Testosterone, aging and men's health: what you need to know

Three things to check before you buy testosterone supplements or remedies

Most men won’t experience a dramatic change in their hormone levels as they age – but the gradual changes can still sneak up on you.

For example, testosterone levels decline every year after the age of 30. For some men, this can bring on a range of issues, like reduced muscle mass and libido, and even sleep changes.

But before you race out to buy expensive testosterone supplements or remedies, it’s critical to check what’s going on in your body so you don’t trigger any other health issues.

In this article, we’ve outlined three things men over 40 should consider before starting any testosterone treatment.

Check your total and bioavailable testosterone and serum estradiol

Testosterone is a powerful male sex hormone, responsible for things like libido, sperm production, fat distribution, muscle mass and even energy levels.

In men, testosterone levels typically fall about 1%, on average, every year after age 30. This natural decline doesn’t mean a man is testosterone deficient or should start hormone replacement therapy.

However, sometimes low testosterone levels can be caused by a condition called hypogonadism. This means the body is unable to produce normal amounts of testosterone due to a problem with the testicles or the pituitary gland.

Low testosterone levels can cause symptoms like reduced sexual desire and erectile dysfunction, changes in sleep patterns, difficulty concentrating, reduced muscle strength, decreased bone density, depression and fatigue.

Importantly, you’ll need thorough lab testing and a careful interpretation of the results to confirm a diagnosis of low testosterone.

There are a few different ways to check if your testosterone levels are outside the normal range for your age, including a total testosterone test and a bioavailable (or free) testosterone test.

That’s because some testosterone travels through the blood attached to the proteins albumin and sex hormone binding globulin (SHBG), and some testosterone is free (not attached to any proteins).

A total testosterone blood test may be able to identify a significant issue with your hormone levels. However, for some men, physicians will need the free or bioavailable testosterone measurement to confirm the diagnosis.

Do you have belly fat? If so, you should measure your serum estradiol. Yes, men do make some of this predominant female hormone. Our belly fat has an enzyme called 5′ aromatase which converts testosterone into estradiol.

The more belly fat we have the more of our testosterone is converted to belly fat. Unfortunately, the higher estradiol we have, the harder it is for us as men to lose weight.

Testosterone replacement and heart health

Testosterone replacement can improve symptoms of low testosterone, but it’s important to know that treatment comes with some risks.

For example, testosterone therapy may increase the risk of blood clots, which can lead to a heart attack or stroke.

It has also been known to increase the risk of sleep apnea, which can raise your blood pressure and lead to stroke. Sleep apnea is also associated with a higher risk for heart valve disease and dangerous heart rhythms.

Another consideration is the impact testosterone therapy may have on your cholesterol levels, although research in this area has produced mixed results.

Importantly, having regular blood tests while undergoing testosterone treatment will mean your health-care team can adjust your dose and catch any side effects before they become an issue.

Testosterone and prostate health

While testosterone replacement therapy doesn’t cause prostate cancer, increasing testosterone could raise prostate specific antigen (PSA) levels, which may lead to an increased risk for prostate cancer.

PSA is an antigen made by the prostate gland. High PSA levels may be a sign of a noncancerous condition such as prostatitis (infection in the prostate), or an enlarged prostate gland.

And, although it’s not a definitive test, according to the National Cancer Institute, a continuous rise in a man’s PSA levels over time can be a sign of prostate cancer.

Having a baseline PSA test before commencing testosterone therapy, and follow-up tests during treatment, can help you and your health-care team stay on top of any issues.

You can order The Testosterone Replacement Package” which includes all of the tests above.

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