Testosterone supplements: The tablets can help with potency problems, but they also involve risks.
Among other things, testosterone is to blame for potency problems, the production of which decreases steadily from the mid-30s. The hormone can be replaced with the help of testosterone preparations. But these involve risks and are not suitable for everyone.
Lack of drive, decreasing libido, and growing belly fat affects men with increasing age. “Around the age of 35, testosterone levels in men decrease by around one percent a year,” says Dr. Wolfgang Bühmann, press spokesman for the professional association of German urologists.
Falling testosterone is part of getting older
The decrease in testosterone is due to its age-related breakdown in the testes or in the brain regions that control the hormonal balance. “We men are ‘biologically constructed’ for 40 years – even if we are actually becoming twice as old these days.” That potency, libido and strength decrease after a certain age is, therefore, a completely natural process.
By the mid-50s at the latest, men can clearly feel this physically and mentally. Because testosterone is important for muscle building, bone density and the formation of red blood cells. The hormone is also important for the metabolism in adipose tissue, sex life, and reproductive ability.
Testosterone therapy for sexual reluctance
However, the drop in testosterone in the blood alone doesn’t make a man sick. However, if a lack of drive and sexual discomfort become so strong that they affect everyday life, it makes sense to have the value of the hormone checked by a urologist. If this is too low, testosterone therapy can be prescribed.
This can also improve my love life. Because: “Testosterone makes you want,” says Bühmann. It can help with libido problems. In contrast, the hormone does not work in the case of erection problems. Because these have other causes.
There are two versions of testosterone therapy prescribed by a doctor: the hormone can be supplied to the body as a gel via the skin or can be injected directly into the glutes. A refresher usually takes place after three months.
Expert warns of tablets from the Internet
“Testosterone should not be taken in the form of pills,” says Buhmann. They hardly worked, but they put a strain on the liver. The urologist urges against testosterone preparations from the Internet, which may still come from abroad. “You never know what’s really in here.” In addition, testosterone therapy should always be given under medical supervision.
No therapy without prior cancer screening
There are several reasons for this: “On the one hand, hidden prostate cancer must be excluded,” says Bühmann. If such a tumor is present, it can still be “fired” by the hormone administration. A corresponding preventive examination is, therefore, the prerequisite for testosterone therapy.
In any case, this should be accompanied by the doctor. Because too high values pose health risks and damage heart health.
First the confusion of terms: Andropause or ADAM (for Androgen Decline in the Aging Male = androgen decline in the aging man) or climacteric virile (virilis = male) or penopause?
Testosterone has made its way from the black market to the mass phenomenon. So far, athletes and bodybuilders have largely used the hormone illegally to get their bodies in shape. In addition, there were men with a rare underactive testicle. But more and more doctors want to tell us about a mysterious phenomenon that could eventually make every man a candidate for a testosterone cure: the “menopause of men”.
But the scientists are extremely contentious.
The new theory is modeled on the menopause of women. Then the ovaries stop producing estrogens. About one in three women feel the decrease in sex hormones as menopausal symptoms. However, we are already much further here than with men: as a hormone-dependent symptom, only the hot flushes (especially at night) are recognized as a disease, against which many women are prescribed the female sex hormone for relief. In addition, estrogens quickly gained a reputation as an elixir of eternal health: the hormones should also help against heart diseases, Alzheimer’s and so on (which is demonstrably not true – see! ).
Age problems should not be confused with hormone deficits!
A real testosterone deficiency in men over the age of 60 is less common than previously thought. Instead of 10 to 30 percent, as was assumed a few years ago, only about 3 to 5 percent of 60 to 79 year olds actually have a real testosterone deficiency, which explains the lack of libido and other symptoms. Men over 60 years of age sometimes no longer feel vital, muscle mass shrinks, fat tissue increases. If the libido then decreases, sometimes even hot flashes and depressive moods are added, media reports of the consequences of a testosterone deficiency in old age naturally fall on fertile ground.
In these reports, however, the relationships are greatly simplified. Age complaints are generally attributed to testosterone deficiency. But the complaints attributed to hormone deficiency are so numerous and unspecific that many other causes can be considered. In fact, even for older men with excess testosterone, there are enough reasons to get into a “mid-life crisis”. Strength and potency decrease with age; the role in the family changes; one realizes that one has not achieved one’s goals in life, the younger competitors threaten one another at work and, in addition, age-related illnesses are on the horizon – this can sometimes put pressure on the mood. There are few research groups that have systematically examined whether older men with lower hormone levels are really less fit. One is the group around the psychologists Annette Degenhardt and Andreas Thiele from the University of Frankfurt. In their study of 300 men between 35 and 65, the opposite of what testosterone believers assume today came out. The men who were not satisfied with themselves had significantly higher levels than those without complaints. Still, it’s not surprising that despite these gaps in knowledge, belief in the hormone is increasing. Testosterone suits the zeitgeist too perfectly. US studies show that male models have gained more and more muscle in recent years. Some commercials for aftershave are more of an advertisement for mass doping, because the model’s washboard belly, biceps and chest circumference can only be reached with the help of hormones.
Warning: FDA warning!
The FDA is tightening its warning for all products that contain testosterone and warns of risks such as heart attack, stroke, infertility, depression, and aggressive behavior. Testosterone is often taken in combination with the anabolic steroid, which increases the risks. Withdrawal symptoms often include withdrawal symptoms such as tiredness, loss of appetite, insomnia, etc. Moreover, “normal” men do not benefit from the intake but have the same risks … ( FDA Safety Information and Adverse Event Reporting Program. Posted 10/25/2016. Http : //www.fda.gov/Drugs/DrugSafety/ucm526206.htm )
The big problem with younger men who take testosterone is that the natural testosterone often doesn’t get going properly after taking it! Testosterone can ruin you forever: Taking it as an anabolic substance carries the significant risk that the pituitary gland will fall asleep irreversibly and cause a so-called “hypogonadotropic hypogonadism” to develop!
Libido deficiency is the guiding principle of the testosterone deficiency!
I also recommend all men over 60 with reduced libido and erectile dysfunction to the laboratory test – as well as men with excess weight, increased blood pressure, increased blood lipids and increased blood sugar, who often experience erectile dysfunction. It has been proven that it only helps against osteoporosis in “hypogonadic” men, ie when there is a real lack of testosterone – see here !
