Declining testosterone levels in men not part of normal aging

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A new study finds that a drop in testosterone levels over time is more likely to result from a man’s behavioral and health changes than by aging. The study results will be presented June 25 at The Endocrine Society’s 94th Annual Meeting in Houston.

“Declining testosterone levels are not an inevitable part of the aging process, as many people think,” said study co-author Gary Wittert, MD, professor of medicine at the University of Adelaide in Adelaide, Australia. “Testosterone changes are largely explained by smoking behavior and changes in health status, particularly obesity and depression.”

Many older men have low levels of the sex hormone testosterone, but the cause is not known. Few population-based studies have tracked changes in testosterone levels among the same men over time, as their study did, Wittert said.

In this study, supported by the National Health and Medical Research Council of Australia, the authors analyzed testosterone measurements in more than 1,500 men who had measurements taken at two clinic visits five years apart. All blood testosterone samples underwent testing at the same time for each time point, according to Wittert.

After the researchers excluded from the analysis any men who had abnormal lab values or who were taking medications or had medical conditions known to affect hormones, they included 1,382 men in the data analysis. Men ranged in age from 35 to 80 years, with an average age of 54.

On average, testosterone levels did not decline significantly over five years; rather, they decreased less than 1 percent each year, the authors reported. However, when the investigators analyzed the data by subgroups, they found that certain factors were linked to lower testosterone levels at five years than at the beginning of the study.

“Men who had declines in testosterone were more likely to be those who became obese, had stopped smoking or were depressed at either clinic visit,” Wittert said. “While stopping smoking may be a cause of a slight decrease in testosterone, the benefit of quitting smoking is huge.”

Past research has linked depression and low testosterone. This hormone is important for many bodily functions, including maintaining a healthy body composition, fertility and sex drive. “It is critical that doctors understand that declining testosterone levels are not a natural part of aging and that they are most likely due to health-related behaviors or health status itself,” he said.

Unmarried men in the study had greater testosterone reductions than did married men. Wittert attributed this finding to past research showing that married men tend to be healthier and happier than unmarried men. “Also, regular sexual activity tends to increase testosterone,” he explained.

The study findings were presented by Andre Araujo, PhD, who was a visiting professor at the University of Adelaide and is vice president of epidemiology at New England Research Institutes, Watertown, Mass.

Source: Endocrine Society. “Declining testosterone levels in men not part of normal aging.” ScienceDaily. ScienceDaily, 23 June 2012. <>.

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Safety of Testosterone Therapy & Clueless Primary Care Physicians

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Boston, MA – Testosterone replacement therapy for hypogonadal men has been used for decades. However, there are still scores of primary care doctors spreading irresponsible misinformation regarding the safety of this treatment, particularly to elderly men who can benefit mightily from a balanced hormonal health.

A study was done with 255 men with an Average age of 60.6 ± 8.0 years, with testosterone levels between ≤ 3.5 ng/ml. They received parenteral (injectable) testosterone undecanoate.

After more than five years of monitored testosterone therapy, the study noted that a mere 3 out of 255 patients were diagnosed with prostate cancer.  The study stated that “3/255 patients with prostate cancer does not suggest an increased risk of prostate cancer in elderly men on long-term testosterone treatment.  Long-term treatment with testosterone undecanoate with monitoring according to the guidelines is acceptably safe.”

Now, according to, “About 1 man in 6 will be diagnosed with prostate cancer during his lifetime.”  They also stated, “Prostate cancer can be a serious disease, but most men diagnosed with prostate cancer do not die from it.  In fact, more than 2.5 million men in the United States who have been diagnosed with prostate cancer at some point are still alive today.”

In over 50 years of studies and research, there has never been a connection between testosterone levels in men and prostate cancer growth.  Moreover, a study from Harvard Medical School in 2006 concluded, “there is not now, nor has there ever been a scientific basis for the belief that testosterone causes prostate cancer to grow.”

Just more evidence that testosterone replacement therapy does not cause cancer or prostate cancer.  We can’t explain why leagues of completely clueless primary care doctors still spread baseless accusations that TRT is unsafe. … statistics

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See:  Side-Effect Profile of Long-Term Treatment of Elderly Hypogonadal Men with Testosterone Undecanoate  – Farid Saad, Ahmad Haider, Gheorghe Doros, Louis Gooren. Bayer Pharma AG, Berlin, Germany; Gulf Medical University School of Medicine, Ajman, United Arab Emirates; Private Practice, Bremerhaven, Germany; Public School of Health, Boston University, Boston, MA; VUMC Amsterdam, Amsterdam, Netherlands.

