Op-ed: Straight-up talk about testosterone

DR. SALVATORE J. GIORGIANNI AND DR. STEPHEN M. GIORGIANNI

It’s almost impossible to turn on the TV or open a newspaper (or website) without hearing about testosterone deficiency in men. We’re barraged with information that ranges from scientifically correct concerns about a very real medical condition, to completely unsubstantiated claims about “miracle” supplements that promise to do everything from improving a man’s mood and sex drive to giving him a body that would rival that of his favorite action hero. On the other hand, clinicians (and, in some cases, the FDA) are concerned about overuse of testosterone treatments, the effects of testosterone supplements on men and boys who don’t have a testosterone problem, and the overall value and safety of these treatments.

Men and boys are wise to be concerned about their testosterone levels, and health policymakers are right to be concerned about inappropriate uses and practices. But with all the contradictory — and sometimes alarmist — information out there, many men and boys are scared away or feel uncomfortable about getting the help they need.

Testosterone is a naturally produced essential hormone found in both males and females but at differing levels.

Testosterone plays a very important role in healthy sexuality and can influence sexual desire and performance for both men and women. But testosterone’s importance goes far beyond the bedroom; it’s also involved in regulating mood, energy level, muscle mass and strength, bone density, fat distribution, red blood cell production, and in maintaining intellectual and cognitive levels for both male and females.

As with other naturally produced hormones such as insulin and adrenalin, a certain base level of testosterone is essential to keep the body and mind healthy. When testosterone levels are too low, they can produce very real symptoms in men and boys of any age. These include depression, constantly feeling tired even after rest and sleep, loss of strength and muscle tone (or in the case of younger males, inability to develop age-normal muscle structures), being unable to lose excess body fat — especially around the belly — even with a proper diet and exercise, forgetfulness, trouble concentrating, loss of body hair, inappropriate breast development, and yes, decreased sex drive and erectile dysfunction. These symptoms are not imaginary and they can often indicate the presence of serious medical problems.

The most important thing a boy or man who suspects he may have abnormally low testosterone levels can do is to get tested by a professional. No website, news report, television or internet ad, or recommendation from a friend can replace an actual blood test and a hands-on check-up by a healthcare practitioner who is knowledgeable about overall male health.

The goal of any rational, healthy and appropriate hormone replacement therapy is to restore key body functions to normal and to keep hormone levels in the appropriate range. We receive thousands of requests for low-testosterone-related advice at www.menshealthnetwork.org and we recommend to boys, men, and those who care for them to skip the slick commercials, wild claims, airbrushed before-and-after pictures, and avoid anyone who makes a “diagnosis” of low testosterone or prescribes a “treatment” based on anything less than a medical exam.

Instead, find a skilled health practitioner who takes a comprehensive approach to male health and wellness across the lifespan. The ideal provider will:

• Document in an age- and health-status-adjusted way whether testosterone levels are below the normal range for the patient
• Do valid diagnostics to identify why these levels are below the norm
• Create a multi-component treatment strategy to treat the underlying cause and safely and gently restore testosterone to the optimal level for the patient
• Provide medically appropriate strategies to address long-term hormonal wellness
• Use a comprehensive approach to male wellness across the life span.

So, if you’re feeling down and out, or something’s just not quite right, find a healthcare provider and Get It Checked. And visit the Men’s Health Resource Center for more information about the health and well-being of men and boys.

Salvatore J. Giorgianni, PharmD, is the Science Advisor to the Men’s Health Network, and the Chair of the American Public Health Association Men’s Health Caucus.

Stephen M. Giorgianni, DO, is a Board Certified Family Physician practicing in Melbourne, Fla., and is a member of the Board of Advisors of Men’s Health Network.

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