Low testosterone associated with aging is sometimes referred to as Andropause. It is often associated with diabetes, hypercholesterolemia and other chronic diseases.
Some of the common symptoms include:
• Fatigue or tiredness
• Mood changes
• Loss of libido or sexual interest
• Concentration problems or “brain fog”
• Erectile Dysfunction , especially loss of early morning erection
• Hot flashes
There is hormonal decline as one age, and this in part causes the aging process. While aging is a natural process, it can be modulated by hormonal manipulation. We do a thorough assessment to determine if your problem is at the testicular or pituitary level.
Androgens basically create “masculinity” and the loss of androgens such as testosterone leads to physical changes. In men, subtle changes occur in the post-andropausal years. There is loss of early morning erections. The skin can get dry, and there is hair loss. Hair loss occurs not only in the scalp, but also in the genitalia area as well as in the armpits. The testes can also get smaller. There can be loss of height because of osteoporosis.
The following questionnaire has been used popularly for screening for possible Andropause. If you answered yes to #1, #7, or any three others, you may have symptoms associated with andropause; and should be subject to blood screening of an early morning sample of free and total testosterone. The ADAM, like the Aging Male Symptom Scale (AMS) questionnaire is sensitive but may not be specific. At the OPAL Clinic, we will help make an accurate diagnosis, and will not commit you to hormonal replacement unnecessarily.
ADAM Questionnaire [ download PDF ]
1. Do you have a decrease in libido (sex drive)? Yes No
2. Do you have a lack of energy? Yes No
3. Do you have a decrease in strength and/or endurance? Yes No
4. Have you lost height? Yes No
5. Have you noticed a decreased enjoyment of life? Yes No
6. Are you sad and/or grumpy? Yes No
7. Are your erections less strong? Yes No
8. During sexual intercourse, has it been more difficult to maintain your
erection to completion of intercourse? Yes No
9. Are you falling asleep after dinner? Yes No
10. Has there been a recent deterioration in your work performance? Yes No
Andropause, if symptomatic can be treated with various modalities. This can include hormonal replacement, clomiphene, HCG, aromatase inhibitors, SERMs, antidepressants, supervised exercise programs and diet. At OPAL Medical Clinic, we prescribe both brand name testosterone preparations as well as bioidentical hormones through compounding. Other modalities include sublingual preparations, injections and implants.
You can refer to Dr. Tan’s book for patients entitled “The Andropause Mystery”. It is available at Amazon.com For health care professionals & more in depth discussion, the Textbook “Aging Men’s Health” edited by Dr. Tan is available at the OPAL Medical Clinic. Please call us for further information.