As men age, they undergo a natural process known as andropause, akin to the female experience of menopause. This transformation signifies a gradual decline in testosterone production, a hormone critical to male well-being. “It's an inevitable process, with testosterone levels diminishing by roughly one per cent each year after the age of 30,” says Dr. Martin Galy, Body Identical Hormone Lead Physician at 23MD, a specialised cosmetic and medical clinic. However, the impact varies among individuals, depending on their initial testosterone levels.
For some men who start life with naturally high testosterone levels, this decline may not significantly affect them. Their bodies maintain sufficient testosterone to support essential functions. “In contrast, approximately 20 to 30 per cent of men who began adulthood with mid-range or lower testosterone levels might face challenges in their midlife, typically in their early to mid-40s,” he adds.
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As testosterone levels drop, they can experience symptoms related to andropause, often mirroring menopausal symptoms in women, including mood swings, depression, irritability, weight gain, hot flashes, reduced libido, and erectile problems.
The consequences of untreated andropause can be severe, potentially leading to long-term health issues such as diabetes, cardiovascular disease, and cognitive decline. However, awareness of andropause remains limited, as it has not received the same attention as menopause in women. This knowledge gap presents a significant challenge in healthcare, as many men suffering from andropause may not recognise the root cause of their symptoms. They might be misdiagnosed and prescribed treatments for unrelated conditions like depression or erectile dysfunction, leaving the underlying hormonal issue unaddressed.
To address these challenges, it is crucial to raise awareness about andropause and its symptoms among middle-aged men, encouraging open discussions.
“In terms of solutions, pharmaceutical companies and healthcare providers offer safe and effective treatments for andropause. Hormone replacement therapy (HRT), often administered through gels or creams applied to the skin, can help restore testosterone levels to a more balanced state, replicating the body's natural hormone production rhythm,” explains Galy. This medical intervention not only alleviates symptoms but also reduces the risk of long-term health complications.
Dr. Martin Galy
Testosterone can be administered in two primary forms, each with its unique benefits and considerations. The first method involves the application of testosterone in the form of creams or gels that are absorbed through the skin. This approach is widely regarded as a safer alternative, thanks to its ability to mimic the body's natural testosterone production. The key distinction lies in its ability to provide a natural peak in testosterone levels twice daily, aligning with the body's circadian rhythm.
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In contrast, the second method entails the use of injectable forms of testosterone. While injectables are effective in elevating testosterone levels, they do so without the natural peaks and troughs experienced with transdermal application. This constant elevation of testosterone may present some associated risks. Notably, high testosterone levels can stimulate the bone marrow to produce excessive red blood cells, leading to thickened blood. Thickened blood can pose risks of clotting, potentially resulting in blood clots and even heart attacks.
In light of these considerations, a cautious approach is recommended. For middle-aged men seeking HRT with testosterone, experts often advise starting with transdermal methods before considering injectable forms. This step can help mitigate potential risks while striving for optimal hormone balance.
In essence, HRT serves as a vital tool in restoring and maintaining hormone balance for both men and women. It has the potential to alleviate symptoms, enhance well-being, and improve overall health. By embracing the right approach, guided by medical expertise, individuals can embark on a journey towards a healthier, more balanced life through HRT.
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