How Low Testosterone Affects Health, Mood, and Sex
Low Testosterone and Your Health
Researchers are unlocking the mysteries of how low testosterone is related to men's overall health. Along the way, they're uncovering connections between low testosterone and other health conditions.
Diabetes, metabolic syndrome, obesity, and high blood pressure have all been linked to testosterone deficiency. Low testosterone isn't known to cause these health problems, and replacing testosterone isn't the cure. Still, the associations between low testosterone and other medical conditions are interesting and worth a look.
Does Low Testosterone Indicate Poor Health?
In recent years, researchers have noticed general links between low testosterone and other medical conditions. One showed that in 2,100 men over age 45, the odds of having low testosterone were:
- 2.4 times higher for obese men
- 2.1 times higher for men with diabetes
- 1.8 times higher for men with high blood pressure
Experts don't suggest that low testosterone causes these conditions. In fact, it might be the other way around. That is, men with medical problems or who are in poor general health might then develop low testosterone.
Research into the relationship between low testosterone and several other health conditions is ongoing.
Diabetes and Low Testosterone
A link between diabetes and low testosterone is well established. Men with diabetes are more likely to have low testosterone. And men with low testosterone are more likely to later develop diabetes. Testosterone helps the body's tissues take up more blood sugar in response to insulin. Men with low testosterone more often have insulin resistance: they need to produce more insulin to keep blood sugar normal.
As many as half of men with diabetes have low testosterone, when randomly tested. Scientists aren't sure whether diabetes causes low testosterone, or the other way around. More research is needed, but short-term studies show testosterone replacement may improve blood sugar levels and obesity in men with low testosterone.
Obesity and Low Testosterone
Obesity and low testosterone are tightly linked. Obese men are more likely to have low testosterone. Men with very low testosterone are also more likely to become obese.
Fat cells metabolize testosterone to estrogen, lowering testosterone levels. Also, obesity reduces levels of sex hormone binding globulin (SHBG), a protein that carries testosterone in the blood. Less SHBG means less testosterone.
Losing weight through exercise can increase testosterone levels. Testosterone supplements in men with low testosterone can also reduce obesity slightly.
Metabolic Syndrome and Low Testosterone
Metabolic syndrome is the name for a condition that includes the presence of abnormal cholesterol levels, high blood pressure, waistline obesity, and high blood sugar. Metabolic syndrome increases the risk for heart attacks and strokes.
Studies show that men with low testosterone are more likely to develop metabolic syndrome. In short-term studies, testosterone replacement improved blood sugar levels and obesity in men with low testosterone. The long-range benefits and risks are still unknown.
Testosterone and Heart Disease
Testosterone has mixed effects on the arteries. Many experts believe testosterone contributes to the higher rates of heart disease and high blood pressure that tend to affect men at younger ages. By this reasoning, high testosterone might be bad for the heart.
But testosterone deficiency is connected to insulin resistance, obesity, and diabetes. Each of these problems increases cardiovascular risk. Men with diabetes and low testosterone also have higher rates of atherosclerosis, or hardening of the arteries.
A certain amount of testosterone may be necessary for healthy arteries because it's converted into estrogen, which protects arteries from damage. As yet, no studies show that testosterone replacement protects the heart or prevents heart attacks.
Testosterone and Other Conditions
Low testosterone often exists with other medical conditions:
- Depression: In a study of almost 4,000 men older than 70, those with the lowest testosterone levels were more than twice as likely to be depressed. This link remained even after allowing for age, general health, obesity, and other variables.
- Erectile dysfunction (ED): Problems with erections are one of the most common symptoms of low testosterone. Most ED is caused by atherosclerosis. Men with risk factors for atherosclerosis -- diabetes, metabolic syndrome, or obesity -- often have low testosterone, too.
- High blood pressure: The effects of testosterone on blood pressure are many and complex. Men with high blood pressure may be almost twice as likely to have low testosterone as men with normal blood pressure. On the other hand, too much testosterone can increase blood pressure. Testosterone acts in multiple ways on blood vessels, so this may account for the varying effects.
Testosterone Replacement Treatment Options
The question that remains is, does low testosterone cause or worsen medical problems like diabetes? Or are people who develop diabetes, or other health problems, simply more likely to also have low testosterone?
