In Search of Your Lost Testosterone: 8 Reasons to Hire a Guide

By Jed Diamond, PhD, LCSW

Most everyone has heard of testosterone, but have only a vague idea of what it is, what it does, and why it is important. I’ve been researching testosterone since 1994 when I hit the big 5 0 and became concerned about my loss of desire, difficulty with erections, decreasing energy and vitality, and irritability and mood swings.

Here some things about testosterone that I’ve learned:

• Hormones are your body’s chemical messengers. They travel in your bloodstream to tissues or organs. Hormones are powerful. It takes only a tiny amount to cause big changes in cells or even your whole body. That is why too much or too little of a certain hormone can be a problem.

• Testosterone is the most important sex hormone that men have. It is responsible for the typical male characteristics, such as facial, pubic, and body hair as well as muscle. This hormone also helps maintain sex drive, sperm production, bone health, and other important functions throughout the body.

• Although we think of testosterone as the quintessential male hormone, it is present in both males and females. Normal levels in males range from 300-1000 ng/dl. Normal levels for females are much lower, ranging between 15-70 ng/dl.

• Make no mistake; testosterone is vitally important to the health and well-being of both men and women. In their book, entitled Natural Hormone Replacement for Women Over 45, Jonathan V. Wright, MD, and John Morganthaler recommend that “Replacing inadequate testosterone with natural testosterone can help protect the heart, improve mental alertness, make bones stronger, and revive a sagging sex life.

• Testosterone levels peak in the late teens and then gradually decline over time, typically about one percent a year after age 30. Since there is a wide range of healthy testosterone levels in males and females, we don’t experiencing symptoms of decline until levels become too low.

• Low testosterone, or Low T, can occur at any time of our lives, but generally can cause symptoms, including lack of sexual desire and vitality, when we are between the ages of 40 and 55, though problems can occur earlier or later. Stress, lack of exercise, and weight gain can also cause T levels to decline and cause symptoms.

So, it’s clear that testosterone is important to our health and well-being, but can decline and cause problems as we get older. Since my first books, Male Menopause and Surviving Male Menopause: A Guide for Women and Men, (http://menalive.com/store/) were published, I have been helping to guide men and women in their quest to restore their vitality, passion, and health. When we venture into unknown territory a good guide may be the difference between getting there and getting lost. Here are the main reasons I believe a guide may be helpful.

1. There’s a tremendous amount of “hype” in the health-care field with a lot of recent focus on testosterone.
Here are a few headlines I’ve seen recently:
“REDUCED sex drive? Decreased energy? Unwanted mood or body changes? Is it low testosterone?”
“Bigger, faster, stronger? 5 benefits of testosterone”
“Feeling like a shadow of your former self?” “Lost your appetite for romance? The problem could be Low T.”

2. It’s difficult to know what kind of health-care professional one should seek out if they are having problems.
One of the most common questions I’m asked: “I’m experiencing symptoms including loss of desire, sexual dysfunction, irritability, loss of energy and vitality, but I don’t know who I should see. Do I go to my family doctor, an endocrinologist, a psychologist, a Low-T clinic?”

3. Most health-care professionals, including your family doctor, are not trained to address hormonal changes as we age.
When I was in medical school there was little focus on hormonal changes in men and women. Even now, with our increased knowledge, few doctors are well-versed in the complex issues relating to hormones. This is particularly true for men. Menopause has been addressed for many years. Andropause is still a mystery that most practitioners do not understand.

4. There is a lot of money to be made in the Low-T field.
The August 18, 2014 issue of Time Magazine, features a cover story titled, “Manopause?! Aging, Insecurity and the $2 Billion Testosterone Industry.” The percentages of men 40 and older being treated for “Low T” more than tripled from 2001 to 2011. U.S. prescription-testosterone sales hit $2.4 billion in 2013, and the market is expected to swell to $3.8 billion by 2018, according to Global Industry Analysts.
The fact that billions of dollars are being made in the field doesn’t mean Low-T treatment is bad, but it does mean that it’s more difficult to separate what’s good for our health from what’s good for the bottom line of big business.

5. Testosterone generates strong emotions in people.
Some of the most solidly based research on testosterone was conducted by Dr. James McBride Dabbs. We can get a sense of the emotional aspects of the field from the title of his popular book, Heroes, Rogues, and Lovers: Testosterone and Behavior. Few people take a purely intellectual approach to understanding testosterone. Even the word “testosterone” generates strong feelings in people.

6. Even experts in the field of health have different views of testosterone treatment.
Abraham Morgentaler, MD, Associate Clinical Professor at Harvard Medical School, is an advocate for scientifically-based treatment of low testosterone. In the introduction to his book, Testosterone for Life he asks, “Are you tired? Have you lost your edge, your sense of vitality, your ‘mojo? Does sex feel like work, or maybe it doesn’t work out anymore? Is your mood blah? Have you put on a gut even though you don’t seem to be eating any more than you ever did? Maybe it’s age. Or maybe, just maybe, you have a medical condition called low testosterone, or, as I prefer to call it, low T.”

John La Puma, MD, is a board-certified specialist in internal medicine. In a New York Times editorial “Don’t Ask Your Doctor about Low T,” he says that Low T isn’t nearly as common as drug ads for prescriptions would have us believe. “Pharmaceutical companies have seized on the decline in testosterone levels as pathological and applicable to every man. They aim to convince men that common effects of aging like slowing down a bit and feeling less sexual actually constitute a new disease, and that they need a prescription to cure it.”

7. Determining if someone needs treatment for Low T isn’t always easy.
The range of healthy T levels varies a great deal. One man’s high-normal level may be 400 ng/dl. Another man’s may be 1,100. Both may have a T level of 350 when they are fifty year’s old. The man who is used to a T level of 400 may not have any symptoms. The man who is used to a T level of 1,100 may have lots of symptoms, but both would fall within the “normal” range.
Some doctors will recommend Testosterone Replacement Therapy (TRT) when T levels are low. Others will only recommend it if there are symptoms as well as a low laboratory results.

Things are also complicated by the fact that different labs have different ways they determine their normal testosterone levels.

8. There are other ways to increase testosterone levels besides TRT.
In my forthcoming book Manopause and Low-T: What Every Man and Woman Needs to Know About Sex, Love, and Vitality I describe 11 other ways to improve our health and increase our T levels, in addition to TRT including the following:
• Balancing other hormones
• Stress relief
• Treating irritability and anger (Irritable Male Syndrome or IMS)
• Addressing symptoms of depression
• Losing belly fat that converts testosterone to estrogen
• Exercise
• Improving sleep
• Developing and deepening a better sex and love life
• Improving important friendships and social connections
• Treating addictions
• Finding new hope and purpose in the second half of life

The good news is that we no longer have to live with the loss of sexuality, vitality, health, and joy that often occurs when our testosterone levels decline. But in order to take advantage of all the benefits we may need guidance. I look forward to answering your questions and addressing your concerns.

Jed Diamond, PhD, LCSW, is the Founder and Director of the MenAlive, a health program that helps men live well throughout their lives. Though focused on men’s health, MenAlive is also for women who care about the health of the men in their lives. Diamond’s new book Stress Relief for Men: How to Use the Revolutionary Tools of Energy Healing to Live Well