He's a guy. They don't talk, they fight. It's all that crazy testosterone.- Kim Cattrall as Samantha Jones on Sex in the City
If testosterone is responsible for all of the negative behaviors among men, wouldn't that mean that men with lower levels are healthier than those with normal or high levels of testosterone?
Most people know that testosterone (T) is responsible for sexual development in men and is important for libido and sexual function. However hormones, by definition, have effects throughout the body. There are testosterone receptors in nearly all tissues in the body, so this primary male hormone impacts nearly every organ system. We know that testosterone impacts hair growth in some areas (face, chest) and loss in others (scalp). It is also especially important in muscle and bone growth, impacts cardiac function and affects the central nervous system. Truth be told, it is linked to behaviors such as aggression, risk-taking and territoriality.
As a counter-point, the central nervous system effects of testosterone are not all negative. Testosterone has positive effects on mood, energy levels, feelings of well-being and vitality. Low T is associated with depression and with poor brain function on tests of memory and comprehension. Testosterone also has been shown to be an important anti-oxidant, protecting nerve cells against oxidative damage. In fact, low levels may make diseases like Alzheimer's worse.
Most testosterone is produced in the testes with stimulation from hormones secreted by the hypothalamus (GnRH) and pituitary glands (LH). The adrenal gland also produces some testosterone as well as other androgens (male hormones) such as DHEA. These other androgens are also important for libido and energy.
More and more, we are finding low T in our male patients. This does not appear to be only because we are checking levels more often. A large study showed that average T levels have fallen from 1987 to 2007. Among 1,532 randomly selected men at three time periods between those years, there was a slow, steady decline in T levels such that a 65 year old in 2007 had 15 percent lower T than a 65-year-old in 1987 -- even correcting for being over weight or smoking.
Low testosterone may be caused by diseases of the hypothalamus, pituitary gland or testicles. Usually, however, low levels are the result of a natural decline with age (after the age of 40 or so) and/or lifestyle factors such as stress, physical inactivity, chronic illness, poor sleep or substance abuse (including tobacco and alcohol). To some degree this decrease in testosterone due to stress is evolutionary. The body's production of sex hormones is exquisitely sensitive to stress - be it physical or emotional. Testosterone in men drops in the face of chronic stress or anxiety, partly because the primal role of the sex hormone system is to drive reproduction. If the body senses an inability to care for itself, the last thing it wants is to produce a child needing to be taken care of in the face of such external stress. This system can't differentiate attack by tigers from the daily grind in an unhappy job - it is all translated chemically in the body and ends in low testosterone production.
Coming back to the initial question - is it better for men to have low T so that they will talk more and fight less? Unfortunately, such a trade-off has its cost.
Cardiovascular disease is the number one killer in men in the United States. Men with subnormal T levels have higher cholesterol and an increased risk of diabetes, both of which are significant risk factors for heart disease. Obesity also increases the risk for diabetes and heart disease, and men with low T have more body fat. In fact, the obesity-low T link manifests as a vicious cycle. Body fat causes an increase in the conversion of testosterone into estrogen - yes, men have estrogen. In fact, a 50-year-old man has, on average, more estrogen than a post-menopausal 50-year-old woman. The more T that gets converted, the lower is the ratio of testosterone to estrogen and the more muscle mass is lost and fat is gained. This gets to be self-perpetuating.
So, it appears that while testosterone is associated with riskier health behaviors, low T is associated with serious diseases like osteoporosis, Alzheimer's, depression, diabetes and heart disease. Therefore it is unhealthy to leave low T untreated. While elevating levels of T above physiologic levels, as is done by some body builders and athletes, has been associated with enlarged hearts (cardiomyopathy) and higher risk of heart attacks, high blood pressure and stroke, replacing low testosterone to achieve normal values has not been associated with such negative outcomes.
Men over 40 should have their levels of testosterone checked regularly, especially if they are experiencing any of the symptoms listed above. That level may be as important to overall health as cholesterol number or blood pressure. There are many proven ways to treat low T, under a doctor's supervision. Testosterone may make us fight more and talk less, but it also keeps us going in many healthy ways.
