If you are a middle-aged or older man, do you assume that a decline in energy, low libido, moodiness, and weight gain are just part of “normal aging”?

If so, you are like many American men who do not understand that these symptoms may be a sign of low testosterone (Low T), an often treatable condition. Low T is known medically as hypogonadism and can be accompanied by fatigue, inability to concentrate, increased irritability or depression, reduced muscle mass and strength, low sex drive and erectile dysfunction, decreased bone density or osteoporosis, and increased body fat.

Testosterone is the most important sex hormone produced in the male body. At puberty, it is the hormone primarily responsible for producing and maintaining the growth of facial and pubic hair, deepening of the voice, increasing muscle mass and strength and growth in height. Testosterone production does decline with age, however, in some cases, it can decline to abnormally low levels. Low T may also be caused by other medical conditions, infections, trauma to the testicles, use of certain prescriptions, and genetic factors.

It is estimated that Low T affects four to five million American men, yet only about five percent of those affected are currently receiving treatment.

Lack of Awareness

According to a recent survey by Harris Interactive, commissioned by the private, nonprofit Alliance for Aging Research, the vast majority (91%) of American men over the age of 39 do not know or are unsure of at least one of the symptoms associated with Low T. In addition, although one third of men reported experiencing two or more symptoms of Low T, 95 percent said that their doctors did not mention Low T as a possible cause of the symptoms. The common assumption that these symptoms are attributable to the normal aging process may often prevent them from seeking diagnosis and treatment.

Getting Tested for Low T

A simple blood test by your doctor can determine your testosterone level. Testosterone levels can vary from hour to hour, and the test is generally given in the morning, when levels are highest. The normal range for testosterone in men is generally 300 to 1,000 nanograms per deciliter (ng/dL) depending on the lab performing the test and the method used.

Treatment Options

Testosterone Replacement Therapy (TRT) is available in a variety of FDA-approved dosage forms including injections, gels and patches. Oral forms of TRT are rarely prescribed because they can cause damage to the liver. However, other forms of TRT can help provide the following benefits:

• Improved mood
• Increased muscle mass and strength
• Increased sexual interest
• Improved erectile function
• Improved or sustained bone density
• Decreased body fat

According to the Harris Interactive survey, men over age 39 report that they would be willing to take a prescription medication to improve their energy levels (60%) and to decrease body fat (57%).

Relationship to other Health Conditions

According to Andre T. Guay, MD, director, Center for Sexual Function/Endocrinology, Lahey Clinic Medical Center, North Shore, “The diagnosis of Low T and treatment with TRT may encourage a more active lifestyle and alleviate symptoms such as decreased energy, low libido, reduced muscle strength, increased body fat, weaker bones, and mood swings.

“Importantly, normalizing testosterone levels may reduce the risk of serious medical conditions, such as metabolic syndrome, type II diabetes, coronary heart disease, osteoporosis and depression.” In addition, Dr. Guay cautions that, “Men with prostate or breast cancer should not use testosterone replacement therapy, and all men should see their doctor for a prostate cancer exam before initiating TRT.”

Educating the Public

Given the general lack of awareness about Low T, and the fact that estimates indicate four to five million otherwise healthy men may have Low T but only about five percent are currently receiving treatment, the Alliance for Aging Research has launched a public education campaign called Men’s Health and Aging in America.

“We expect that broader education of the public on the symptoms of Low T will enable more patients to be properly diagnosed and treated,” said Alliance Executive Director Daniel Perry. The campaign calls on patients and doctors to open the lines of communications and discuss the symptoms of Low T, encourage testing for the condition and facilitate education about treatment. For more information, including a patient checklist to use when visiting your doctor, visit the Men’s Health Corner at www.agingresearch.org/menshealth.