Studies to answer these questions are under way, but it will be years before we know the results. In the meantime, remember that testosterone replacement hasn't been conclusively shown to improve any health condition other than testosterone deficiency and its symptoms. For men with low testosterone levels as measured by a blood test who also have symptoms of low testosterone, the decision to take testosterone replacement is one to make with your doctor.
WebMD Medical Reference
AXIRON is a prescription drug used to treat adult males who have low or no testosterone. AXIRON is not intended for use in women or anyone under 18 years of age. It is not known if AXIRON is safe and effective in children younger than 18 years old. Improper use of AXIRON may affect bone growth in children.
Important Safety Information for AXIRON
What is the most important information I should know about AXIRON?
AXIRON can transfer from your body to others. This can happen if other people come into contact with the area where the AXIRON was applied. Signs of puberty that are not expected (for example, pubic hair) have happened in young children who were accidentally exposed to testosterone through skin to skin contact with men using topical testosterone products like AXIRON. Women and children should avoid contact with the unwashed or unclothed area where AXIRON has been applied. If a woman or child makes contact with the application area, the contact area on the woman or child should be washed well with soap and water right away.
To lower the risk of transfer of AXIRON from your body to others, follow these important instructions:
- Apply AXIRON only to your armpits.
- Wash your hands right away with soap and water after applying AXIRON.
- After the solution has dried, cover the application area with clothing. Keep area covered until you have washed the application area well or have showered.
- If you expect another person to have direct skin-to-skin contact with your armpits, first wash the application area well with soap and water.
Stop using AXIRON and call your healthcare provider right away if you see any signs and symptoms in a child or a woman that may have occurred through accidental exposure to AXIRON. Signs and symptoms in children may include enlarged penis or clitoris; early development of pubic hair; increased erections or sex drive; aggressive behavior. Signs and symptoms in women may include changes in body hair and a large increase in acne.
Who should not use AXIRON?
Do not use AXIRON if you:
- have or might have prostate cancer
- have breast cancer
- are pregnant or may become pregnant or are breast-feeding. AXIRON may harm your unborn or breast-feeding baby.
Women who are pregnant or who may become pregnant should avoid contact with the area of skin where AXIRON has been applied.
What should I tell my healthcare provider before using AXIRON?
Before you use AXIRON, tell your healthcare provider if you have:
- breast cancer
- or might have prostate cancer
- urinary problems due to an enlarged prostate
- heart problems
- kidney or liver problems
- problems breathing while you sleep (sleep apnea)
- any other medical conditions
Tell your healthcare provider about all the medicines you take, including prescription and non-prescription medicines, vitamins, and herbal supplements. Using AXIRON with other medicines can affect each other. Especially, tell your healthcare provider if you take:
- medicines that decrease blood clotting
What are the possible side effects of AXIRON?
AXIRON can cause serious side effects. Call your healthcare provider right away if you have any of the following:
- If you already have enlargement of your prostate gland, your signs and symptoms can get worse while using AXIRON. This can include: increased urination at night, trouble starting your urine stream, having to pass urine many times during the day, having an urge that you have to go to the bathroom right away, having a urine accident, being unable to pass urine or weak urine flow.
- Possible increased risk of prostate cancer. Your healthcare provider should check for prostate cancer or any other prostate problems before you start and while you use AXIRON.
- In large doses AXIRON may lower your sperm count.
- Swelling of your ankles, feet, or body.
- Enlarged or painful breasts.
- Problems breathing while you sleep (sleep apnea).
- Blood clots in the legs. This can include pain, swelling or redness of your legs.
The most common adverse events include: skin redness or irritation where AXIRON is applied, increased red blood cell count, headache, diarrhea, vomiting, and increase in blood level of Prostate Specific Antigen (a test used to screen for prostate cancer). Other side effects include more erections than are normal for you or erections that last a long time.
AXIRON is flammable until dry. Let AXIRON dry before smoking or going near an open flame.
Axiron is available by prescription only
AXIRON is a controlled substance (CIII) because it contains testosterone that can be a target for people who abuse prescription medicines. Keep your AXIRON in a safe place to protect it. Never give AXIRON to anyone else, even if they have the same symptoms you have. Selling or giving away this medicine may harm others and it is against the law.
You are encouraged to report negative side effects of Prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.
TS Axiron CON ISI, 10AUG2011 PV8160
Eli Lilly and Company
Lilly Corporate Center
Indianapolis, IN - USA
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