Balance is critical to many aspects of life. Work-life balance ensures that we have time to enjoy the fruits of our labor. Financial balance sets us up for long-term security. Balance in our relationships helps us create mutually supportive connections with others.
Balance is also required to keep our internal environment running at its peak, compensating for stressors and unexpected events. So many different processes must be balanced for our bodies to maintain health and optimum functionality, but hormones play a particularly critical role. Imagine the internal chaos possible when your hormones—the chemical messengers responsible for mediating many important processes inside our bodies—are out of balance. Unfortunately, hormonal imbalance in men closely parallels the aging process. While women experience a sudden and permanent drop in natural estrogen levels in mid-life, most men see a gradual and progressive decline of testosterone beginning around age 30, at a loss of about 1-2% per year. For some men, though, the rate of decline is much faster, too fast for the body to adequately compensate. In these cases, the fallout can be felt throughout the body with symptoms that are both disruptive and inconvenient. Sometimes referred to as male menopause or andropause, this hormone imbalance can complicate normal aging for men, leaving them desperate for effecting ways of balancing male hormones.
How Significant Is Hormone Imbalance for Men?
Having too much testosterone is rare and typically limited to men with certain tumors and those who abuse anabolic steroids. Low testosterone, however, is a common phenomenon that increases dramatically with age; according to one estimate, 30% of men aged 60-70 and 70% of men aged 70-80 have low levels of testosterone. And though not all men will notice symptoms, those that do may experience a disruption in many facets of life. Loss of libido can deeply affect your most important relationships. Changing energy levels and stamina impact exercise and physical activity. Mood swings and cognitive difficulties may interfere with both your personal and professional life. Changes in body composition can affect your confidence and body image. Each of these symptoms and their sequalae may leave you discouraged and frustrated.
So what causes low testosterone in the first place?
Testosterone, the primary male sex hormone, is produced in the testicles and the adrenal glands. Its production is regulated by the hypothalamic-pituitary-gonadal (HPG) axis, a feedback system that responds to circulating hormone levels. Low testosterone, also called androgen deficiency or hypogonadism, may be primary when caused by testicular dysfunction or secondary when there is a flaw in the system that regulates its production. Causes of primary hypogonadism include genetics, cancer, environmental toxins, infection or trauma to the testicles, and varicocele (blood vessel abnormalities in the scrotum). Secondary causes that affect testosterone levels include disease of the pituitary or hypothalamus, inflammatory disorders, HIV/AIDS, obesity, and the use of opiate pain medications. The low testosterone level experienced with aging is considered to be of mixed origin, having both primary and secondary aspects.
Low testosterone affects overall hormonal balance and can disrupt the important, hormone-mediated reactions in our cells. As a result, it can impact a variety of body systems and tissues, resulting in:
- Breast tenderness and breast tissue development
- Low sex drive
- Reduced muscle mass and increased fat deposition
- Joint pain
- Bone loss
- Lack of energy and stamina
- Sleep problems, including insomnia or increased sleepiness
- Mood changes, including depression
- Decreased red blood cell production resulting in anemia
- Increased risk of cardiovascular disease and metabolic syndrome
It’s important to note that other health issues can cause some of these same symptoms, including thyroid conditions, obstructive sleep apnea, and major depression, and these should be ruled out before attributing symptoms to low testosterone. It is also necessary to consider how the use of prescription medications and other substances like alcohol and marijuana may affect hormone balance.
The Best Treatment for Balancing Male Hormones
Treatment for balancing male hormones begins with detailed diagnostics. A diagnosis of low testosterone will depend on both the presence of clinical symptoms and confirmation by laboratory testing. This will start with an in-depth history and physical to assess overall health and note specific symptoms that point to hormone imbalance. This will be followed by a comprehensive hormone balance test to determine circulating hormone levels.
The most effective way of balancing male hormones is through the use of testosterone replacement therapy (TRT). By supplementing your body’s natural hormones with exogenous testosterone, you can bring your testosterone levels back into a healthy range. Once levels are restored, the symptoms related to low testosterone typically begin to resolve rapidly, enhancing both immediate quality of life and long-term health. While hormone therapy must be approached with caution for men with some types of cancer and should be avoided by those who are planning to father biological children due to its impact on sperm count, TRT is generally considered to be the best treatment for low testosterone.
If it is determined that TRT is appropriate, your hormone health practitioner will calculate the dosage and, with your input, decide upon a mode of administration. These are some of the most popular hormone replacement therapy treatment options:
- Transdermal patch, cream, or gel. These topical forms of testosterone are applied to and absorbed through the skin. While typically well-tolerated, side effects may include itching, burning, and skin irritation or thickening.
- Troches. A lozenge form of testosterone, a troche is placed inside the mouth between the upper cheek and the gums and allowed to dissolve. This route of absorption crosses the mucous membrane inside the mouth and bypasses the digestive system, offering a relatively controlled delivery that minimizes risk of side effects.
- Intramuscular injections. The injection of testosterone into a muscle is an inexpensive method that can be adjusted for dosing. Although most men have minimal side effects, injections carry the risk of injection-site discomfort, bruising, and scarring. Additionally, there is more variability in blood testosterone levels, which may result in greater adverse reactions.
- Subcutaneous pellets. Tiny pellets, implanted under the skin of the abdomen or buttocks, deliver a consistent level of testosterone to the bloodstream. This method of administration closely mimics the natural delivery of hormones from the testicles and avoids the hormonal peaks and valleys associated with some administration methods. Therapeutic levels are reached quickly and symptomatic relief can be achieved within days. New pellets are inserted at 3-6 month intervals.
The benefits of testosterone therapy touch multiple aspects of a man’s life, reversing many of the disconcerting changes men experience with aging and falling hormone levels. Perhaps the most obvious and rapid impact is realized in rekindled sexual desire and greater sexual satisfaction. TRT also improves muscle strength, increases lean muscle mass, and helps to maintain bone density. Furthermore, excess body fat is shed more easily, depression decreases, and cognitive functioning improves. These effects can translate into increased confidence, better relationships, and enhanced overall functionality.
Start the Journey Toward Symptom Relief
Though aging is inevitable, the uncomfortable and debilitating symptoms of diminishing hormones are not. If you are struggling with the symptoms of low testosterone, there is hope and help available. With testosterone replacement therapy, you can restore circulating hormone levels to those that will have you looking and feeling more like yourself. An expert hormone health practitioner can help to assess your hormonal status and fine-tune a treatment strategy that brings balance back to your life.
If you recognize the symptoms of age-related hormone imbalance in your life, BodyLogicMD can help. The BodyLogicMD network is comprised of top medical professionals who specialize in hormone health and are committed to providing personalized, state-of-the-art care. A BodyLogicMD-affiliated practitioner can guide you toward the most appropriate therapies for your individual needs and help you to achieve balance for the long-term. Contact a local practitioner to schedule your first appointment, or take the BodyLogicMD Hormone Balance Quiz to learn more about the role hormones may be playing in your everyday life.
Disclaimer: These statements have not been evaluated by the Food and Drug Administration. All content on this website is for informational purposes only. The content is not intended to diagnose, treat, cure or prevent diseases.
Charlotte is a patient care coordinator specializing in bioidentical hormone replacement therapy. She is committed to helping patients who struggle with the symptoms of hormonal change and imbalance explore their treatment options and develop effective strategies to optimize wellness.