Studies examining the effects of testosterone on some age-related complaints are too small and too short to be really meaningful or show an insignificant effect ( see here). In essence, they confirm the effects bodybuilders have on buying the hormone on the black market: testosterone is an anabolic steroid. Men over 65 also gain muscle under the effect. However, this is not necessarily of medical importance. In a study on 108 men, US researchers found that after three years of testosterone therapy, their muscle mass had increased, but not their strength.
What is too little testosterone?
The testosterone level of men drops by 1 to 2 percent each year in earlier years. This natural process usually has no noticeable effects.
In fact, the importance of hormones for the well-being of a man is still completely open. We don’t even know how much testosterone is normal for an older man. Out of embarrassment, you help yourself with the values foofoung men. Due to a lack of studies and long-term experience, there are currently hardly any binding guidelines and recommendations as to the level at which a deficiency that requires treatment is present.
The Institute of medicine in 2004, the United States decided that the effectiveness of treating older men with low-normal testosterone levels (300-400 ng/dl or 10-12 nmol / l) was not sufficiently established to be effective in long-term studies of testosterone administration. A large, well-controlled and best-conducted 6-month study shows no positive results in 2007 ( Emmelot-Vonk MH et al. Effect of testosterone supplementation… .JAMA 2008; 299: 39-52 )!
The reference range for free serum testosterone, calculated by harmonizing measurement data and uniformly calibrating the analysis technology for healthy, non-obese (BMI <30 kg / m2) men aged 19 to 39, is between 264 and 916 ng/dl. (Travison TG et al .: Harmonized reference ranges for circulating testosterone levels in men of four cohort studies in the USA and Europe. J Clin Endocrinol Metab 2017; DOI: 10.1210 / jc.2016-2935) .
Testosterone should only be considered if the total testosterone is clearly reduced in an older man over the age of 60: total testosterone: measured twice between 6 a.m. and 9 a.m .: <9 nmol / l (depending on the study, however, only <7 nmol / l! ). If this is the case, the question arises whether there is a so-called primary hypogonadism (= LH high: genetic Klinefelter syndrome) or a secondary hypogonadism (LH low to normal: ie looking for other causes of this under function of the testicles, e.g. in the pituitary gland or medication side effects, e.g. pain medication abuse, chronic pain, obesity, stress, a lot of sport, …).
Patients who are being treated with testosterone should be carefully monitored. For the time being, the aim of the therapy is values of 300-450 ngnglresp. 10.4-15.6 nmol / l.
Patients should be checked for the derailment of testosterone-dependent diseases (e.g. prostate cancer, cardiovascular, liver damage, etc.). ( Snyder PJ. Hypogonadism in elderly men – what to do, until evidence comes. N Engl J Med 2004; 363: 440-2 and 482-92 ). Always have laboratory controls of PSA and hematocrit while taking testosterone.
Men with prostate cancer, increased red blood cells (hematocrit), untreated obstructive sleep apnea or untreated heart failure must not be treated with testosterone!
DHEA (precursor of testosterone) has no anti-aging effect!
Testosterone is no longer fun, health, and youth!
The only detectable effects of studies with testosterone are undesirable side effects !!! >>> see here!
Role of the pharmaceutical industry
In addition, the pharmaceutical industry is cleverly picking up on this trend and has the idea of male menopause marketed vigorously by advertising agencies. The success is evident in the USA: Testosterone preparations have been experiencing annual sales increases of 30 percent for several years. And for those for whom injections or plasters were previously too annoying, there is now a testosterone gel: If you have the impression that something is missing, you can rub yourself in with masculinity like with sunscreen. (Side effects of gel include involuntary smearing and “spreading” to loved ones, to women and children & it usually smells a bit …).
Against the background of such trends, the warnings of some experts about the risks of testosterone therapy sound more like a know-it-all. Some of them consider the sex hormone to be one of the reasons why strong sex dies of cardiovascular diseases a few years earlier than women.
Can Testosterone Shorten Life ?!
Men with testosterone supplementation may be at higher cardiovascular risk! This is suggested by an observational study from the USA, in which the data from around 9000 US veterans with testosterone values below 300 ngngl10.4 nmol / l) were evaluated. 20% of men without testosterone therapy, but 26% with therapy, experienced either death, a heart attack or stroke within 28 months of observation, even though the men in the testosterone group were somewhat younger and healthier on average!
(Vigen R et al. JAMA 2013; 310 (17): 1829-1836)
The TOM study ( Basaria S et al., N Engl J Med 2010; 363 (2): 109-122 )was therefore canceled prematurely! There the risk ratio was already 22% within half a year instead of 5%!
Heart attack under testosterone
Taking testosterone increases the risk of a myocardial infarction, at least in the first three months after taking it! The risk of a myocardial infarction under testosterone treatment increases with age. The risk of a myocardial infarction with testosterone intake increases significantly in under 65 year olds with existing coronary heart disease. The risk triples in the first three months of taking testosterone. (Among others, Finkel WD et al. Increased risk of non-fatal myocardial infarction following testosterone therapy prescription in men. Plus One 2014; 9, e85805.)
Prostate cancer
Added to this is prostate cancer, the most common cancer among older men.
It is not entirely clear what role testosterone plays in the development of tumors in the prostate gland, but it clearly promotes the growth of existing tumors. Fortunately, these tumors tend to grow so slowly that most men die before they notice anything of their tumor. This could change testosterone therapy: Even advocates of testosterone therapy, therefore, advise you to monitor your prostate continuously.
Bone density
First, it turns out differently, and second, then you think! Osteoporosis is a concern not only for postmenopausal women. It also affects men over 50 in 13%. And 30% of all femoral neck fractures occur in aging men. Testosterone improves bone density (BMD) in young hypogonadal men. Shouldn’t older men also benefit from it? Not at all! In 448 men over the age of 70, (total) testosterone and estradiol, luteinizing hormone and bone density were followed for eight years. Surprise: In the elderly man, age-related hypogonadism is not associated, but reduced estradiol levels are associated with reduced BMD. It would be premature to draw therapeutic conclusions from these results. (Amis S. et al. Association of hypogonadism and estradiol levels with bone mineral density in elderly men from the Framingham study. Ann Intern Med 2000; 133: 951-63 (Editorial 1002-4))
Phthalates (BPA or Bisphenol A) = plasticizers from plastic in our environment and testosterone/sperm count
Avoid nicotine, alcohol, and stress. This trio in particular drops testosterone’s hormone levels. Increasing it does exercise and slimming down.
