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  • Testosterone therapy

    Yesterday, I got one of the strangest request I have ever had a man in his late 40’s stated that he and his wife had virtually no sex life because her libido was very low and his sex drive was still very high. His solution , since he wanted to stay with her, was to ask me to remove his testicles, the major source of the male hormone testosterone, to eliminate or reduce his sex drive and replace his silicone implants. This of course was absurd and the sign of desperation. I advised both to have a medical check up and see a good sex therapist.
    So lets talk a little about testosterone (Ts). In men, Ts level begin to drop in the mid 30’s and become low enough at some point, usually late 40’s, 50’s, or 60’s to cause signs and symptoms such as low energy and low sex drive, weight gain, loss of bone muscle and hair- even depression. The good news is that replacement therapy with injection or skin preparation is simple enough and should be under a doctor’s care. The clinical term for low Ts is hypogonadism.
    As always Ts therapy should be monitored since serious side effect such as increased red blood cells leading to blood thickening with blood clot that breaks off and travel causing heart attacks, strokes or clot in the lungs (called pulmonary emboli).
    The major concern, though Ts will not cause prostate cancer it can make it spread. Another concern is infertility, since men have children at older ages and the Ts therapy can shut down sperm production.
    Even men in there 60’s and 70’s are being treated. It won’t make you live longer but will improve the quality of life.
    More later

    Stephen X. Giunta, M.D.

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