The primary hormone that we think about in association with men is testosterone. This hormone gets some bad publicity as it seems to drive a lot of men’s thoughts and decisions for several years of their life (and from a woman’s perspective, not always in a good way!). Differences in testosterone and estrogen balance do account for many differences between men and women, and sometimes it seems to create a disconnect; but testosterone is such an important hormone for men, and too much of it or too little of it can certainly have far-reaching effects.
Men and women have the same sex hormones in their bodies, just in different proportions. Men have a predominance of testosterone, while their estrogen levels are supposed to be much lower than those of women.
Testosterone is commonly regarded as a ‘sex hormone’, but it’s really so much more than that — it’s a “total body hormone” affecting every cell in the body. As men age, their hormone levels change and this causes a range of effects in the body, including a loss of muscle mass, weight gain especially around the abdomen, decreased libido and sexual function, and depression. Hormone changes in men are also associated with a range of significant degenerative diseases, including heart disease, stroke, diabetes, arthritis, osteoporosis and hypertension.
There are several changes in the hormones that contribute to andropause. One is a reduction in free testosterone. This is the testosterone that is ‘unbound’ in the body, and therefore free to exert its effects. But low testosterone is just part of the picture. Research shows that as men age, they convert more of their testosterone to estrogens. In fact, it is the increase in estrogens that is thought to be responsible for Benign Prostatic Hypertrophy (BPH), which is extremely common. Men also have increased levels of Sex Hormone Binding Globulin (SHBG), a protein that binds testosterone and leaves less of the free, active testosterone in the blood.
Hormone replacement therapy can therefore be just as effective and important for men as it is for women. Lab testing is crucial to determine the levels of active, free and bound testosterone, estrogens, DHEA and other markers such as Prostate Specific Antigen (PSA), which is important in assessing BPH and prostate cancer.
There are many potential benefits of hormone replacement therapy for men, including increased feeling of well-being, increased libido and greater sexual performance and satisfaction, increased strength and stamina and greater muscle mass, and weight loss (especially around the abdomen). There are also longer term benefits such as protection against cardiovascular disease and neurological diseases including Alzheimer’s.
Dr. Gary C. Bellman is a Board-Certified Urologist with over 20 years of experience.
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West Hills, CA 91307
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