If you exercise regularly over a long period of time, you can keep your testosterone levels high. That means taking at least three times a week for half an hour of endurance training.
Pay attention to your diet: It should contain enough zinc because this mineral is necessary for the build-up of testosterone. Zinc is mainly found in cheese, fish, seafood, poultry, meat, nuts and to a lesser extent in cereals, legumes, and vegetables.
Those who are overweight should slim down. If the organism loses five kilograms of fat through regular sporting activities, for example, the testosterone release is automatically promoted (5 kilos less means around a third higher testosterone level).
Regular sex has a positive effect on testosterone levels.
Men who are exposed to bright light in the early morning are able to raise their testosterone levels. To do this, men need 1000 lux for one hour between 5 a.m. and 6 a.m. The luteinizing hormone (LH) responsible for testosterone formation climbed by almost 70% (In-Young Yoon et al., Neuroscience Letters 2003; 341: 25- 28). Just like depression, the researchers conclude that loss of libido and subdued sex activity – which is known to often accompany depression – can be favorably influenced by bright light. The increase in testosterone may be just a consequence of the increased sex activity and not a direct result of the influence of light.
Phytoandrogens also have an impact on testosterone levels. Phytoandrogens are herbal substances that have a similar effect to androgens. These include the isoflavones, which also have an estrogenic effect (contained in soy, for example), as well as ginseng, nettle root, and oats. There are ready-made products of these. The nettle root is also very suitable for tea.
Milk helps muscles grow: If you want to gain muscle mass during strength training, you should drink milk. This is shown by a study in men who lifted weights for 12 weeks. They were divided into three groups: the first drank low-fat milk after training, the second a soy drink and the third carbohydrate drink. Milk drinkers lost most of their fat – and most of their muscles (Hartmann JW et al, Consumption of fat-free milk after resistance exercise, Am J Clin Nutr. 2007 Aug; 86 (2): 373-8) .
No! Not directly … It is always the result of a testosterone deficiency, which is the prohormone of estrogen in men, ie most of the estrogen in men is generated from his testosterone. If this is too deep, there is also a lack of estrogen. Therapy with estrogens is therefore senseless in men, even dangerous since breast growth and cardiovascular diseases can develop or worsen. You should only ever treat with testosterone!
Is there an androgen deficiency syndrome in women?
Just at a time when the benefits and safety of long-term estrogen administration after menopause are increasingly being questioned (read about it here!), women are increasingly talking about androgen deficiency syndrome. Not only the aging man, so the advocates of the new syndrome plead, but also women after menopause felt in certain cases thanks to the administration of male sex hormones more vital and had a greater sexual resilience. However, the existence of such a syndrome – at least in healthy, older women – is extremely controversial in specialist circles, because the role of androgens in the female organism has been little investigated, and any deficiency symptoms are unspecific and show wide individual fluctuations. Above all, it is extremely difficult to differentiate the symptoms from the expression of an unsatisfactory partnership situation, depression or other illnesses. There are also no large studies
There is an exception here: if you have severe hirsutism (male hair on a woman) and testosterone is over 5, testosterone therapy is the order of the day.
The decrease in sexual desire is just one of the signs of testosterone deficiency in men. Here you can find out when testosterone therapy should be used.
Testosterone is an androgen from the group of sex hormones. The hormone has a variety of functions in the body, such as Dr. Mario Pones, University Clinic for Urology at MedUni Vienna, reported on the MINI MED lecture “Testosterone – The Elixir of Men” in Vienna.
Causes of a testosterone deficiency
Testosterone deficiency can be congenital or acquired. If the problem arises from the testicles, one speaks of primary hypogonadism. On the other hand, if the function of the pituitary gland, which is involved in hormone production, is disturbed, one speaks of secondary hypogonadism. Other reasons for testosterone deficiency include B. burns, opioid abuse, cancer therapies or renal insufficiency.
Testosterone deficiency in old age
With the increasing life expectancy of the population, the spread of a form of androgen deficiency that only appears in later adulthood is becoming more common: late-onset hypogonadism. From the age of 40, the testosterone level in men decreases by about 1 – 2% per year. “Compared to female menopause, however, the decrease in testosterone levels and the associated symptoms are very different individually,” explained Dr. Pones.
Symptoms of a testosterone deficiency
The following symptoms indicate hypogonadism that begins before puberty:
Small testicles
male breast growth (gynecomastia)
High pitched voice
Sparse body / facial hair
Decreased sexual desire
Infertility
Low bone mass
Muscle loss
However, these are signs of late-onset hypogonadism:
Libido loss
Erectile dysfunction
Depressed thoughts
Exhaustion and loss of energy
Low bone mass
Muscle loss
Hot flashes
Loss of body hair
The path to diagnosis
“Unfortunately, there are no uniformly defined limit values as to when one really speaks of a testosterone deficiency,” complained Dr. Pones. Testosterone levels should be measured early in the morning – a single measurement is not enough. However, the blood test only takes place if the man actually experiences symptoms that worsen his quality of life.
Testosterone therapy
The testosterone can in principle be administered in various ways, for example in the form of capsules, as a gel for application to the skin or as a depot syringe under the skin, in which the hormone is gradually released. “Sexual interest can increase after only three weeks, but in many cases, a plateau occurs after six weeks and there is no improvement,” said Dr. Pones. “Changes in erectile function and ejaculation can take up to half a year. Positive effects on the psyche can be achieved within a month, but sometimes it takes longer.”
At first glance, the thing is clear: testosterone increases performance. The fact that men are on average more muscular and physically efficient than women is also due to the fact that they have more testosterone in the body – about a factor of 15 to 20. It is also undisputed that athletes who artificially take in testosterone have an unfair advantage. That is why the hormone is on the doping list. Caster Semenya doesn’t dope, but her body produces more testosterone than most of her competitors. For the World Athletics Association, it is clear that this also gives them an unfair advantage – and two out of three judges in Lausanne also saw it that way. So why the fuss?
