Testosterone is the male hormone which is responsible for a man’s and (partially) a woman’s sex drive. In men it is important for a man’s well-being, as it maintains his reproductive tissues, stimulates sperm formation, stimulates and maintains his sexual drive and function, as well as increases his muscles, strengthens his bones and stimulates blood formation. All in all, it’s a vital component of a man’s make-up. A man’s testosterone gently falls from age 20 onwards and at 75 it can be half the level of a 20 year old. A too- low testosterone can cause many problems. Low testosterone can reduce your ability to have satisfying sex. Lack of sex drive and erectile dysfunction are sexual problems that can result from low testosterone. If low testosterone is the cause, Hattat Clinic treatments can help.
In studies, as many as one in three men mentioning ED to their doctor have low testosterone. Experts believe that in men with other factors causing erectile dysfunction, low testosterone can strongly contribute, making a difficult situation even worse.
Strengthening the connection, low testosterone is linked in some way with many of the conditions that lead to erectile dysfunction:
- Metabolic syndrome
- Obesity
- Endothelial dysfunction
- Diabetes
Symptoms of a low testosterone in an adult man
- There is reduced drive and energy, sexual and physical – he’s just not interested in sex, and gets tired more easily, frequently tending to fall asleep on getting home after work rather than doing jobs round the house.
- He has fewer spontaneous or early morning erections.
- His ability to get an erection is worse than it was, and he may well have erectile dysfunction, much to his and his partner’s distress.
- Often, he has a poor response to treatment with the PDE5 inhibitors – Viagra, Cialis and Levitra – which don’t work as well as expected.
- There is a loss of muscle bulk, strength and endurance, so that he can’t lift as heavy weights as he used to be able to do and he has increased fatigue.
- There is marked decrease in enjoyment of life and he feels ‘out of sorts’
- He has poorer concentration and memory
- There is increased upper and central body fat with a pot belly and a raised BMI (Body Mass Index)
- He may have profuse, drenching sweats particularly in bed, as well as a red face and hot flushes, very much like a menopausal woman’s
- His testes may get smaller and his breasts increase (“man boobs”)
- His mood changes, with depression and increased irritability – “a grumpy old man”
They may not all be present – and some symptoms are more severe than others.
Signs of a severe, long term fall in testosterone:
- Loss of body especially pubic and armpit hair
- Smaller testicles
- A low sperm count (important if trying to conceive children)
- There is a greater likelihood of fractures, because he gets thinning of the bone structure (osteoporosis)
- Sleep disturbance, especially having shorter and delayed periods of sleep
- Mild anaemia
What Happens at Hattat Clinic?
A careful history is essential, so your Hattat Clinic physician needs to know all the facts you may complain about, including any trauma to your head you may have had in the past. A physical examination of pulse, urine and blood pressure and a prostate examination are mandatory.
The serum testosterone and the sex hormone binding globulin (SHBG) need to be measured. A base level cholesterol and full blood count including the haematocrit, are helpful.
Hattat Clinic Sexual Wellness Programme
Androgen deficiency in the adult male (otherwise the ‘andropause’) exists. Testosterone replacement therapy (TRT) can make an enormous difference TRT needs careful monitoring and after screening for contraindications, it should only be considered when the testosterone levels are lower than the normal limit for a younger man, together with unequivocal signs and symptoms of androgen deficiency. TRT is a lifelong treatment so it is important to get the correct diagnosis at the start. But it improves sex drive and satisfaction with sex in many men.
Hattat Clinic treatment protocol involves a life style adjustment way beyond a testosterone replacement therapy as low testosterone is related to men’s overall health. Diabetes, metabolic syndrome, obesity, and high blood pressure have all been linked to testosterone deficiency.
In recent years, researchers have noticed general links between low testosterone and other medical conditions. One showed that in 2,100 men over age 45, the odds of having low testosterone were 2.4 times higher for obese men; 2.1 times higher for men with diabetes; 1.8 times higher for men with high blood pressure.
- A link between diabetes and low testosterone is well established. Men with diabetes are more likely to have low testosterone. And men with low testosterone are more likely to later develop diabetes. Testosterone helps the body’s tissues take up more blood sugar in response to insulin. Men with low testosterone more often have insulin resistance: they need to produce more insulin to keep blood sugar normal.As many as half of men with diabetes have low testosterone, when randomly tested. Obesity and low testosterone are tightly linked. Obese men are more likely to have low testosterone. Men with very low testosterone are also more likely to become obese. Fat cells metabolize testosterone to estrogen, lowering testosterone levels. Also, obesity reduces levels of sex hormone binding globulin (SHBG), a protein that carries testosterone in the blood. Less SHBG means less testosterone.
- Metabolic syndrome is the name for a condition that includes the presence of abnormal cholesterol levels, high blood pressure, waistline obesity, and high blood sugar. Metabolic syndrome increases the risk for heart attacks and strokes. Studies show that men with low testosterone are more likely to develop metabolic syndrome.
- Testosterone also contributes to the higher rates of heart disease and high blood pressure that tend to affect men at younger ages.
- In a study of almost 4,000 men older than 70, those with the lowest testosterone levels were more than twice as likely to be depressed.
- Problems with erections are one of the most common symptoms of low testosterone. Most ED is caused by atherosclerosis. Men with risk factors for atherosclerosis — diabetes, metabolic syndrome, or obesity — often have low testosterone, too.
- Men with high blood pressure may be almost twice as likely to have low testosterone as men with normal blood pressure.
Replacing testosterone isn’t the cure for all these important effects, only the necessary life style changes are. Losing weight through exercise can increase testosterone levels. Hattat Clinic programme offers you a wholistic sexual wellness programme combining medical therapies with life style evaluations to improve overall sexual well being and performance.
Prof. Dr. Halim Hattat
