Word on Health

Word On Testosterone Deficiency Syndrome

Our grateful thanks to Diabetes UK & the Centre For Men's Health for their assistance with this week's report which, you can hear again, via the audio player below. The information below is derived from a number of sources including NHS Direct. 

Testosterone Deficiency Syndrome relates to the slow but steady reduction in the production of the hormone, testosterone, in middle-aged men (and younger), and the consequences of that reduction. Testosterone Deficiency is associated with heart failure, diabetes, obesity and osteoporosis.

Unlike women, middle-aged men do not experience a complete and permanent physiological shutting down of the reproductive system as a normal event.

A very gradual decline in testosterone occurs from age 30 onwards at a a rate of 1% per year. Factors can increase that decline such as drinking too much, poor lifestyle and a whole series of stress inducing life events. It's not a mid life crisis. nor is it 'the male menopause'. 

Symptoms Testosterone Deficiency Syndrome is characterised by depression, weight gain, reduced loss of muscle and reduced ability to exerciose, 'brain fog', poor concentration and short term memory, irritability, night sweats, difficulty sleeping and increased tiredness, decreased sex drive, erection problems and loss of energy. These symptoms can interfere with everyday life and happiness, so it's important to find the underlying cause and work out what can be done to resolve it. 

Prevalence according to research by the Centre for Men's HealthTestosterone Deficiency Syndrome is estimated to affect 2 million men over 50 and an undetermined number of younger males.  According to Diabetes UK 50% of men living with type 2 diabetes live with Testosterone Deficiency Syndrome.  Research shows only 1% of all sufferers have been diagnosed and treated. (Treatment is available via the NHS.)

Premature Testosterone Deficiency Syndrome can occur in males who experience excessive female hormone stimulation through workplace exposure to oestrogen. Men who work in the pharmaceutical industry, plastics factories, near incinerators, and on farms that use pesticides are high-risk.

A testosterone deficiency that develops later in life, also known as late-onset hypogonadism, can sometimes be responsible for these symptoms, but in many cases the symptoms are nothing to do with hormones.

  • Personal or lifestyle issues 
  • Lifestyle factors or psychological problems are often responsible for many of these symptoms.
  • For example, erectile dysfunction, loss of libido and mood swings may be the result of either:
  • stress
  • depression
  • anxiety

There are also physical causes of erectile dysfunction, such as changes in the blood vessels, which may happen alongside any psychological cause.

  • lack of sleep
  • a poor diet
  • lack of exercise
  • drinking too much alcohol
  • smoking
  • low self-esteem

In some cases, where lifestyle or psychological problems do not seem to be responsible, the symptoms may be the result of hypogonadism, where the testes produce few or no hormones.

Hypogonadism is sometimes present from birth, which can cause symptoms like delayed puberty and small testes.

Hypogonadism can also occasionally develop later in life, particularly in men who are obese or have type 2 diabetes.

This is known as late-onset hypogonadism and can cause the "male menopause" symptoms.

But this is an uncommon and specific medical condition that's not a normal part of ageing.

A diagnosis of late-onset hypogonadism can usually be made based on your symptoms and the results of blood tests used to measure your testosterone levels.

What to do. If you're experiencing any of these symptoms, see your GP. They'll ask about your work and personal life to see if your symptoms may be caused by a mental health issue, such as stress or anxiety.

If stress or anxiety are affecting you, you may benefit from medication or a talking therapy, such as cognitive behavioural therapy (CBT).

Do I need hormone replacement therapy (HRT)? Your GP may also order a blood test to measure your testosterone levels.

If the results suggest you have a testosterone deficiency, you may be referred to an endocrinologist, a specialist in hormone problems.

If the specialist confirms this diagnosis, you may be offered testosterone replacement to correct the hormone deficiency, which should relieve your symptoms.

This treatment may be either:

  • tablets
  • patches
  • gels
  • implants
  • injections

Listen to this weeks radio report

All material on this website is provided for your information only and may not be construed as medical advice or instruction. No action or inaction should be taken based solely on the contents of this information; instead, readers should consult appropriate health professionals on any matter relating to their health and well-being.