Testosterone; Male or Female you need it!

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We don’t have to be miserable as we age like many want us to believe.  Find out where your levels are and get them balanced.

Testosterone; Male or Female you need it! 

by: Michelle LeSueur


It is amazing how many people are suffering from low testosterone.   What is concerning is how young they are both male and female. Many are in their 20′s and early 30′s. So I decided that I would write on this in hopes to enlighten people and give them a direction.

When you talk about testosterone we tend to think that it is a male hormone.  Testosterone is considered a male hormone but both men and women have it.  For men it is primarily produced in the testes, women only make one tenth of what men do and it is made in smaller amounts in the ovaries.  Both male and female produce smaller amounts in the adrenal glands.  Testosterone is the main component when it comes to a sex drive for both men and women.

Many people believe that low testosterone only affects older men but,  According to the FDA, more than 4 million men suffer from low testosterone levels.  Yet, 95 out of 100 men fail to seek treatment.  Many believe that low hormone levels are just a part of getting older.  What men and women don’t realize is if you replace your hormones with Bio-identical natural hormones you don’t have to age!!

Research shows that by the time we get to 70 and 80 there is an increased risk of obesity, brittle bones, muscle loss, impotence and you are at higher risk for a heart attack, because of low testosterone.  When women finish menopause, they usually have low testosterone levels and it can be even worse for those using synthetic estrogen replacement.  Many find they have no energy, muscle tone or libido.  Testosterone increases the metabolic functions, which contribute to faster healing and lower total body fat.

If you are training and working to build muscle and shed fat, you need healthy testosterone levels.  One of the first things many notice when their levels start to drop is midsection weight.  Once levels have been restored many find that they are able to lose that unwanted belly fat.

When we are born we have so many fat cells.  At puberty and for women, pregnancy are two times in your life that you can actually increase the amount of fat cells you have.  Once you have increased fat cells you can never get rid of them.  You are able to shrink them, but never get rid of them.  These fat cells can expand mach larger than what they were originally if we over eat and need to store more and more fat.  But again, you can shrink them.  Hormones affect fat cells in two different ways, depending on the message they get.  A lipolytic or beta hormone tells the body to in crease fat burning energy and lipogenic or alpha hormones tell the body to store fat.  In different parts of our bodies we have alpha or beta-receptors and that is why it is easier to lose weight in some areas over others.  The name of the game is for our fat cells to have more beta-receptors than alpha.  By increasing testosterone, we increase beta-receptors. I have seen men with high cholesterol levels drop into normal range after they started replacing their testosterone.

Testosterone is necessary for sperm to mature and contributes to the overall quality of the sperm.  In the last 15 years male infertility is on the rise.  But here is the problem; it takes 3 months for sperm to develop verses one cycle with women, so male infertility is more of a problem than when a woman has fertility issues.  There is a lot of research that supports that we are seeing a rise in this because of all the estrogen’s in our environment.  You can find out more about environmental factors in the book, “Willing to Change! Can You Beat Genetics”.

So what are the symptoms of low testosterone?

Here is a little test to take, if you think you may have low levels.   The Saint Louis University Androgen Deficiency in Aging Men (ADAM) Questionnaire. Dr. John Morley, a researcher with the Saint Louis University School of Medicine, developed the self-screening tool to help identify symptoms of low testosterone in men. Choose the responses below that best describe how you have been feeling.

1. Do you have a decrease in libido (sex drive)?

2. Do you have a lack of energy?

3. Do you have a decrease in strength and/or endurance?

4. Have you lost height?

5. Have you noticed a decreased “enjoyment of life”?

6. Are you sad and/or grumpy?

7. (MEN) No longer wake up with a morning erection?

8. (MEN) Are your erections less strong?

9. Have you noticed a deterioration in your ability to play sports?

10. Are you falling asleep after dinner?

11. Has there been a recent deterioration in your work performance?

12 Do you have a hard time sleeping through the night?

13. (WOMEN) Do you have a hard time getting aroused?

If you answer yes to question one or seven, or at least three of the other questions you may have low testosterone levels.

What is the side affects from low testosterone?

