Androgen Insufficiency in Men
Circulating androgens (male sex steroid hormones) have direct effects on diverse physiological and behavioral systems. Androgens affect sexual desire, bone density, muscle mass and strength, adipose tissue distribution, mood, energy and psychological well-being. There is a well-documented age-related gradual decline in serum testosterone and androgen concentrations in healthy adult men. Levels start to decrease at age 35 and continue to decrease at a rate of 2% per year. Erectile function is partly dependent upon androgens which include substances such as DHEA (dehydroepiandrosterone), androstenedione, testosterone and four other androgens. If your androgen levels are low your diagnosis is androgen insufficiency syndrome.
Symptoms which may be associated with androgen insufficiency syndrome in the aging male include decrease in sexual activity, loss of libido, erectile dysfunction, poor intensity and decrease in volume of ejaculation, irritability, nervousness, generalized weakness, osteoporosis, decrease of body hair and abdominal obesity.
Blood tests will be performed to determine androgen levels, including testosterone (free and total), DHEA, DHEA-S (sulfate), and androstenedione. Symptoms of androgen insufficiency often improve by taking androgen therapy (formerly known as androgen replacement therapy or androgren supplementation). Androgen blood levels must be measured every 3 months until they reach normal physiologic levels, at which time they should be measured every 6 months. Each time androgens are measured a PSA blood test is taken as well. In addition, cholesterol, liver function enzymes, PSA, and BCC will be evaluated to determine any adverse effects of the increase in serum androgens.
The side effects associated with androgen therapy are mainly those attributable to increases in blood androgen levels and include acne, hair loss, on the scalp, hair growth on the face and weight gain. You should not exceed the dose of androgen supplementation recommended by your physician. Recent studies have not demonstrated any significant adverse effect of androgen therapy in prostate enlargement, however, androgens accelerate the growth of an existing prostate cancer.
You may choose to live with the sexual dysfunction and low androgens levels without treatment.
If you have any questions regarding your treatment with androgen therapy, either now or at any time in the future, please feel free to ask them. If you are concerned with any physical changes which might occur after you start androgen therapy, you are welcome to contact one of our health professionals at 617 638-8576 or csm@bmc.org.
