Impact of Low Testosterone

When there is less testosterone available to do its work, the testosterone target-organ response decreases, bringing about many changes.

There is great variability in testosterone levels among healthy men so not all will experience the same changes to the same extent. But typical responses to low bioavailable testosterone levels include:

• Low sex drive 
• Emotional, psychological and behavioral changes
• Decreased muscle mass 
• Loss of muscle strength 
• Increased upper and central body fat 
• Osteoporosis or weak bones and back pain
• Cardiovascular risk

Why should andropause be taken seriously?
Apart from the impact that andropause may have on your quality of life, there are other longer-term and silent effects of andropause that are harder to track: increased cardiovascular risk and osteoporosis.

Andropause & Osteoporosis
In a healthy individual, bone tissue is constantly being broken down and rebuilt. In an individual with osteoporosis, more bone tissue is lost than is regenerated. We've all heard of women suffering from weaker bones, or osteoporosis, after menopause. In men, testosterone is thought to play a role in helping to maintain this balance. Between the ages of 40 and 70 years, male bone density falls by up to 15 percent.

Unfortunately, with advancing age and declining testosterone levels, men, like women, seem to demonstrate a similar pattern of risk for osteoporosis. What's more, approximately one in eight men over age 50 actually have osteoporosis.

The incidence of hip fractures rises exponentially in ageing men, as it does in women, starting about 5 to 10 years later. In Canada, 20-30 percent of osteoporotic fractures occur in men. The incidence of fractures has been increasing in men, whereas it seems to be stabilizing in women - likely due to their lifestyle changes, calcium supplements and hormone replacement therapies (HRT).

Low bone density puts one at risk of frequent fractures, associated pain, and in many cases, loss of independence. Wrists, hips, spine and ribs are most commonly affected.

Two important consequences of osteoporosis are often seen as a slow but progressive rounding of the shoulders as well as a loss of height and back pain. Particularly devastating seem to be hip fractures, up to one third of patients never seem to regain full mobility.

Cardiovascular risk*
It is now well accepted that women's risk of atherosclerosis (hardening of the arteries) increases after menopause. Estrogen replacement therapy seems to reverse this trend.

New evidence suggests that a similar phenomenon occurs in men as their testosterone levels diminish with age. While research is not as complete as for women, the clinical findings point to an association between low-testosterone levels and an increase in cardiovascular risk factors in men.

*A cause and effect relationship has not yet been established in large clinical trials. Further clinical research is needed into this important area of study.

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