Increased body fat, Gyneomastia, Weak erections, Loss of muscle mass, Lack of libido, Lack of motivation, depression, memory loss, irritability, low self esteem, heart disease, diabetes, Hypertension, Osteoporosis, and even premature death.  We need our hormones!!

We don’t have to be miserable as we age like many want us to believe.  Find out where your levels are and get them balanced.

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Testosterone Replacement Use Low Among Hypogonadal Men

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Testosterone replacement therapy (TRT) is seldom prescribed to hypogonadal men, researchers reported at the American Urological Association annual meeting.

In a study of men who participated in a nationwide health screening program, a team led by Nelson N. Stone, MD, Professor of Urology and Radiation Oncology at Mount Sinai School of Medicine in New York, found that hypogonadism (HG)—defined as a testosterone level below 300 ng/dL—was present in 42.8% of subjects, yet TRT was used by only 3.9%.

Men with erectile dysfunction (ED) had the highest reported use of TRT (6.2%). TRT was more commonly used in men older than 65 years and those with a body mass index (BMI) of 30 kg/m2 or higher. Lower mean testosterone levels were associated with older age, diets high in fat, sedentary lifestyle, diabetes, and higher BMI. TRT use did not differ in diabetic versus non-diabetic men.

The study included 11,584 men from the general population who participated in Prostate Cancer Awareness Week in 2011 and 2012 and completed health assessments. Of these, 4,849 (41.9%) had their testosterone levels determined. The men had a mean age of 61.6 years and mean testosterone levels of 358.8 ng/dL.

The authors concluded that urologists involved in men’s health should be aware of the high prevalence of HG and consider the potential benefits of TRT, especially in men with a high BMI or diabetes, and those who consume a high-fat diet and engage in minimal exercise.


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Hypogonadal Symptoms in Younger Men May Begin at Higher Threshold

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Among men younger than age 40, a total testosterone level of less than 400 ng/dL was linked with hypogonadal symptoms.

Lack of energy appeared to be the most important symptom of hypogonadism in young men.

Many men younger than 40 years with testosterone levels of 300 – 400 ng/dL still experience hypogonadal symptoms, a new study suggests. The standard threshold of below 300 ng/dL, based on studies in elderly men, may not apply to younger men.

“The notion that common and uniform concentrations of androgen levels can be applied to describe the increasing prevalence of testosterone-related symptoms in young men should be challenged on the basis of the conclusions from the present study,” stated lead researcher Larry I. Lipshultz, MD, of Baylor College of Medicine in Houston, and colleagues.

The investigators suggest a 400 mg/dL threshold can be used along with symptoms and a comprehensive general assessment to determine the underlying health problems in young male patients. It should not be used as the sole criterion to start testosterone replacement therapy.

For the study, they reviewed the charts of 352 men younger than age 40 who complained of “low testosterone” while attending an outpatient clinic in 2013 – 2014. Serum total testosterone levels were collected and analyzed. Patient responses to the Androgen Deficiency in Aging Male (ADAM) questionnaire about sexual, psychological, and physical symptoms were also assessed. Despite poor specificity, the 10-question ADAM questionnaire is validated for hypogonadism.

According to results published  online ahead of print in BJU International, the probability of hypogonadal symptoms increased at a total testosterone level of 400 ng/dL for young men. None of the 10 symptoms predicted a testosterone level below 300 ng/dL.

Sexual symptoms, such as erectile dysfunction (ED), often seen in elderly men, did not predict hypogonadism in these younger patients. Instead, low energy and sadness, along with decreased strength, lowered ability to play sports, and decline in work performance were associated with low testosterone. After multivariable analysis, lack of energy appeared to be the most important symptom.

“Young men are less likely to have organic factors contributing to ED, and our present data suggests that sexual symptoms often seen in elderly hypogonadal men are less important in diagnosing clinical hypogonadism in younger men,” according to the researchers.


  1. Scovell, JM, et al. BJU International, 2015; doi: 10.1111/bju.12970.

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Men with ‘low testosterone’ have higher rates of depression

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WASHINGTON (July 1, 2015) — Researchers at the George Washington University (GW), led by Michael S. Irwig, M.D., found that men referred for tertiary care for borderline testosterone levels had much higher rates of depression and depressive symptoms than those of the general population.