In fact, things are much more complicated. Critics sometimes make serious allegations – from a scientific, medical and ethical perspective. The main arguments in detail:
Article section:
1. There are massive doubts about the studies
In a detailed analysis, Roger Pielke, professor at the University of Colorado Boulder, sports scientist Ross Tucker and Oslo cell biologist Erik Boye question the scientific results behind the IAAF rule. They focus primarily on the study that comes with the performance benefits described above.
According to their review, between 17 and 33 percent of the data in this study are incorrect. You will find double-counted athletes – as well as times that cannot be assigned to any athlete. In addition, the authors used times of athletes who had been disqualified for doping. Pielke and his colleagues call for the British Journal of Sports Medicine to withdraw the publication.
That does not happen. But the authors of the criticized work react: in 2018, they published a revised version in which they respond to allegations by Pielke and other researchers. They confirm irregularities in the original version. However, the basic statement on the performance advantages remains in the revised version.
But there are still irregularities, says Roger Pielke, who also deals extensively with the topic in a blog on his website. He sees the case as “the integrity of science at risk”.
In fact, the CAS also sees problems with the evidence, at least for two of the disciplines concerned. The judges see a “lack of evidence” to justify applying the rule to the 1500 meter and one mile routes. The judges recommend that the rule should not be applied to the two disciplines until more evidence is available. However, they leave the decision to the IAAF officials. An IAAF spokesman for the Sports Integrity Initiative website said that the recommendation had been reconsidered and decided to “ignore it”.
For Caster Semenya, who also starts over 1,500 meters, this is further evidence of her assumption that the rule should be tailored especially to her personally.
Other errors discovered
The sports scientist Ross Tucker from the University of Cape Town in South Africa emphasizes further, very fundamental inconsistencies in the online magazine The Science of Sports. For example, he points out that the study is not only flawed but also does not explicitly compare intersex athletes with non-intersex athletes. In fact, the study compares the performance of low and high testosterone athletes. Tucker finds it questionable that on this basis such a far-reaching rule is introduced that explicitly refers to a group of athletes.
Upon request, the IAAF would like to point out data related to the previous “testosterone rule”, which applied from 2011 to 2015. During this time, affected athletes, including Caster Semenya, had to lower their elevated testosterone levels with medication. The data thus provide information about the performance of the athletes before, during and after taking testosterone depressants.
Caster Semenya was slower between 2011 and 2015 than in the years before and after – but during that time she also suffered from a knee injury. The IAAF keeps secret from how many other athletes comparable data are available, to protect the affected athletes. Intimate and medical details should not be made public. However, one of the IAAF studies says that there is a statistical accumulation of athletes with XY chromosomes in the relevant competitions: “7.1 out of 1000 top athletes have increased testosterone values - the majority of them in the disciplines 400 meters to one mile. That’s about 140 times more than the rest of the female population. ”
However, confidentiality only works to a limited extent, as research by the ARD doping office shows. It says: “Research by the ARD doping editorial team has shown that far more athletes are affected than previously suggested by the public discussion limited to Semenya. Out of nine athletes with different sexual development, whose documentation is known by the ARD doping editorial team, five have almost exactly identical hyperandrogenic factors as Semenya. ”
The evidence is questionable
Another aspect that independent scientists stumble upon is the limitation to the distances of 400 meters to one mile. Patrick Diel, biochemist and doping expert at the Cologne Sports University, says: “The testosterone level has an impact especially on routes where strength and speed dominate.” Of course, this also included the 100 and 200 meters.
In this connection, he points to a fundamental problem of the studies. It is hardly possible to completely exclude other influencing factors. In other words, it is hard to prove that testosterone alone is responsible for the differences in performance.
Testosterone alone does not make a world champion. This is shown by the example of the Indian Dutee Chand. Despite hyperandrogenemia, she was eliminated in the run-up to the 2016 Summer Olympics and was almost a second slower than the Olympic champions. And apparently the performance of the other athletes with hyperandrogenemia is not as clear as that of Caster Semenya. At least not so much that they become a public issue.
Despite all the inconsistencies, Diel still finds the decision of the court “understandable” as a scientist. As a doping expert, he knows the importance of the hormone in top-class sport. From the perspective of the competition, it is simply unfair if women are allowed to start with an elevated testosterone level – even if the increase is natural. “If the other women took testosterone to get into Ms. Semenya’s area, they would be banned for doping.”
Article section:
2. Not only hormones offer physical benefits
As stated above, the judges also consider the rule to be discriminatory – but not discriminatory enough. Criticism is also discharged at this point. Nobody would come up with the idea, for example, of restricting body size for basketball players or hand size for swimmers. It is in the nature of the top-class sport that hard training and an iron will are usually not enough – exceptional athletes usually also have the appropriate physical equipment.
That Caster Semenya has an increased level of testosterone in the blood is basically due to her physical equipment. So what’s the difference – why is one regulated, the other not?
The IAAF argues that the integrity of women’s sports should be preserved. The argument relates to the basic separation between competitions for men and competitions for women. It seems logical that men should not compete with women. However, implementation requires that the gender issue in sport has to be clarified, i.e. there has to be a dividing line between males and females. The problem: Biology does not know this dividing line – the transition between typically male and typically female is not sharp, but smooth.
Article section:
3. Hormone therapy carries unnecessary risks
The “testosterone rule” requires that the athletes concerned artificially lower their body’s hormone levels to below 5 nanomoles per liter of blood – permanently. In practical terms, this means that you have to take medication even though you are healthy. The case is clear for medical professionals. Interventions in the hormonal balance have side effects, endanger the health and should only be carried out if there is a medical reason.
According to the IAAF, “normal contraceptives” are enough to lower the hormone level to the required level. Aside from the fact that contraceptives like the pill also have side effects, endocrinologists doubt that this is true. In order to achieve such reductions, special drugs, so-called antiandrogens, are needed. The risks would include depression, anemia, and osteoporosis.
In fact, the World Medical Association (WMA) has commented on the case. Your President, Dr. Leonid Eidelman, has strong ethical reservations about the rule. In a statement on the WMA website, he says: “[The rules] are based on weak evidence from a single study. They also conflict with a number of important WMA ethical statements. That is why we are calling for the rules to be withdrawn immediately. ”
The German chairman of the WMA, Dr. In a conversation with the Australian broadcasting company ABC, Frank-Ulrich Montgomery emphasized that doctors cannot be forced to carry out hormone therapy. He further said: “We urge all our colleagues to defend themselves and to refuse to do so”.
