The expert scoop on some surprise symptoms of Low Testosterone, and the safe route to balancing your hormones and improving your life (and not just your sex life either.)
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I recall shaking my head in disbelief while watching a debut television commercial back in the early 1990’s – a local attorney advertising his services. “What is this world coming to?” I wondered. “Law firms advertising their professional services to sue people? “
I wasn’t the only one ruffled; the general population thought these commercials were unethical and distasteful, opening the door for anyone to get on TV. Who would be next, physicians?
Actually, it was a pharmaceutical company.
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By the end of the 90’s, Pfizer hired Bob Dole to raise awareness about impotence. One of the first television ads was with Viagra, the “little blue pill” that helped men achieve an erection. Whoa! Just how much could a young mom allow her children to hear? Viagra was everywhere; TV ads, print, radio, billboards, clocks, stationary, clothing, even men’s ties. It didn’t take long for Viagra to become a household name, and it didn’t take long for me to jump on board, either. If women could turn the world pink for breast cancer awareness, men could turn it blue.
Today, clinics specializing in men’s health are established worldwide and erectile dysfunction (ED) is commonplace; 30-40 million men suffer from ED in the United States.
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We’ve come a long way in our comfort levels with marketing tactics. Over the years, we swiftly adapted to the new wave of direct advertising, appreciating the benefits -no matter the business. Today, clinics specializing in men’s health are established worldwide and erectile dysfunction (ED) is commonplace; 30-40 million men suffer from ED in the United States. “ED” and “Low T” are universally understood abbreviations, and at our dinner table tonight, they’re the topic of our conversation.
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Full disclosure — I’m married to a urologist, Dr. Joseph Banno, who specializes in men’s health. So this dinner table conversation isn’t as unusual as you might think.
There’s a lot of negative information hitting the news in recent days regarding the side effects and misuse of testosterone. Since this effects millions of men, I asked if he could give a dose of insight to the good, the bad, and the ugly facts about its use.
Me: What is testosterone and what are the symptoms of low testosterone (low T)?
Dr. J: Testosterone (T) is a hormone controlled by the pituitary gland in the brain. The majority is produced in the testicles and then released into the blood stream.
As a sexual expert with testosterone therapy, I can say that the non-sexual benefits of testosterone far outweigh the sexual. I test for low T when men come to my office explaining how tired they are, some say they even nod off at their desks. They can’t focus, they’re moody, they’re depressed, some are on probation from their jobs, and unfortunately, far too marriages have been lost.
Patients who have mild to moderate depression should be screened for low T at any age, 20-80.
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Patients who have mild to moderate depression should be screened for low T at any age, 20-80. Typically, they don’t come to me for depression; they’re already taking anti-depressive meds. They come to see me because they’re fatigued; they have a decreased libido, and ED. Now, I’m not saying some don’t have depression along with low T, but 80% of patients on chronic opioids have very low T. When replaced properly, these patients generally begin to respond to their pain treatment therapy.
Unfortunately, testosterone is a widely abused drug. And abusive anabolic steroids have given testosterone a bad name.
ME: You mean the body builders and professional athletes who use testosterone to build muscle mass? How does testosterone affect these men?
Dr. J: -Don’t forget the thousands of gym-rats who abuse it, too.
We have the same amount of muscle cells in our body; normally, they never increase in number. Through weight lifting they get bigger, increasing the muscle mass. When abnormal levels of testosterone are in the body, muscle cells recruit nearby cells, turning them into muscle cells – which really increases the size and strength of the muscles.
ME: Why is this so bad?
I had a couple come into my office; both were body builders trying to have children. Unfortunately, because of the years of testosterone abuse, his testes were the size of garbanzo beans.
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Dr. J: “Street drugs” in oral form can lead to severe liver disease and infertility. I had a couple come into my office; both were body builders trying to have children. Unfortunately, because of the years of testosterone abuse, his testes were the size of garbanzo beans.
But, there are other misuses. I see young couples for fertility testing and many times the male has low T, and here’s the rub; unfortunately many physicians administer testosterone to these patients when it’s really contraindicated to those who want to conceive. What they really need is a medicine that stimulates the pituitary gland so their body can produce their own testosterone, like HCG (Human Chorionic Gonadotropin).
