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Addressing Andropause

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So how do we address the sexual issues? Most men notice a loss of desire before a loss of potency. As I said before, they attribute this to overwork and stress, and indeed overwork and stress can cause a loss of desire and potency, but this desire is not restored with rest.{{more}}

Indeed, most of these men, when they are chronically tired, they “relax” with the “boys” by having a few drinks, usually beers, and come home only to fall asleep due to “tiredness”. In other words, this is a chronic loss of libido, not caused by work, but work may be used as an excuse to hide the problem.

The same can be said of the erection problem that accompanies andropause. Although, there are a lot of medications and over-the-counter (OTC) preparations that are used for impotence, there is very little that is used for a loss of libido, apart from a few herbal preparations that are reputed to, but not proven to help. The mainstay of treatment is hormone replacement therapy, but some herbal preparations, education, exercise, diet and rest have a part to play. The treatment of diabetes, hypertension and other chronic diseases, like an enlarged prostate or alcoholism, is pivotal to the return of the libido, as is the treatment of impotence, as an impotent man has no desire to make love.

What is hormone replacement therapy or HRT? As its name implies, it is the restoration of the reduced hormone levels to levels that help to reduce or reverse the symptoms of andropause. As I have said in previous issues, every man who has testicles, which are functioning, is endowed with an adequate quantity of the male hormone testosterone that makes him function as a man. This function does not only include procreative functions that we are all too familiar with, but other essential duties, like the ability to provide, due our stronger muscles, bigger bones and higher blood count and our ability to protect, due our aggressiveness, mental alertness and stamina, along with our physical prowess just mentioned.

With the onset of andropause, men notice a reduction in these abilities. When exercise, diet, rest and herbal preparations fail to help, then HRT is recommended. However, before HRT is started, the man’s blood testosterone level is measured; if it is low, then HRT is recommended to treat his symptoms. This level should be done early in the morning, as levels are low in the evenings. Usually, 2-3 tests are done to confirm the low level before treatment is started. Men who have used HRT report an increased level of energy, return of the libido and sometimes the potency. Like HRT in women, there is also a reduction in the loss of muscle and bone mass and an increase in lean body mass. Unlike HRT in women, there is no link to an increase of breast cancer; instead there is a reduction in cardiovascular events, like heart attacks, stroke and high cholesterol and diabetes, even though the good cholesterol is the one that is reduced. Men who start HRT are screened for prostate problems, especially cancer, as well as liver disease, as both can be exacerbated by HRT with testosterone. Unlike liver problems, HRT does not cause prostate cancer if there was no pre-existing prostate cancer, but HRT can cause liver problems if taken by mouth for a prolonged period of time. It is also still advisable to screen for cardiovascular disease, as HRT over a long period can exacerbate, but not cause heart disease. There are many preparations for HRT, but the best are the patch (andropatch) or gel. There are also 1 or 4 monthly slow-release testosterone injections and, as you will expect, the tablet. Of these, the safest is the patch; however, the levels of testosterone in the blood may be erratic and so, as with all the other preparations, the blood testosterone levels should be monitored.

For comments or question contact:
Dr. Rohan Deshong
Tel: (784) 456-2785
email: [email protected]