Article section: And now?
And now?
A third competition category?
The situation seems to be going on. Both sides have understandable arguments. Are there any ideas for mediation? Theoretically, a third competition category would come into question, for example, besides women and men, the category Divers. Stéphane Bermon, head of the IAAF science department, told the British Guardian last year that he felt that “it will happen someday, probably in 5 to 10 years”. But he also said: “I also feel that the public is not yet ready for this. We don’t want to stigmatize athletes. ”
It is also unclear whether that would solve the problems. Because the IAAF would still have to determine who falls into which category. It is unlikely that all athletes would agree with the classifications.
Testosterone is the main male sex hormone. It is necessary and responsible for the masculine appearance, for hair and muscle mass, for sperm formation and libido.
They can be admired in the bodybuilding studio: the muscular, men who feel particularly male. Testosterone from the group of androgens, i.e. the male sex hormones, is also a synonym for exaggerated male behavior: for dominant-aggressive macho behavior and for supposedly high sexual activity. In fact, testosterone is also the “fuel of masculinity”, explains Dr. Manfred Ventz, hormone specialist at the Berlin Charité.
“Testosterone is the most important male sex hormone, it is formed in the testes and also in small numbers in the adrenal gland, it is the hormone that is practically necessary for development, that is to say when it is fetish, so that it becomes a male infant at all it plays a vital role during puberty, and later it is there to maintain male habit. ”
Testosterone is necessary and responsible for the male appearance, hair and muscle mass, sperm formation and libido. The hormone also influences drive, stamina, willingness to take risks or competitive behavior. For muscles and bone stability, testosterone also occurs in women, but to a much lesser extent.
“And in women of fertile age this is partly formed in the ovaries, but also in the adrenal glands, so it is converted from precursors, for example in the adipose tissue or in the skin.”
Only a small part of the testosterone circulates freely in the blood and is therefore normally usable. In women, an excess of testosterone in the blood can lead to “masculinization”, which can be seen, for example, in beard growth.
How much testosterone a man needs varies. The amount of hormones fluctuates seasonally and throughout the day – it is highest in the morning. In addition, the testosterone level drops after hard physical work, also as a result of, for example, stress or alcohol consumption.
If the testicles are underactive, called “hypogonadism”, there is a permanent testosterone deficiency. The deficiency can also be caused by various diseases. Doctor Ventz:
“There are congenital diseases, for example when there are no testicles, but the best known is Klinefelter syndrome, which is where the chromosomes XXY are. They have small testicles, and initially, testosterone may be enough, but later there is a testosterone deficiency. But of course, there are also acquired cases: operations after tumors on the testicles or after operations on the inguinal canal, sometimes damage can occur if the testicles do not move into the scrotum at all. ”
The testosterone deficiency leads to a “feminization” of the affected men: they develop a female-looking breast, have no male hair, muscles and bone structure become weaker. However, disease-related deficiency of this hormone is rare overall.
However, “quite normal” is that testosterone levels decrease with age. Some doctors speak of the Climacterium virile – of male menopause. The term is controversial because the testosterone breakdown differs from the female climacteric. Professor Wolfgang Harth, dermatologist and head of the center for men’s medicine at the Vivantes Clinic Berlin-Spandau:
“From the age of 40, testosterone decreases continuously by one to one and a half percent a year. It is not like overnight with women that these hormone changes lead to menopausal symptoms, for men it is a slow process. ”
Nevertheless, this can also lead to massive health problems in men, mostly from the age of 60.
“Frequent need for sleep or that you can no longer get going in the morning, have a profuse sweating, up to psychological changes: irritability, mood swings, depression, or that you suddenly become anxious, and of course sexual disorders, there First and foremost is the loss of pleasure, loss of potency, a multitude of complaints, which must be discussed individually with the patient and doctor. “
Only if signs of illness and measured low testosterone levels occur together, hormone replacement therapy may be considered. Artificial testosterone is often offered for sale as “anti-aging” and potency aid, is required by older men of creation, and is uncritically prescribed by some doctors. Certain underlying diseases, especially the adrenal glands, must be excluded beforehand. If the substitution really makes sense, you should proceed step by step, says the dermatologist and andrologist – “male doctor” – Professor Harth:
“What you can do is that you usually start with short-term replacement therapies, i.e. the gel form, because if side effects should occur, you only have side effects for a short time, and if this initial phase has been successfully completed, you can also take injections change, which must first be given after six weeks, later only every three to four months. ”
But here too, there is no effect without side effects, says the Charité hormone expert Doctor Manfred Ventz.
“Testosterone was sometimes traded as a fountain of youth, but there are also side effects. For example, especially in the elderly, when there are cells that develop into prostate cancer, you can stimulate them, including prostate hyperplasia, which means enlargement. ”
In addition to prostate cancer, damage to the heart and blood vessels or mental illnesses can also result from unduly medically undisclosed excessive testosterone intake. Precise weighing is therefore necessary.
The greatest risk to health, however, is taking testosterone as an anabolic steroid, as a muscle-building supplement in all kinds of sports and in bodybuilding. There seems to be no problem getting something like this on the black market. And the risk of excessive dosing is particularly high here.
“So there are a large number of men who take this to achieve increased performance and muscle building. And this too much testosterone can have an impact on the psyche, i.e. making it more aggressive, for example, or increasing libido in the beginning, but this usually adjusts again in the area of the psyche and this excess remains in the area of body. ”
anabolic-doping is therefore permanently dangerous, Professor Wolfgang Harth, Director emphasized the center for Men medicine at Vivantes Klinikum Berlin-Spandau.
“This means that too much blood is created, for example. Muscles may continue to grow so excessively that there are problems with the heart muscles, and we have always had reports that competitive athletes who did doping died very early. In young men, this leads to a limitation in the number of sperm. “
With age, testosterone levels drop in every man. | Image: The first
According to the menopause in women, it is now said that men are also affected by a so-called “andropause”. These “menopause of men” are said to happen to men between the ages of 40 and 65. Complete nonsense! – say experts and professional society.
Business model testosterone
Testosterone – careless use can be dangerous. | Image: The first
But dealing with the supposed problem is about a lot of money. Testosterone preparations are prescribed to treat symptoms such as lack of energy and weakness. Sales increased noticeably, last year pharmacies in Germany sold over 500,000 packs of various testosterone preparations, 55 percent more than in 2007, according to a BR-Data research.
