Bio Identical Hormone Replacement Therapy (BHRT) for MEN
Men are not immune to hormonal changes and in fact, can experience significant changes from hormone imbalance. A man’s Testosterone level can gradually drop as early as in his 30’s and decline at a rather slow rate (compared to a woman) through his 40’s and 50’s. This phenomenon is known as Andropause or male menopause.
Men, just like women, can suffer needlessly from these dropping levels of hormones. The main difference between men and women going through menopause is the slower rate drop for men and the overall smaller symptomatic changes that may not be as noticeable to them. The symptoms, however, are very similar in that men experience a decrease in energy level, mental clarity, loss of sex drive, mood swings, erectile dysfunction, thinning hair, muscle atrophy and an overall decline of wellbeing.
WHAT ARE THE BENEFITS OF BHRT?
Since Testosterone governs sexual function for men, balancing Testosterone can improve libido and erectile dysfunction. Dr. Christine does not treat lab results. Through a comprehensive physical exam, history intake and a detailed questionnaire, she is able to identify men suffering from a decline in their Testosterone levels. The majority of the time, these symptoms are supported by data collected from the lab results. However, Dr. Christine focuses her treatment plan on her patient’s goals and lifestyle. In doing so, the male patient achieves balance, resolution of symptoms and improved overall wellbeing.
Healthy Testosterone levels are important for achieving and maintaining a healthy weight. Testosterone helps build muscle, which ramps up your insulin sensitivity, maintains metabolic health, and delivers all kinds of other important benefits.
When a man is overweight, his production of Testosterone is impaired. Low Testosterone creates the environment amenable to storing more fat. Low Testosterone can also lead to the metabolic inability to handle carbohydrates and sending it all to be stored in the fat tissue; this phenomenon is known as insulin resistance.
This area is a bit tricky and requires finesse. Restricting fat intake can also reduce Testosterone levels. The resulting weight loss that ensues from a low fat diet, steals muscle mass along with the fat. We do not have a way of telling the body to just lose the fat and leave the muscle. Therefore, the goal for our male patients is to preserve lean muscle mass while losing weight.
Dr. Christine takes a great deal of time to educate her male patients on how to maintain their body fat in order to maintain healthy levels of Testosterone. Dr. Christine recommends a workout program that incorporates weightlifting or resistance training to help maintain healthy muscle mass, and in turn, maintain the integrity of their Testosterone.
The relationship between Testosterone and other hormones in the body cannot be ignored, but in an effort to provide the education our patients need, let us talk about Estrogen. As with women, an increased level of body fat can increase Estrogen levels and suppress Testosterone. The suppression of Testosterone reduces the amount of available Testosterone in the blood, which viciously increases Estrogen. This cycle can be broken once balanced levels of Testosterone are achieved with Dr. Christine’s Bio identical Hormone Replacement Therapy Program.
Cortisol is the hormone that wakes you up in the morning. It is responsible for our “fight” OR “flight” response, which is essentially deciding to fight a bear or run as fast as you can. Cortisol levels are elevated in people that are chronically stressed out. Cortisol is essentially the opposite of Testosterone. Some have gone as far as calling Cortisol the “enemy” when trying to keep higher levels of Testosterone.
Here is the skinny… A man’s testicles produce an enzyme called 11ßHSD-1, which protects Testosterone from the destructive effects of Cortisol. However, under continuous stress, Cortisol levels are too high. There is not enough of the enzyme 11ßHSD-1 to counteract Cortisol. As a result, Testosterone molecules are destroyed before they even leave the testicles.
Both Cortisol and Testosterone are produced from Pregnenolone (a hormone synthesized from Cholesterol). Under chronic stress, a phenomenon known as the “Cortisol Steal” takes effect. Testosterone is basically robbed of the building material and it all goes into keeping up with the production of the stress hormone – Cortisol.
In addressing Testosterone balance, Dr. Christine discusses lifestyle changes and behavioral modification in achieving a stress free lifestyle or ways to control stress that is outside of anyone’s control. Simple changes such as getting 8-9 hours of sleep, proper diet, manageable workouts and not overly dieting, can generally help control excess Cortisol levels, reducing stress and maintaining a healthy level of Testosterone. When indicated, Dr. Christine may recommend adrenal support and adrenal detox to help reboot the system.
Testosterone replacement therapy in men with low Testosterone levels moderates metabolic components associated with CV risk, thus reducing the risk of mortality and disease.
A study in the European Heart Journal:
The study consisted of 83,000 men 50 years of age and above, with documented low levels of Testosterone and had received treatment in Veteran Affairs medical facilities between 1999 and 2014.
The men were categorized into one of three groups:
Group 1: men who were treated until their Testosterone levels returned to normal
Group 2: men who were treated whose Testosterone levels did not return to normal
Group 3: men who did not receive Testosterone replacement treatment whose levels remained low.
The men who received treatment until Testosterone levels returned to normal (Group 1) were 56% less likely to die, 24% less likely to have a heart attack and 36% less likely to have a stroke than those who were untreated (Group 3).
“It is the first study to demonstrate that significant benefit is observed only if the dose is adequate to normalize the total Testosterone levels,” the authors write. “Patients who failed to achieve the therapeutic range after Testosterone replacement therapy did not see a reduction in heart attack or stroke and had significantly less benefit on mortality.”
As hormone levels become balanced, mental clarity is achieved. This is critical to many men when in business negotiations, courtroom litigations or simply in their day to day lives. A balance of Testosterone levels improves the function of neurotransmitters that carry messages to the brain. This leads to the improvement of brain chemistry, which can reduce anxiety, depression and anger control.
Healthy levels of Testosterone promote thicker hair. When Testosterone levels are low, another form of Testosterone, called DHT (DihydroTestosterone) can increase and cause hair follicles to die away. Increasing free Testosterone helps preserve hair follicles and increase the thickness of hair. Excess levels of testosterone can also result in higher levels of the DHT and hence the greater likelihood of hair loss or baldness. Finding that sweet spot and achieving testosterone balance is our ultimate goal.
I DO NOT WANT TO INCREASE MY RISK OF CANCER
Prostate safety and the risk of Prostate Cancer are discussed with every patient seeking Bio Identical Hormone Replacement Therapy. There are several reputable, published studies and the current evidence clearly states that appropriate Androgen (Testosterone) administration, in men with low Testosterone levels does NOT have a causal relationship with prostate cancer. Treatment of andropause or male menopause has been used for almost 75 years and is considered safe and effective.
In fact, there is a great deal of experimental data showing that treatment of Testosterone in men may actually aid in prevention of prostate cancer.
HOW DO I GET STARTED?
It is clear that improving Testosterone levels in men and achieving optimum balance, have a tremendously positive impact on libido, prostate health, mental clarity, heart health, weight loss and improved muscle mass and most importantly, you get to hang on to your hair. Dr. Christine can prescribe Bio Identical Hormone Replacement Therapy in various forms including transdermal creams and gels or injections, or pellets. She monitors her patients on a regular basis until optimum levels are achieved and on a quarterly basis with minimal, relevant blood work to continue monitoring. Patients are given a great deal of education from day one and continue to replenish their knowledge base as they work side by side with Dr. Christine.