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Men's Clinic in Singapore (Caring & Treating Since 2005)

Hypogonadism - Causes, Symptoms & Treatment

Do all men experience symptoms of Hypogonadism (Andropause or Male Menopause) or do some men not even notice that they’re going through it?

Male hypogonadism is a condition in which the body doesn’t produce enough testosterone.

Male hypogonadism Vs. Andropause (Male Menopause)

Technically, the term andropause (Male Menopause) does not exist in the medical field. This is because unlike the large drop in estrogen levels in females undergoing menopause, there is no such large drop in testosterone level in males hence there is no “pause” per say. More accurately, it should be termed as androgen deficiency or testosterone deficiency syndrome or Male hypogonadism.

Highest Testosterone level between age 20 – 30.

Generally, males have the highest level of testosterone levels when they are between age 20 – 30. By the time they hit age 80, testosterone levels can drop by up to 30%. While androgen deficiency is not a life-threatening condition, it can have a significant impact on the quality of life for the man and his family/relationship.

As some of the symptoms are nonspecific like tiredness or mood swings or increase in weight, they can be misdiagnosed as stress-related or not doing exercise. Some may even be told by their doctor they are depressed.

Why Is Testosterone Important?

Testosterone is important throughout the life of any male.

It determines the development of male sexual characteristics during the development of the fetus. Without testosterone at the correct time of fetal development, the external male genitalia will not be developed or be underdeveloped.

During puberty, it is required for males to develop secondary sexual characteristics such as facial hair, pubic hair, enlargement of the penis and testes to adult size.

In cases where there is an infection of the testes, or trauma or injury to the testes or undescended testes before puberty, then males do not develop those secondary sexual characteristics.

It is required for the production of sperm by the testes. Testosterone is also required to maintain good bone health directly and indirectly as some testosterone is converted to estrogen which also helps to maintain bone health.

It also helps in maintaining muscle mass which indirectly improves body fat levels.

Testosterone can also affect mood and sex drive in males and may also affect erection.

There is also a growing body of evidence to suggest that testosterone is a factor to consider for cardiovascular health. A number of studies have shown that men who had coronary artery disease have lower levels of testosterone levels.

Low testosterone levels are also associated with increased risk of high-grade prostate cancer.

What are the Main Symptoms of Low Testosterone?

The common symptoms of low testosterone are:

  1. Low Energy Levels
  2. Mood Swings or Irritability
  3. Poor Concentration
  4. Reduced Muscle Strength
  5. Low Libido
  6. Erection Issues (difficulty getting erection or maintaining erection)

Questionnaire on Testosterone Deficient

You can also use the questionnaire below as a tool to assess the possibility of being testosterone deficient

1. Do you have a decrease in libido (sex drive)?
2. Do you have a lack of energy?
3. Do you have a decrease in strength and/or endurance?
4. Have you lost height?
5. Have you noticed a decreased ‘enjoyment of life’?
6. Are you sad and/or grumpy?
7. Are your erections less strong?
8. Have you noted a recent deterioration in your ability to play sports?
9. Are you falling asleep after dinner?
10. Has there been a recent deterioration in your work performance?

If you answer yes to Question 1 or 7 and any other 3 questions, then you may want to see your doctor discuss testosterone deficiency.

Is Low Testosterone Dangerous in Any Way?

(Should men worry about decreasing testosterone levels?)

There is a growing body of evidence showing an association between low testosterone levels and cardiovascular risk and also mortality (death). It remains to be further elucidated as to whether low testosterone causes the increase in cardiovascular risk/death or the their way round.

As mentioned previously, there are some studies to show that there is a risk of high grade prostate cancer in males with low testosterone levels. In addition, low testosterone levels are associated with diabetes, obesity and high cholesterol levels. It is found on average very obese men have testosterone levels 25% lower than non-obese men.

Video On Hypogonadism (Andropause)

What are the Treatment Options for Low Testosterone?

If your testosterone is low but with no symptoms, the general consensus is not to treat. However, there are non-pharmaceutical ways of boosting your testosterone levels.

 

READ: 7 Testosterone Boosting Foods That You Can Find In The Supermarket

 

1. Resistance Weight Training

Resistance weight training – there is a number of studies that shows that resistance weight training can improve levels of testosterone albeit temporarily.

2. High Intensity Interval Training (HIIT)

High Intensity Interval training (HIIT) can also increase levels of testosterone up to 17% in a study after 6 months of training.

3. Reducing Body Fat

Reducing body fat levels through appropriate diet and exercise can improve testosterone levels as well.

FAQs on Hypogonadism:

1. What is the Different Between Hypogonadism and Low Testosterone?

You can have low testosterone levels but as long as you have no symptoms attributable to testosterone, you do not have testosterone deficiency syndrome or androgen deficiency

 

2. How Common is Hypogonadism?

One in 10 older men may have testosterone deficiency syndrome.

 

3. How is Hypogonadism Treated?

There are various options for Testosterone replacement available in Singapore.

Testosterone injection:

This is an option for those who do not wish to take medication on a daily basis. Generally, this injection is given once every 8-12 weeks depending on individual. There are also short term injections as well but requires the person to be comfortable with self-injection thus not many men would choose the short-term injections.

Testosterone Capsules:

This is an option for those who do not like needles and prefer the oral route. Absorption is dependent on diet (better with high fat meal).

Testosterone Gel:

This option provides the best absorption and most stable levels compared to the other 2 routes of administration. It is also the easiest option for most people as it only requires you to apply the gel on the skin.

However, some people find it inconvenient to use as you need to wait for the gel to dry and also there is risk of accidental transfer of testosterone to female partner or children.


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