What testosterone levels are normal?
The testosterone level is measured in nanomoles per liter.
At over 12 nanomoles per liter, one speaks of the normal range.
Between 8 and 12 nanomoles per liter is called the limit range.
A pathological deficiency is only present below 8 nanomoles.
Danger from testosterone
If there is no pathological deficiency, the administration of testosterone is dangerous.
There can be a dependency on the drug because your own body produces less and less of the hormone.
Cancer of the prostate has to be excluded. Testosterone would speed up the course of the disease.
Trial with a test patient
A thorough examination is imperative when prescribing testosterone. | Image: The first
In the “health check” a test patient is sent to various doctors. Who prescribes the hormone when there is no pathological finding? The test patient received a prescription three times after a single test of his testosterone level. He felt insufficiently informed about the risks and side effects of the preparations. But above all, its values should have been determined a second time before a prescription was issued.
Earn money with testosterone?
Prof. Dr. med. Oliver Hakenberg from the German Society of Urology has a critical assessment of our test patient’s visits to the doctor: “The sample you made has now shown that some are very quick with testosterone therapy at hand, without it really being necessary. And then of course the question arises whether monetary aspects may also play a role with these doctors.
Men over 40 years of age can suffer from age-related complaints such as sleep disorders, mood swings, erectile dysfunction, and declining sex drive. Hormone therapy with artificial testosterone is often prescribed for menopause. But doctors warn of possible side effects.
Testosterone controls the sex drive
Testosterone is the main male sex hormone. It is mainly formed in the testicles. The main functions:
During puberty, the hormone ensures the development of the genital organs. It controls sperm production and sex drive.
Testosterone promotes the growth of body and whiskers, but not the scalp.
Testosterone is beneficial for muscle building.
A high testosterone level increases sexual desire (libido) as well as drive, endurance, and zest for life, but also dominant and aggressive behavior.
What is the normal testosterone level?
The concentration of testosterone in the blood in adult men is between 2.4 and 8.3 micrograms per liter. In the evening, the testosterone level is about 20 percent lower than in the morning. Around the age of 40, the testosterone level drops by one to two percent annually. Most of the time this has no noticeable effects so that hormone deficiency does not usually have to be treated. For symptoms and clinical suspicion, a hormone test is a cash benefit.
With testosterone deficiency, hormone therapy can be useful. However, side effects can occur at higher doses. Prof. Sven Diederich answered questions on the topic.more
Causes of hormone deficiency
Only three to five percent of men over 60 suffer from testosterone deficiency (hypogonadism) that requires treatment. Possible causes are
stress
Overweight
Alcohol and drug use
Tumors of the testicle or pituitary gland
Hormone therapy with gel or syringes
In the case of a pathological testosterone deficiency, many doctors consider hormone therapy to be useful. The administration of testosterone gels or depot injections can support the health and well-being of the patient. Some doctors are convinced that testosterone helps you lose weight and has a positive effect on blood sugar levels in diabetes. However, testosterone must not be used for concomitant diseases such as prostate cancer and heart diseases.
Serious side effects possible
But the higher the dose, the greater the risk of undesirable side effects such as aggression, liver damage, infertility, heart attack, and stroke. Deaths from testosterone therapies are also known. The natural variant is safer: through targeted exercise, the body produces up to 30 percent more of its own testosterone.
Sleep disorders, fatigue, loss of muscle strength, erectile dysfunction and less desire for sex – men also have symptoms if they exceed 50. Do they also go into menopause? And does the gift of testosterone, the “king hormone of men” help them? Promises of advertising and research results diverge widely as to the consequences of additional testosterone use. Why testosterone is not a lifestyle drug, what a real testosterone deficiency means and how men can run away from the supposed menopausal symptoms, explains Thomas Ebel, a doctor in the AOK federal association.
Testosterone increases joie de vivre and activity! Regulates muscle building and mental fitness! It provides more lust and masculinity! The market for the male hormone testosterone is booming. If you believe the advertising promise, the remedy seems to be a true fountain of youth for men over 50 and successfully fights aging problems such as sleep disorders, fatigue, loss of muscle strength, erectile dysfunction and less desire for sex. In the United States, the number of testosterone users has doubled within three years. There the phenomenon is marketed under the term “Low T”, so-called Low-T centers have specialized in the testosterone treatment of older men. The number of prescriptions for testosterone preparations is also increasing in Germany: According to the Medicinal Products Ordinance Report 2019, the volume of prescriptions has almost quadrupled since 2004.
Radio-ready sound broadcasts with Thomas Ebel, a doctor in the AOK federal association
Not proven that testosterone helps with age problems
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Risks outweigh the benefits
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A new clinical picture was created: menopause. Also called andropause, climacteric virile, aging male syndrome or simply hormone low in men. “But menopause, like that of women, does not exist in men,” emphasizes Thomas Ebel, a doctor in the AOK federal association. “And there is no evidence of the benefits of testosterone supplements for aging disorders.”
Normal aging process
In contrast to women, in whom the sex hormones drop abruptly with the last menstrual period, testosterone formation in men gradually decreases: from around 30 years of age by one to two percent per year, “This is a normal aging process and most men feel nothing of it,” says medical doctor Ebel. The non-specific complaints such as reduced performance, sleep problems or loss of libido can have many causes and can be attributed to stress or to diseases such as cardiovascular diseases or thyroid disorders. In addition, men with fairly low testosterone levels often have no symptoms and, conversely, men with normal levels suffer from such symptoms. In short: There is no scientifically proven causal link between certain complaints and low testosterone levels. The effects of hormone preparations – as capsules, syringes, plasters, gels or solutions for application to the skin – have not yet been proven. So far, studies have not shown
RUNNING GO RUNNING VALUE
If a man has no discomfort, determining testosterone doesn’t make sense.
With severe complaints and low testosterone levels, testosterone agents may be considered – but only under medical control. However, it should be borne in mind that there are no generally applicable testosterone limits and there are no long-term studies on the benefits and risks of the preparations.
A healthy lifestyle is the best anti-aging remedy, i.e. avoiding nicotine and excessive alcohol consumption, healthy eating, lots of exercises and good stress management.
These measures may also help to control erectile dysfunction, which is mainly due to constricted blood vessels and not due to a lack of hormones.
