What’s it all about? You enter midlife and assess where you are at and where you are going. We can sometimes set Hollywood style expectations for ourselves. In an hour or two someone becomes the hero, gets the girl, makes the big deal or gets recognition for their accomplishments and hard work. Life is not that simple. So what happens in mid-life?
Men tell me, they feel listless or restless and they just don’t feel like themselves. Some try to drive themselves or satisfy their unease by buying a fast car, having an affair or some other means to feel like a man. Could it be “manopause?” On examination, some are developing breasts, have less strength and carry their weight in their belly. They complain of tiredness, lack of energy, reduced strength, and frailty, loss of libido, decreased sexual performance, depression and mood change. Any or all of these factors drives men to seek help or solace through their behaviors. Testing testosterone levels reveals many men have low levels. Total testosterone levels fall at an average of 1.6% per year while the free and bioavailable levels fall by 2%–3% per year.
Testosterone is the hormone that makes men who they are. Aside from sexual and reproductive development and desire, it increases muscle and bone mass and is essential for health and well-being as well as preventing osteoporosis. It has a profound effect on mental and physical energy.
Many people fear that taking hormones increases the risk of cancer and there is a lot of bad press associated with inappropriate use. The most recent and reliable studies have shown that testosterone does not cause prostate cancer. Recent studies have shown conflicting results concerning the importance of testosterone in maintaining cardiovascular health. However, normal testosterone levels in elderly men has been shown to improve many parameters which are thought to reduce cardiovascular disease, risk such as increased lean body mass, decreased visceral fat mass, decreased total cholesterol, and blood sugar control.
The best way to determine if your symptoms are related to low testosterone is to measure your level. If low, discuss the findings with a knowledgeable health care professional and educate yourself on the risks and benefits. The American Society of Andrology’s position is that “testosterone replacement therapy in aging men is indicated when both clinical symptoms and signs suggestive of androgen deficiency and decreased testosterone levels are present.” There is no need for man to pause in midlife – you can go full speed ahead.