Jun 26, 2019 12:00 AM


Understanding hypogonadism

It’s a fact of life that the human body changes as it gets older. For women, menopause is a significant life change that often brings serious physical complications. Men don’t experience a comparable change, but as men age, many do begin to suffer from hypogonadism, a condition ultimately stemming from low levels of testosterone.

When Hypogonadism Begins

Starting around age 30, men tend to lose about one percent of their testosterone per year. For some, the amount lost is higher and for others, it is lower. There is a normal range when it comes to testosterone levels, and once a man hits the lower limit of this normal range, problems begin, which usually leads to hypogonadism.

Some studies even show a link between diabetes and hypogonadism, as men with diabetes seem to be more prone to hypogonadism and the accompanying difficulties.

Hypogonadism Symptoms

To be diagnosed with hypogonadism requires more than just having low levels of testosterone in the blood. Doctors will also factor in other symptoms, which include:

  • fatigue,
  • low sexual desire,
  • worsening sexual function,
  • erection problems,
  • weight gain, and
  • problems gaining muscle.

Not all symptoms are required for a diagnosis, only a combination of at least a few symptoms and low testosterone in the blood. While these symptoms can be difficult to live with, low levels of testosterone can eventually cause other problems. According to Alex Pastuszak, MD, a urologist with University of Utah Health, “Guys with low testosterone levels have worse heart health and their bone density is lower. Guys may not sleep as well or complain that their thinking is 'cloudy.' Of these, the most concerning is obviously the increased risks of heart disease, which can lead to an early death."

The Next Step

For most of human history, men who suffered from hypogonadism didn’t realize anything was wrong and just thought that they were slowing down with age. Things have changed. As Pastuszak puts it, “Back in the day, guys would just assume they were getting older and slowing down, but in the last decade, there has been a marketing push telling men that they have low testosterone. A lot more men know that slowing down isn’t normal and they can get treated for it.”

The most effective treatment tends to be testosterone, but it comes with risks, namely side effects including shrunken testicles, infertility, increased estrogen levels, increased red blood cell count, and growth of breast tissue.

There are other drugs that are effective. One of them, HCG, is a substance that directly tells the testicles to make more testosterone. The other, Clomid, tricks your body into thinking hormone levels are low, which stimulates the testicles to produce more testosterone.

While these drugs are effective and don’t have as many side effects, they are not without their issues. HCG can be prohibitively expensive, even for those with good insurance. Clomid tends to work better for younger men, while older men sometimes don’t see an effect.

A Reason for Optimism

While current methods to combat hypogonadism have their issues, doctors and scientists are optimistic that eventually new techniques and technologies will eliminate this problem and allow men to age without worrying about low testosterone levels.

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