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Studies Question Andropause and Testosterone Replacement

24 Jul

Male menopause, or andropause, is one of the anti-aging industry’s favorite diagnoses. Is your energy level wanting? Is your sex drive waning? Are your muscles not as bulky as they used to be? Perhaps it’s time for some testosterone gel–or so the sales pitch goes.

But some studies question the wisdom of prescribing testosterone to aging men. Most recently, the prestigious New England Journal of Medicine published a study questioning the safety of testosterone replacement. During the study, which was sponsored by the National Institute on Aging, testosterone was prescribed to several men with limited mobility, in the hopes it would improve their ability to get around.

Unexpected side effects brought the trial to a screeching halt, though. The men receiving the gel suffered higher rates of cardiac, respiratory and skin reactions than did those getting a placebo. And 23 men on testosterone gel had adverse cardiovascular events, as opposed to only five in the placebo group. The researchers stopped the trial earlier than planned.

Until recently, there had been precious little research on testosterone replacement in aging men. Despite the alarm bells raised by this study, researchers are powering ahead; The NIA is planning a trial with 800 men, and the National Academies’ Institute of Medicine is also looking into testosterone research.

But as I found while researching Selling the Fountain of Youth, there is some compelling research questioning whether men who think they’re suffering from male menopause really have low testosterone. In 2006, scientists at the University of Turku in Finland set out to treat 200 healthy aging men with testosterone and track their results. They sent questionnaires to 30,000 men–1,800 of whom reported common symptoms of male menopause.

As it turns out, only 250 of them had low testosterone as it would be defined by traditional doctors. And most of those men suffered from other diseases–which disqualified them from a study designed to look at healthy men. The scientists pulled the plug on the study.

“Our finding begs the question, is there such a thing as andropause in men with no diseases, who are living a normal life?” said lead investigator Antti Perheentupa in an interview with me. “Is there any reason to treat healthy men with testosterone at all? The answer is probably no.”

 
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