“In an era where more and more men are being tested for “Low T” — or lower levels of testosterone — there is very little data about the men who have borderline low testosterone levels,” said Irwig, associate professor of medicine and director of the Center for Andrology at the GW School of Medicine and Health Sciences. “We felt it important to explore the mental health of this population.”

The research, slated to publish online on July 1 in the Journal of Sexual Medicine, involved 200 adult men, aged 20-77, with a mean age of 48 years old, who were referred for borderline total testosterone levels between 200 and 350 ng/dL. Information gathered included demographics, medical histories, medication use, signs and symptoms of hypogonadism, and assessments of depressive symptoms and/or a known diagnosis of depression or use of an antidepressant.

Depression and/or depressive symptoms were present in 56 percent of the subjects. Furthermore, one quarter of the men in the study were taking antidepressants and that the men had high rates of obesity and low rates of physical activity. The most common symptoms were erectile dysfunction, decreased libido, fewer morning erections, low energy, and sleep disturbances.

While more research is needed in this area of study, the researchers concluded that clinicians should consider screening for depression and depressive symptoms, overweight and unhealthy lifestyle factors in men who are referred for tertiary care for potential hypogonadism.


“High Rates of Depression and Depressive Symptoms Among Men Referred for Borderline Testosterone Levels” is available at

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UTMB study finds that testosterone therapy is not linked with blood clot disorders in veins

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A new study from The University of Texas Medical Branch at Galveston of more than 30,000 commercially insured men is the first large comparative analysis to show that there is no link between testosterone therapy and blood clots in veins. The study found that middle-aged and older men who receive testosterone therapy are not at increased risk of this illness. The findings are detailed in Mayo Clinic Proceedings.

Venous thromboembolism is a disease where blood clots form in the veins and cause blockages. The most common forms of VTE are deep vein thrombosis, which occurs often in the legs and pulmonary embolism, which is a clot in the lungs. VTE is the third most common cardiovascular illness, after heart attack and stoke.

“In 2014, the Federal Drug Administration required manufacturers to add a warning about potential risks of VTE to the label of all approved testosterone products,” said Jacques Baillargeon, professor of epidemiology in the department of preventive medicine and community health and lead author of the study. “The warning, however, is based primarily on post-marketing drug surveillance and case reports. To date, there have been no published comparative, large-scale studies examining the association of testosterone therapy and the risk of VTE.”

As a result of this conflicting evidence and the broad media attention it has received, there are many men with medically confirmed low testosterone who are afraid to receive testosterone therapy and there may be physicians who are reluctant to prescribe testosterone therapy based on this conflicting information.

The case-control study included 30,572 men 40 years and older who were enrolled in one of the nation’s largest commercial insurance programs between Jan. 1, 2007 and Dec. 31, 2012. Cases were defined as men who had a primary diagnosis of VTE and received an anticoagulant drug or an intravascular vena cava filter in the 60 days following their diagnoses. Cases were matched with three control subjects on age, geographic region, diagnosis of low testosterone and diagnosis of any underlying pro-clotting condition.

The researchers found that having a prescription for testosterone therapy was not associated with an increased risk of VTE. In addition, none of the specific routes of administration examined — topical creams, transdermal patches or intramuscular injections — were associated with an increased risk. There were no differences between men who received the therapy 15, 30 or 60 days before being diagnosed with VTE.

“It is important to acknowledge, for a man who has medically-diagnosed low testosterone, that there are clear risks to not receiving testosterone therapy, including osteoporosis, sexual dysfunction, increased amounts of fat tissue, decreased lean muscle mass, possible metabolic syndrome and cardiovascular disease,” said Baillargeon. “It’s also important to note that further research needs to be conducted to rigorously assess the long-term risks of testosterone therapy.

These findings may help to inform the benefit-risk assessment for men with testosterone deficiency considering treatment.


Other authors include UTMB’s Randall J. Urban, Gwen Baillargeon, Gulshan Sharma and Yong-Fang Kuo; Abraham Morgentaler from Men’s Health Boston at Harvard Medical School and Charles J. Glueck from Jewish Hospital at Mercy Medical Physicians in Cincinnati, OH.

This research was supported by the National Institutes of Health.


To request a free informational packet on all our Men’s Health therapies, visit us at

For for more information and appointments, please contact Clinic Director Charlie Blaisdell at

BTP/CORE New England/ Core Medical Group
920 Washington Street
Norwood, MA 02062
Clinic: 781-269-5953
Fax: 617-336-3400

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