Many side effects
Instead, users have to expect side effects such as the risk of thrombosis, increased blood lipid levels, headaches, prostate problems, breast swelling, mood swings or high blood pressure. Because the relationship between benefits and risks has so far been negative, testosterone preparations in Europe are not approved for basically healthy older men, emphasizes the European Medicines Agency ( EMA ). The situation is different with an unusually low testosterone level, so-called hypogonadism, which affects normal sexual function and development. “A testosterone deficiency in need of treatment can occur, for example, in diseases of the testicle or a tumor in the pituitary gland, “says Ebel. However, other symptoms then also become noticeable, such as the testicles shrinking, the beard not growing strongly or the muscle mass shrinking despite sufficient movement and the body fat increasing.
A healthy lifestyle can relieve symptoms
If these special diseases are not present, sporting activity counteracts shrinking muscles and increasing body fat. In addition, exercise and a healthy lifestyle, in general, can usually relieve other complaints. Incidentally, the testosterone level could also rise. Because men who live healthily often have higher testosterone levels than men who do not pay attention to their health.
The older you get, the less your body produces the important sex hormone testosterone. Unhealthy habits also decrease testosterone levels. With a healthy lifestyle and important nutrients, you can naturally increase your testosterone levels!
The hormone testosterone turns an embryo into a full-blown human being: in girls and boys, it stimulates the growth of muscles and bones right from the start. Already in the womb, it forms the male sexual organs. In puberty, boys’ voices become deeper and hair sprouts all over their bodies.
But from the age of 30, the development turns around: Now the testosterone level drops again. How quickly this happens depends on your lifestyle and possible illnesses. This development is normal – but sometimes it happens too quickly. And then there are health problems.
Find out in this article what causes a testosterone deficiency and how you can remedy it naturally!
Men have an average of ten times more testosterone than women. But the hormone fulfills important tasks in both sexes.
What is testosterone?
Testosterone is one of the most important male sex hormones, androgens. In men, the testes make up 90 percent of the total testosterone, while in women the ovaries produce the majority. Small amounts arise in the adrenal cortex. In the body, testosterone has an anabolic (anabolic) effect: It builds primarily muscle mass.
Testosterone also participates in the following processes [1] :
Training of sexual characteristics, body hair
Sperm production in men
Increase in libido
Bone stability and growth
Blood formation
Testosterone deficiency
20 to 40 percent of all men have low testosterone values from the age of 40. Many of the men affected only notice this when the first complications of testosterone deficiency appear [2] .
What are the causes of a testosterone deficiency?
In addition to increasing age, illnesses or changing living conditions can lower testosterone levels – both for men and women. Possible causes of a testosterone deficiency are [1] :
Overweight, underweight
Constant stress, long-endurance training
Anabolic, alcohol, drug abuse
Cirrhosis of the liver, hypogonadism
Long-term medication with cortisone, birth control pill
Above all, obesity is a clear risk factor for testosterone deficiency. Studies have repeatedly shown that men have remarkably low testosterone levels in old age if they are clearly overweight.
Good to know: A testosterone deficiency can also occur in men under the age of 30. Elevated cholesterol levels, hypertension, and obesity increase the risk of early testosterone deficiency.
What is hypogonadism?
Hypogonadism describes an underactive testicles and ovaries. The gonads produce few to no hormones – the production of testosterone is also restricted. Older people are most often affected. This disease can be congenital or caused by an excess of iron.
What are anabolic steroids?
Anabolic steroids are substances that accelerate growth processes in the body: Among other things, they allow the muscles to grow many times faster. Athletes or hobby athletes, especially strength athletes, use anabolic steroids to build up more muscle mass. Doping with anabolic steroids has been officially banned at the Olympic Games since 1974.
Did you know that no substance has been detected more often than anabolic steroids in doping controls? Hobby strength athletes also always use doping drugs.
Abuse of anabolic steroids reduces testosterone production. In men, they can reduce sperm count and shrink testicles. Women, on the other hand, have to deal with heavy body hair and cycle disorders. In extreme cases, enlargement of the heart and calcification of the arteries can occur.
What are the symptoms of a testosterone deficiency?
It lacks the body of testosterone can build processes do not run properly: The bone mass decreases and muscle strength decreases. Men also suffer from erectile dysfunction and infertility.
Other symptoms are [6] :
Depressive moods
hair loss
Anemia
Increased blood sugar levels
Weight gain on the abdomen
Therapy for a testosterone deficiency
If there are underlying diseases such as cirrhosis of the liver or hypogonadism that lower the testosterone level, they must be treated with medication. If you’re struggling with changing living conditions, you can increase your testosterone level naturally.
How can I increase my testosterone level?
Try to reduce the stress in your everyday life: The stress hormone cortisol is the counterpart of testosterone and suppresses its production. Low cortisol levels usually mean higher testosterone levels. Relaxation techniques and adequate sleep lower your cortisol level.
It also helps you lose weight if you are overweight and avoid alcohol and nicotine in everyday life. The more fat there is, the less testosterone can be found in the body. If you are overweight, the adipose tissue is inflamed and it increasingly forms the aromatase enzyme, which breaks down testosterone.
Nicotine and alcohol can inhibit educational sites from producing testosterone. In addition to weight loss, alcohol withdrawal, and stopping smoking, exercise can help to increase testosterone levels: in contrast to long endurance sessions, strength training can boost testosterone production.
What nutrients increase my testosterone level?
If you lack certain nutrients, the body may reduce testosterone production. If there is also a nutritional deficiency, you can stimulate testosterone production by compensating for the deficiency with a diet change or nutritional supplements. The following nutrients are related to testosterone [12–15] :
nutrient
Occurrence
Vitamin D
Sunlight, cold water fish, food supplements
magnesium
Whole grains, mineral water, legumes
selenium
Brazil nuts, wheat bran, soybeans, chicken egg
zinc
Legumes, wheat germ, nuts, cheese
Dietary fiber and testosterone deficiency
carbohydrates raise our blood sugar levels . In order to lower the blood sugar again, our pancreas then releases the hormone insulin. If the insulin level rises sharply because of this, this can lead to a drop in the testosterone level. Therefore, you should only consume food in bulk if you have low testosterone if you have a high blood sugar level. These include white sugar, white bread, fruit juices, and sweets.
