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Testosterone has gotten some bad press (like estrogen) because of the potential for abuse in professional athletes and body builders. But most men like to think they have LOTS of testosterone. It is what makes them build strong, large muscles, have deep voices, and masculine, hairy bodies. But most of all, testosterone creates desire and libido and without it, our species would not exist.
A colleague once said that testosterone turns his wife into “the most beautiful woman ever”. A woman said, “It wasn’t until I had my testosterone replaced to optimal levels, that I felt like my 20-year-old self again”. Energy, attitude and that feeling of confidence and satisfaction with life are all related to testosterone. Some say that testosterone can cause aggression and while this may be occasionally true, the vast majority of patients that I treat feel more relaxed, calm, and open to life and adventure. Estrogen is a worker and builds and makes things grow, and testosterone says, “OK, I’ll help with that, but let’s relax and have some fun along the way.” Testosterone contributes to emotional stability and if you see your man get teary eyed or if you feel like crying at the slightest upset, your testosterone might be low. Whenever I see John Boehner welling up, I think, “This man needs to get his testosterone checked”. For men, the fall in testosterone with age turns them into grumpy old men with not only little interest in sex, but an overall feeling of apathy, loss of general well-being, ambition, and drive. They may find their thinking is dull and creativity and sense of adventure is a thing of the past.
While estrogen and progesterone help women with symptoms of menopause, it is testosterone that really gives back that sense of confidence and invincibility – it puts the icing on the cake of HRT. From “The Hormone of Desire: The Truth About Sexuality, Menopause and Testosterone” by Susan Rako: “Menopause is a journey through poorly charted waters and most physicians approach the possibility of prescribing supplementary testosterone for women suffering symptoms of deficiency with the resistance and ignorance of sailors who believed the earth was flat, and that if they proceeded to sail on, they would fall off.” I had one patient tell me that her internist told her that she would grow a penis if he gave her testosterone.
Additional Benefits & Downsides
Aside from the emotional and love benefits, testosterone has significant cardiovascular benefits (more matters of the heart). It protects the body against heart disease, improves glucose metabolism and prevents diabetes, increases muscle mass, and promotes weight loss. It improves lipid metabolism (cholesterol) and protects the brain against Alzheimer’s and other dementias.
There are some downsides: testosterone in large doses can increase acne and hair growth in women. Lowering the dose and giving certain nutrients and medications can manage these side effects. For men, the burning question and conventional wisdom has been that testosterone increases the risk for prostate cancer. However, over the last few years, this has been essentially turned on its head. As men age, their testosterone levels fall, and yet their risk for prostate cancer goes up. Studies have shown no relationship with either low or high testosterone in the risk for prostate cancer. If a man with low testosterone is given testosterone, it can “wake up” the prostate and perhaps even uncover an occult prostate cancer.
Abraham Morgentaler, MD, a Harvard trained urologist, in his book “Testosterone for Life”, uses the analogy of a plant that is wilted from lack of water. When you water that plant, it perks up and “grows” for a short time, however, no matter how much you water the plant, once it reaches a certain height, it will not grow anymore. This is how testosterone works on the prostate. Morgentaler also traces the origination of the belief that testosterone causes prostate cancer and it is based on one paper from a study in 1941 with 3 patients treated with castration. Testosterone does not cause prostate cancer. Men who have had prostate cancer, once their PSA goes to 0 and remains there for some time, can be given testosterone. I encourage you to read Dr. Morgentaler’s book if you still have doubts.
Whether you are male or female, don’t miss out on the wonders of testosterone. If your hormone therapy is not optimal, consider asking a knowledge doctor about testosterone therapy. It will change your life for the better.