Alaji Samna is one of the several men that
come to my office and complain of serious
health challenges that no one seems to be
able to diagnose. Alaji Samna, like the rest,
says he is totally uninterested in sex. He also
says he experiences a lack of libido, even
when sexually aroused. Alaji Samna said:
“Even when I try to satisfy my two wives
out of obligation and not out of interest,
I always have a very low energy level.”
Alaji Samna, 48, has been to several doctors
but no one could tell him what was wrong.
Eventually, he was diagnosed with androgen
deficiency, a problem of low testosterone
level in the body, also known as male
menopause. He wanted to know if
testosterone replacement therapy is advisable.
Should he go for the injection or rub the
testosterone on his shoulders for a better sex
life? he wanted to know. I’m less than a man
without sex, he said.
Men experience a decline in the reproduction
of the male hormone testosterone with aging,
but this also occurs with some diseased states
such as diabetes. Along with a decline in
testosterone, some men experience symptoms
such as fatigue, weakness, depression and
sexual/erection problems. Unlike menopause
in women, which represents a well-defined
period in which hormone production stops
completely, testosterone decline in men is a
slower process. The testes, unlike the ovaries,
do not run out of the substance needed to
make testosterone. A healthy male may be
able to make sperm well into his eighties or
longer. While it is also relatively easy to
diagnose menopause in women when their
menstrual period stops, diagnosing male
menopause is trickier and requires a blood
test. Consequently, the condition often goes
undetected.
Definitely, loss of testosterone in a man can
lead to testosterone deficiency, which has a
bad impact on his ego and takes a toll on his
health. Among other potential causes of
testosterone deficiency are: injury or infection
to the testicles, chemotherapy or radiation
treatment, genetic abnormalities such as extra
‘X’ chromosome, too much iron in the body,
dysfunction of the pituitary gland,
medications, stress and alcoholism. Of the
estimated four or five million men with low
testosterone, only five per cent currently is
being treated. About one in every 10 men
between the ages of 40 and 60 has low
testosterone. Among men over the age of 60
the numbers jump to one in every five men,
according to researchers. The big question
now is this: Is testosterone replacement
therapy healthy, even if it needful?”
Some studies have shown that TRT in men who
have low levels of the hormone may improve
libido, enhance sexual performance/ function,
increase bone mineral density, increase
muscular mass/strength and help improve
mood. However, the adverse effects of TRT
outnumber its advantages. One of the
disadvantages is sleep apnea, a potentially
serious disorder in which breathing repeatedly
stops and starts. TRT causes the body to make
too many red blood cells, which can increase
the risk of heart disease. It also causes acne
or other skin reactions, stimulates
noncancerous growth of the prostate and
possibly encourages the growth of existing
prostate cancer.
It also enlarges the breasts, limits sperm
production and causes the testicles to shrink.
So, if you are considering testosterone
therapy to help you feel younger and more
vigorous as you age, know the risks before
you make your decision.
There are the second categories of men who
have low level of testosterone not because of
aging but because of a disease called
hypogonadism. This is a condition in which
the body is unable to produce normal
amounts of testosterone due to a problem
with the testicles or with the pituitary gland
that controls the testicles. Testosterone is a
hormone produced primarily in the testicles.
Testosterone helps maintain men’s bone
density, fat distribution, muscle strength and
mass red blood cell production as well as sex
drive and sperm production. Testosterone
peaks during adolescence and early
adulthood. As a man gets older, his
testosterone level gradually declines to
typically about one per cent a year after age
30. It is important to determine in older men
if a low testosterone level is simply due to the
decline of normal aging or if it is due to a
disease hypogonadism. TRT can improve the
signs and symptoms of low testosterone in
men with hypogonadism, with fewer side
effects than in elderly men. TRT can help
reverse the effects of hypogonadism, but it’s
unclear whether testosterone therapy would
have any benefit for older men who are
otherwise healthy.
Many also want to know if testosterone
therapy helps increase sex drive in women.
Well, research shows that testosterone
hormone does impact sex drive as well as
remedies other sexual problems in certain
women with sexual dysfunction. But the long-
term safety of testosterone therapy for
women is unknown. Testosterone therapy
usually is prescribed only for women who
have low libido but sufficient estrogen levels.
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