When hormones are replaced or restored back to physiologic levels considered normal for younger males, men may experience a dramatic reversal of many of these changes.
On the average, a man’s testosterone levels begin to decline at a rate of 1% per year after age 40. It is estimated that 20% of men aged 60-80 years have levels below the lower limit of normal. The diagnosis of low testosterone levels (medically termed “hypogonadism”) is based on the presence of signs or symptoms and must be confirmed by laboratory testing, which should include Total testosterone, Bioavailable testosterone (Free plus Albumin Bound), Estradiol, Cholesterol, Prostate Specific Antigen (PSA), Complete Blood Count (CBC), Hemoglobin, and Hematocrit. Screening for potential risks of androgen therapy should be performed prior to the initiation of treatment. Evaluation should include a history of or potential for sleep apnea, arrhythmias, significant symptoms of benign prostatic hypertrophy (BPH) or personal or family history of prostate carcinoma, and a physical exam. Proper monitoring of laboratory values and clinical response are essential when prescribing testosterone replacement therapy.
Natural testosterone must not be confused with synthetic derivatives or “anabolic steroids,” which when used by athletes and body builders have caused disastrous effects. For example, administration of synthetic non-aromatizable androgens, like stanozolol or methyltestosterone, causes profound decreases in HDL-C (“good cholesterol”) and significant increases in LDL-C (“bad cholesterol”), and has been associated with serious heart disease. Yet, hormone replacement with testosterone, an aromatizable androgen, results in lower total cholesterol and lower LDL cholesterol levels.