Low T is associated with diabetes and obesity which leads to cardiovascular disease. The American Endocrine Association recommends every man with diabetes to be screened for low T. Unfortunately, many physicians don’t do it, and that affects a lot of patients.
ME: I can’t turn on the TV without hearing about the dangers of testosterone in patients with low T. There’s a big scare of heart attacks, strokes and blood clots when using T therapy. If T therapy is warranted, is safe, or not?
Dr. J: Testosterone is not without problems. Those side effects do occur and we also see acne, swelling, blood clots, irritations from gels, and an increase in red blood cells. But the scare you’re referring to isn’t anything new. JAMA, (Journal of American Medical Association) supplied what I would call a flawed research study. Esteemed members of the urological community and members of the sexual medical society have come out strongly against this article proving T therapy IS safe, but still not without risk. In addition, many people use T in mega-doses without any medical supervision at all.
The cornerstone of ED and T therapy is a sound nutrition and exercise program.
ME: What forms of testosterone are there?
Dr J: In the U.S. there are no safe oral forms. There are injections, gels, and pellets. Patients need to be careful when using gels because transference to women and children can be a problem. There’s a new long-lasting injection and most recently, the FDA approved a nasal spray. My preference is the pellets.
ME: What does T therapy have to do with prostate cancer?
The growing concern is now that low T is a risk for prostate cancer.
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Dr. J: We used to believe that T therapy increased the risk of prostate cancer. However, this statement may be incorrect in some patients. In fact, T therapy is safe for the prostate in most patients. The growing concern is now that low T is a risk for prostate cancer.
ME: When a patient comes to you for help with low T, how long is it before he feels better and his work and home life is restored to normal?
Dr J: With proper treatment combined with a healthier lifestyle, a man usually begins to feel better between 4-8 weeks. More than once a woman has told me, “Thanks for giving my husband back!” That makes me feel good. One of my testosterone patients needed a prosthetic implant. He said if he had it 5 years earlier, it would have saved his marriage.
ME: A penile implant? Maybe this would be a better discussion ‘after-dinner’.
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OK, so that’s the (formalized) version of our dinner conversation. But here’s the bottom line:
Like women who choose hormone therapy, men who use testosterone therapy under a doctor’s care are simply restoring their levels to normal. There’s nothing wrong with wanting to feel normal and to regain sexual intimacy.
The awareness of men’s health has made great strides since the 1990’s; however, there’s more work to be done. More men should be able to reach out to their physicians for advice, but they don’t. There are many physicians who are intimidating to talk to -and surprisingly uncomfortable when talking about ED. If the patient feels awkward and the physician is uncomfortable, there’s no good outcome.
My hope is to help men who suffer from low T and ED to know that they can feel alive again! Options are available – there’s no need to suffer in silence or to fall asleep at your desk.
You only have one life; make it a great one!
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Dr. Joseph Banno is a board certified Urologist specializing in men’s health. He is regarded as one of the top penile prosthetic surgeons in the country. He went on-air with CI News Now for a couple of sessions, here’s the short segment related to Low Testosterone.
Photo: Flickr/Pictr73
Up to a quarter of these prescriptions are dispensed without a blood test. From a psychological perspective, this isn’t helping men. From a medical perspective, it’s devastating. In addition to the cardiac risks, prescription T can mean a permanent shut-off in men’s own, albeit diminished, testosterone production. In other words, once you start, you may well be hooked for life. Instead of heading to the pharmacy to get their fix, men should address the leading cause of the problem. Losing weight is a tried and true way to naturally boost testosterone levels. The Endocrine Society in 2012showed that obese men… Read more »
This doctor has been paid tens of thousands of dollars by Eli Lilly and GlaxoSmithKline. Don’t waste your money and possibly risk your health because of Big Pharma’s ad campaigns. Your “T” is probably fine and if you want to feel better, a proper diet and exercise is in most cases a much better and healthy option to help you feel better.
http://projects.propublica.org/docdollars/payments/10754650 (just one of quite a few payments)
Thank you for the article. I’m hoping a lot of people read it.