat and abnormal cholesterol levels.
• Strong association with diabetes.
• Strong association with atherosclerotic disease of the aorta.
• Higher incidence of prostate cancer.
• Association with more aggressive variations of cancer.

Diagnosis

Testosterone deficiency is usually diagnosed with a simple blood test.

Treatment

When a specific cause for testosterone deficiency can be identified, treatment can be focused on that cause. When it comes to excess pituitary secretion of hormones, for instance, medication or surgery may be used to fix the underlying problem.

In cases where no particular cause can be determined, testosterone replacement therapy is the most common treatment option.

Testosterone replacement therapy raises the body's testosterone levels through regular administration of testosterone. This therapy can take several forms:

• Testosterone patches provide a specified amount of testosterone everyday but must be replaced every day.
• Testosterone gels work in much the same way as testosterone patches, needing daily application.
• Intramuscular testosterone supplementation is an injection that is given every one to four weeks.
• Testosterone "pellets" are implanted beneath the skin, providing a stable level of testosterone for 4-6 months.

There are two other types of testosterone therapy that are either not available in the United States or not recommended:

• The testosterone wafer dissolves between the lip and the gum. It is not commonly used because it has to be taken twice each day and causes gum irritation in many patients.
• A long-lasting oral preparation of testosterone is currently available outside the U.S., but it has not yet been approved by the FDA for sale in this country.

Risks

Before starting testosterone therapy, individuals need to recognize that it is a life-long commitment. Testosterone supplementation leads to a reduction in the amount of testosterone that is naturally produced by the body.

Testosterone replacement therapy can also increase an individual's red blood cell mass, reflected in a test called the hematocrit. Therefore, careful tracking of hematocrit levels is necessary.

For further information about Dr. Stengler’s practice and his clinic in Oceanside, California, please visit our website at MarkStengler.com or give us a call at (760) 274-2377

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