If you are reading this section, your sex drive may have shifted from high gear to neutral or low. You may also have trouble getting and/or keeping an erection. If you are a man over forty, your sexual concerns are most likely caused by dropping testosterone levels. Testosterone levels peak in a man’s 20’s and begin a slow downhill slide as early as age 30, dropping 1 percent a year on average. By his early 40’s, a man’s testosterone deficiency can compromise both desire and performance. Hormone levels decline even more rapidly after 50. An 80 year old man will typically have only 20 to 50 percent of the level of testosterone he had at his peak. As the years go by, this gradual decline in testosterone levels is the biochemical reason why former between-the-sheets enthusiasts shift from enjoying sex several times a week to going through the motions a few times a year.
Not only is testosterone vital for sustaining proper erectile function and libido, it is also involved in building muscle, burning fat, energy level, mood and bone density. Testosterone deficiency can lead to weight gain or obesity, loss of stamina and lean muscle mass, depression and anxiety and an increased risk of diabetes and heart disease. Unlike menopause, a man’s drop in testosterone is so gradual that symptoms of andropause are frequently ignored or attributed to “getting older.” Men also experience an age-related decline in DHEA production. According to the Massachusetts Male Aging Study, which investigated sexual function and activity in men aged 40 to 70, incidence of erectile dysfunction (ED) increased as DHEA levels declined. Stress is also a factor. When you experience chronic stress, your adrenals strain to maintain high cortisol levels and lose the capacity to produce DHEA in sufficient amounts. When levels of DHEA are less than optimal, whether as a result of age-related decline or stressed-out adrenal glands, your sexuality is biochemically compromised. Weight related estrogen dominance is also a sex life saboteur for men. The more body fat you have, the higher your levels of sex hormone binding globulin (SBGH). SBGH binds to testosterone like Velcro. The more testosterone bound to SHBG, the less available to stimulate desire.
Low Testosterone & Serious Health Risks
Multiple medical studies have linked low testosterone levels with a higher death rate of men aged 50 or older. One study conducted at the University of Cambridge followed nearly 12,000 men ranging in age from 40 to 79. After ten years, more than 800 of the men had died. After adjusting for factors that might increase risk of death – including age, weight, smoking, alcohol use, high blood pressure, diabetes and physical activity – the link between low testosterone and earlier death remained. Compared to men in the lowest quartile (25%) of testosterone levels, men in the highest quartile were 41% less likely to die. Similarly a study conducted by medical researchers at University of California, San Diego, followed 800 men ranging in age from 50 to 91 years old from 1984 until death or 2004, whichever came first. Men with low testosterone levels were 33% more likely to die.
In addition, Many studies have shown an association between low testosterone levels and a higher prevalence of heart disease. Lower testosterone levels are also associated with reduced pumping ability of the heart. Growing research suggests that low testosterone levels may be intimately linked with insulin resistance and its related conditions of metabolic syndrome and diabetes. Metabolic syndrome is a group of risk factors– high blood pressure, high blood sugar, unhealthy cholesterol levels and abdominal fat – that make heart disease and diabetes more likely. Recent findings from the Third National Health and Nutrition Survey (NHANES III) demonstrate that men in the lowest bracket of testosterone levels were approximately four times more likely to develop diabetes.
Each year, more than 186,000 American men learn they have prostate cancer. Many physicians continue to have the misconception that high testosterone levels cause an increased risk of prostate cancer. Recent medical studies prove exactly the opposite. In 2004, Abraham Morgentaler, M.D., published a review in the New England Journal of Medicine validating that there was not a single study in human patients to suggest that raising testosterone levels increased the risk of prostate cancer. Dr. Morgentaler’s premise was further validated in 2008 by an article published in the Journal of the National Cancer Institute. New studies continue to confirm this: a 2015 study published in the Journal of Urology showed that exposure to testosterone therapy over a five-year period was not associated with an increased risk of aggressive prostate cancer, and that high-grade prostate cancer did not increase according to the total number of testosterone injections. This is great news for men who struggle with symptoms of hormone imbalance related to andropause and low testosterone!
More than a decade ago, the father of the bioidentical hormone replacement movement, the late John R. Lee, M.D., identified the hormone imbalance known as “estrogen dominance” as the primary cause of prostate enlargement and prostate cancer. In men, estrogen dominance occurs when progesterone AND testosterone levels drop too low to keep circulating estrogen levels in check. The same things that cause breast cancer, also cause prostate cancer – abnormal cell growth fueled by excessive estrogen activity – estrogen dominance. Dr. Lee pointed out that, “It is highly unlikely that testosterone is the cause of prostate cancer. The highest testosterone levels in males are made during one’s late teens, at a time when no one gets prostate cancer. Conversely, prostate problems in men rise when their testosterone and progesterone has fallen and their estrogen has risen.” (Hormone Balance for Men, 2003). Current research supports his findings, linking estrogen dominance in men to hormone-dependent prostate cancer. When you consider that the prostate is the embryonic equivalent of the uterus, it all makes sense. In women, estrogen dominance occurs when there is not enough circulating progesterone in the body to balance the cell- growing tendencies of estrogen. The imbalance has been linked to uterine, breast and ovarian cancer, as well as other diseases.
