MONDAY, Aug. 5 (HealthScoutNews) --
You're a middle-age guy who can still spot your 40th birthday in the
rear-view mirror without having to squint through your new glasses.
However, you can't quite shake the
nagging suspicion that your performance is starting to slip -- in the
boardroom, the bedroom, or the sports field.
The problem may be low testosterone
levels. And a simple 10-part questionnaire could help determine whether
testosterone replacement therapy is the way to put that spring back into your
Lack of energy, depression, decreased
work and sports performance, falling asleep after dinner, muscle loss, fat
gain, low libido, weak erections -- these are just some of the symptoms of
low testosterone levels, also referred to as andropause.
It's a common problem. The U.S. Food
and Drug Administration estimates that 4 million to 5 million American men
suffer from low testosterone, but only about 5 percent receive treatment.
The Androgen Deficiency in Aging Men
(ADAM) questionnaire could improve those treatment numbers by helping men 40
and older recognize the signs of testosterone decline, a slow process that
can occur over 10 to 15 years.
The questionnaire was developed by
gerontology professor Dr. John Morley, director of the geriatric medicine
division at St. Louis University School of Medicine.
"We used to say, 'You're getting
old.' Well, now we know you're getting old because your male hormones are
going down, and replacement of your male hormones may make you feel younger
and be more active and more effective," Morley says.
It would be far too expensive to do
regular hormone tests on all men over 40. So, the questionnaire is a cheap,
effective screening tool to educate and encourage men to talk with their
doctors about low testosterone.
If a man's answers to the 10 questions
show a potential problem, his doctor can then do a hormone test to check the
If there's a deficiency, the man may
need testosterone replacement therapy, which can offer a major improvement in
the quality of his life, Morley says.
At least 70 percent of men who have
testosterone replacement therapy get relief from their symptoms, and almost
every man will have an increase in his muscle mass and perhaps in his bone
mineral density, Morley says.
"It's very effective. You can
normalize testosterone levels," says Dr. Richard F. Spark, director of
Beth Israel Deaconess Medical Center's Steroid Research Lab in Boston.
Some compare low testosterone in men to
menopause in women, but Spark says that's somewhat misleading.
"There is nothing dramatic that
happens in men, like the hot flashes occurring in women that signal that
there's some disruption in hormone production," says Sparks, who's also
the author of Sexual Health for Men: The Complete Guide.
While women experience an abrupt
decline in estrogen production, men have a gradual ebbing of testosterone.
Many men on testosterone treatment feel
stronger, more confident, have an improved sense of well-being and are more
effective at work, Spark says.
In the United States, testosterone
replacement therapy is done three ways -- with injections, skin patches or
skin gel. Injections are administered every two weeks; the patches and gel
need to be applied every day.
It's also a lifetime commitment.
"If they want to keep their
testosterone levels increased, they will have to do this for the rest of
their lives," Spark says.
He cautions that testosterone therapy
isn't a fountain of youth. If you're 60 years old, it won't restore your buff
21-year-old physique -- if you ever really had one.
"There are other men who are
expecting too much from the treatment, and are disappointed when they don't
get the results that they fantasize about," Spark says.
As for side effects, "the major
concern has always been whether testosterone supplementation would put a man
at greater risk for developing prostate cancer than men who haven't received
testosterone supplementation," Spark says.
"But there's really no evidence
that testosterone supplementation puts a man at greater risk for developing
prostate cancer than another man his age who has the same testosterone level
normally and is not taking testosterone supplements," Spark adds.
Some men receiving testosterone
treatment also need to have their red blood cell count monitored. The therapy
can sometimes elevate red blood cell counts to dangerously high levels, and
could increase the risk of stroke. In those cases, the testosterone treatment
should be stopped, Spark says.
If you answer "yes" to
questions one through seven, or "yes" to three or more questions,
Morley suggests you make an appointment with your doctor to discuss the