To refer to a lower activity of the sex glands and hormones in men, it is preferable to speak of male climacteric, a word that comes from the Greek and means ladder or step. The term “andropause” is inadequate, since men do not lose fertility as women do.
From the age of 40, there is approximately a 10% partial deficit of testosterone in men, and around the age of 45 there is a gradual decrease of 1% per year. Thus, according to the Baltimore study, there is a 20% loss of testosterone at the age of 60, 30% at the age of 70 and 50% at the age of 80.
Therefore, it is advisable that from the age of 45, in addition to requesting the PSA (as a marker of prostate cancer), we control free testosterone. In the case of men, it would be necessary to visit the doctor at least once a year (in the same way that women visit the gynecologist annually).
It should be noted that one of the most frequent manifestations of low testosterone levels is erectile dysfunction. This can also be a symptom of other more serious pathologies, since in 40% of cases the origin of this dysfunction can be of vascular origin, and in another 20% the cause can be a metabolic syndrome that involves alterations in glucose, lipids, blood pressure, uric acid and obesity. It has also been proven that low testosterone increases the risk of prostate cancer.
Low testosterone levels
It should be taken into account that in 40% of the cases the drugs that facilitate an erection (such as Viagra, Levitra or Cialis) are not effective if there is not a sufficient level of testosterone. This occurs because this hormone stimulates the synthesis of nitric oxide, increasing its synthesis by means of an enzyme; if it is not sufficient, sexual desire or libido will be diminished or absent.
This drop in testosterone levels will depend on whether total testosterone or free testosterone is estimated. According to statistics, the figure in the general population would range from 5% to 18%.
Based on the fact that 20% of erectile disorders are of psychogenic origin, many patients are polymedicated with antidepressants, a fact that only aggravates the problem, since it is not taken into account that there may be an underlying hormonal deficiency.
Controlling testosterone
Because of cultural barriers and inhibition to discuss such problems, 90% of carriers of free testosterone deficiency are not treated. On the other hand, the Endocrinology specialist does not usually make an effort to inquire about the sexual life of his patients, because he considers that this belongs to the most intimate sphere of each person.
The consequences of this behavior can have dire consequences, since important pathologies can remain undiagnosed, which in the long term will not only affect the quality of life, but also its duration.
Thus, we must encourage overcoming these taboos, as they may be hiding dysfunctions that may exist at various levels, be they vascular or metabolic.
It is a mistake to believe that low testosterone levels only affect secondary sexual characteristics, or that it only concerns the sphere of male sexuality.