It is also important to understand how hormone imbalances can reduce PSA (prostate specific antigen) production in men. PSA protects against prostate cancer by inhibiting the growth of blood vessels that feed tumors. We know that testosterone and progesterone levels fall as men age. Both of these hormones are “anabolic,” – in other words, they produce energy, rather than using it up. So when hormones levels fall below normal, less PSA is produced. When testosterone deficiency is restored, PSA levels normalize again.
Low DHEA levels may also put men at risk for prostate cancer. Declining DHEA production caused by stress and aging have been linked to an increased risk for a number of diseases, including cancer. Supplemental DHEA has been reported in study after study to have a positive effect on the immune system and to be involved in the prevention of diabetes, cancer, hypertension and obesity. There is controversy about DHEA supplementation and prostate cancer, but in our opinion, medical science overwhelmingly demonstrates the benefits of medically supervised bioidentical DHEA replacement.
Needless to say, it is extremely important that men with symptoms of hormone decline get tested for imbalances of estrogen, progesterone, and testosterone to protect their prostate health. Bioidentical hormone therapy is fundamental to restoring healthy male hormone levels and improving prostate health!
The Massachusetts Male Aging Study established erectile dysfunction (ED) as a plague stalking American men. Of 1,290 men aged 40-70 years, 50 percent of men over 50 and 70 percent of men over 70 suffered from ED. In 1998, former U.S. Senator Bob Dole helped make ED a topic of everyday conversation when he honestly responded to a question about the aftermath of his prostate surgery on Larry King Live. Producers of the segment said that their phone lines were immediately flooded with calls. Millions of men indicated that, not only could they identify, they wanted help.
When you were in your 20’s, you probably thought no more about getting an erection than you did about breathing. Though seemingly effortless, your youthful erections resulted from a complex interplay between your nervous system, biologic activity, and your hormones, that begins when your sex drive causes the sympathetic nervous system to release nitric oxide. Nitric oxide causes the arteries to enlarge and blood to engorge the penis. A continual supply is essential for a firm, long-lasting erection. Both ED and heart disease have been linked with impaired nitric oxide activity, although struggles with erectile function usually precede symptoms of heart disease by several years. Release of nitric oxide can be sabotaged by elevated cholesterol levels, high blood pressure, increased triglycerides, smoking, metabolic syndrome, diabetes, and low testosterone levels. Because men with low testosterone are also at greater risk for heart disease, metabolic syndrome and diabetes, the convergence amplifies the risk that optimum production of nitric oxide will be disrupted. Restoring testosterone deficiency with bioidentical hormones can help maintain healthy blood flow and release of nitric oxide.
Sexual Vitality Treatments
At the Ageless & Wellness Medical Center, we believe that sexual health is an important aspect of every person’s quality of life. We offer a wide range of solutions for men who suffer from issues with sexual vitality and erectile performance. From bioidentical hormone replacement therapy (BHRT) using testosterone and/or progesterone, to pharmaceutical-grade supplements that boost the libido, we can treat the underlying hormonal causes naturally. To help our patients who wish to take the next step toward optimal sexual health, we also offer the “Priapus Shot®.”
The Priapus Shot® is a medical procedure developed and trademarked by Dr. Charles Runels, M.D. He was the first to apply an established technique using platelet-rich plasma to increase blood flow and create new tissue — for the purpose of sexual health. Both Dr. Randolph and Steven Garces, ARNP, MSN, have been trained and certified to provide the Priapus Shot® treatments. Platelet-rich plasma (PRP) extracted from a simple blood draw is injected into your body in strategic locations to rejuvenate the tissue. The result is new tissue growth and increased blood flow. For more than 15 years, medical professionals have been using PRP to promote post-operative healing after trauma. This technique has been used for professional athletes; by injecting PRP into joint cartilage, players can recover more quickly from injury and be back on the field stronger than before. The use of PRP for tissue rejuvenation takes advantage of natural healing factors in your own body with the same material used to heal a scraped knee when you were a kid: growth factors and stem cells that stimulate wound healing. The results are new collagen, new blood vessel formation, and enlargement of fat cells, with no abnormal cell formation. As men age, the tissue in the penis changes and problems with blood flow can lead to difficulty with erections. The Priapus Shot® literally regrows new tissue and new blood vessels to rejuvenate men’s erections.