Better for your testosterone are the so-called complex carbohydrates, the fiber. They only raise the blood sugar level slowly. Accordingly, the body makes little insulin. These carbohydrates can be found in whole grains, legumes, fruits, and vegetables.
Can I supplement testosterone?
Only use dietary supplements or medicines with testosterone if you have consulted your doctor. Taking testosterone without a diagnosed deficiency favors an excess of testosterone. Too much testosterone increases the risk of stroke, acne and hair loss [3,17] .
Ashwaghanda and Maca for Testosterone Deficiency
Supplements manufacturers advertise that natural products such as the extracts of Ashwaghanda or Maca root can be used to increase testosterone levels. However, a 2019 study by the American Journal of Men’s Health found that Ashwaghanda has very little impact on testosterone levels. Therefore, further research is needed. Scientists have found similar results in maca.
Excess testosterone
Testosterone levels may be elevated in men and women in rare cases if testosterone is given in the form of tablets or syringes or if there is an adrenal tumor. Cushing’s disease, a disease with high cortisol levels, can also cause an excess of testosterone. In women, ovarian cysts and tumors and a congenital disorder of hormone formation in the adrenal cortex, and in men testicular tumors active, can increase testosterone levels [20] .
Testosterone test
From the age of 30, it is recommended, especially for men, to have the testosterone level determined. The body’s own production decreases with age, some faster, some slower. The female sex cannot be spared from a testosterone deficiency either. A lack of male sex hormones can also trigger specific complaints in women.
What is a testosterone test?
A testosterone test is used to determine your current testosterone level. The hormone can be measured in the blood or saliva. A saliva test is useful because it can determine the free, active form of testosterone. The active testosterone works throughout the body – in contrast to the bound testosterone, which can be examined by a blood test.
Good to know: You can have your testosterone level determined by a urologist, endocrinologist or andrologist or with a self-test for at home.
The cerascreen® testosterone test
The cerascreen® testosterone test is suitable for both men and women. The test measures the active form of testosterone in your saliva. In your test kit you will find the necessary equipment for the test. To determine your testosterone level, you only need to fill three saliva tubes with small amounts of your saliva after getting up. The samples are sent to our certified laboratory . After the evaluation you will receive a result report with detailed information and recommendations for action.
Testosterone and hair loss
In some cases, the scalp is sensitive to testosterone – more specifically, to the breakdown product dihydrotestosterone. The prostate, the male sex organ, converts testosterone into dihydrotestosterone. Many people have the genetic predisposition that their hair roots on the scalp react sensitively to this breakdown product. Contact with dihydrotestosterone causes the scalp hair to fall out. Important to know: Both a low and a high testosterone level can promote hair loss if the scalp reacts strongly to the dihydrotestosterone.
Good to know: In women, the so-called paraurethral glands convert testosterone to dihydrotestosterone. These glands are also called female prostates.
At a glance: testosterone
What is testosterone?
Testosterone is considered the male sex hormone and also occurs in small amounts in women. It is formed in large quantities, especially during puberty. It is responsible for building muscle and bones, for training male sexual characteristics and for sperm formation.
What are the causes of a testosterone deficiency?
Testosterone production decreases from the age of 30. Illness, obesity, and drug abuse can increase the risk of deficiency.
How do I treat a testosterone deficiency?
You can normalize your level through medication, exercise, weight loss, and a balanced diet. Important nutrients for testosterone are fiber, magnesium, zinc, selenium and vitamin D.
Testosterone is the ultimate male hormone. The Leipzig urologist Dr. Tom Kempe explains what role it plays, how testosterone deficiency affects it, how it is treated and why a big belly can lower testosterone levels.
The main thing is healthy: what does testosterone do?
Dr. Tom Kempe: Testosterone is a very important hormone in the male metabolism. It does a lot of things. It is important for the muscle metabolism and for the bone metabolism, for the psyche, of course for the sexual function, but also for the blood composition and the immune system, i.e. for many functions all over the body. In short: it turns man into a man.
What happens if it is missing?
The typical things we see in the clinic are men with depression, with pre-diabetes or diabetes, fatigue, bone problems, muscle weakness, and sexual dysfunction.
What is the typical age for these symptoms to appear?
It is very diverse. There are many causes. It is also often not clear why. This occurs in young men, but also – let’s call it that – during the menopause, i.e. between the ages of 50 and 60.
Can you say how often men go to the doctor about these symptoms?
Men generally don’t like going to the doctor. So I see maybe five to six patients a week with such complaints, who either address this directly or come for something else and then say on the way out, by the way, I wanted to ask something quickly and that may have been the reason why they came here are.
Why do men find it so difficult?
We are so attracted to it, I think. That men are Indians and brave and if the head is not under the arm, then we men do not go to the doctor. That makes up a good part of the causes, which is why our life expectancy is a whole lot lower than that of women who are accustomed to go to the gynecologist regularly from adolescence.
When does a testosterone deficiency need treatment?
The funny thing is that in men it is not so much about the numerical value, but rather about the complaints. In any case, I would only treat if there is a feeling of suffering and, of course, this includes determining the testosterone in the blood. A value of about 10 is the normal value. There are men who are worth 8 and have significant problems. But there are also men who have a value of 3 and are completely symptom-free. I wouldn’t prescribe anything there either.
What are the common treatment options for testosterone deficiency?
Either a gel is prescribed. This is the variant that I usually prefer for my patients. Syringe therapy would be an alternative. If the findings are serious, if the deficiency is severe, or if you have a congenital testosterone deficiency, you would be more likely to go for a syringe treatment. These are depot syringes that have to be administered every three months. But they sometimes cause large fluctuations in the hormone level, so that a high dose “floods” first and then towards the end of the three months, the patients have almost withdrawal symptoms. This is much more balanced and has fewer side effects with the gel, which is administered daily through the skin in a small dose.
What are the side effects of testosterone substitution?
The prostate comes first. We regularly check the PSA level and make sure that no undetected prostate cancer develops, which might be forced by the hormone. Then it affects the composition of the blood components, the risk of thrombosis increases a little.
Can you influence your testosterone level without medication?
Of course, you can and I would recommend that in the first place. Healthy eating and exercise are important to keep the abdominal circumference at bay. This is because adipose tissue produces estrogens from testosterone. And that reduces testosterone levels.
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