Follow Myles Spar, M.D. on Twitter: www.twitter.com/drspar
David Katz, M.D.: The Biological Basis for Behaving Badly: Why DNA Should Not Be Destiny
Jeffry Life, M.D., Ph.D.: The Truth About Low Testosterone -- And What To Do About It
Imagine the uproar over an article that dared mention negatively estrogen in broad strokes: the week of nuttiness it causes periodically (pun intended) for about 30 years, followed by a few *years* of nuttiness for menopause transition -- even if it the article went on to focus on its critical role an ddefend it (and by extension femininity).
You all know damned well what I'm talking about.
But an article that accepts man bashing as a premise is great.
Testosterone decline is a normal part of aging . Extremely low testosterone may require HRT. Weight lifting is a normal testosterone booster, men who regularly strength train are likely to keep their testosterone levels high. It's even possible to become more fit than when one was younger and less active.
-healthy_blogging
Published daily, "Living Fit, Healthy and Happy" is a family-friendly health and wellness resource website with articles on fitness, anti-aging, obesity, diabetes, eating disorders, cardiovascular and respiratory health, mental illness and many other health related issues. There's always something for you at "Living Fit, Healthy and Happy".
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Her point, based on cell-by-cell biology, is that men are not the one-dimensional stick figures we are made out to be by popular culture. This common wisdom that the solution to the "man problem" is that we become more like women is just not based in any scientific understanding of the brain or the role of Testosterone as you so accurately point out.
The real point is to understand men's biology more fully and, in conjunction with efforts like our Good Men Project (www.goodmenproject.org), help guys be *better* men not more like women.
Most of the wars and trouble in the world are caused by testosterone influenced thinking. T is a powerful drug, I know, I have tried it. I can't imagine what it would be like to have my blood flooded with it 24/7 as men do. It would drive you nuts.
healthy_blogging
Published daily, "Living Fit, Healthy and Happy" is a family-friendly health and wellness resource website with articles on fitness, anti-aging, obesity, diabetes, eating disorders, cardiovascular and respiratory health, mental illness and many other health related issues. There's always something for you at "Living Fit, Healthy and Happy".
http://www.livingfithealthyandhappy.com
Don't misunderstand, as I love men, with or without T.
Why do you have to ruin everything with facts and reasoned analysis?
I am a post menopausal woman who has fought osteoporosis (severe) for the past ten years. I tried the usual Fosamax and had to stop abruptly about two years in due to erosion of the cardiac valve (at the upper end of my stomach).
About three years ago, with my lumbar spine at fracture level, I hunted in desperation for a solution. Found an endocrinologist that offers hormone tx. that has added density to my bones each year. This is a recognized treatment in the UK, Canada, Australia and much of Europe.....but not here. The hormones used are natural and Big Pharma can't make a bundle out of those so it is not an "accepted" treatment in this country.
I take two types of testerone and a tiny touch of estrogen intramuscularly every ten days. But, now I have hope. Men are not the only ones that need testerone to be healthy. It is keeping me from spontaneous fractures and has for three years now. My doctor is getting to a good age and I am worried about what is going to happen to me when he is gone. I am very concerned that Big Pharma, the AMA and FDA are going to end up putting me into a wheelchair before my time is up.
and they are left even more energetically depleted than they would be by the disease itself.
Over four years my endocrine system recovered enough that I am weaned off supplemental testosterone completely, and take only a tiny amount of DHEA. I'm post-menopausal now, and require continued estrogen/progesterone supplementation.
I would never take or apply any supplemental hormones other than bio-identical hormones. For those who have had problems with T levels, try finding a doc, NP, or PA that specializes in endocrine systems. Research the issue also. I don't know if this would help or not, but take your health into your own hands.
It might be hard for males. It's hard enough for females, as more than one endocrinologist and internist have told me that s/he doesn't trust compounding pharmacies that make bioidentical hormones. My internist and I have agreed to disagree. On this subject, I trust my expert NP, who has been prescribing bioidenticals for 30 years, more than I trust my internist (female) or the head of my university hospital's head of reproductive endocrinology (wholly patronizing male).
I researched the subject extensively--mostly online, talked with numerous friends I trust, and am confident in my decision. I urge everyone to do the same.
But if it's too low, replacement therapy is the only answer. Instead of gels, a simple once a week injection is easier and cheaper, though some people have a pathological fear of needles. But it's just a tiny pinch.