Testosterone in Ageing Men

In the news today there was an article about the benefits of Testosterone replacement in older men.

The results of a study published in The New England of Medicine show the benefit of replacing Testosterone in men over 65 years of age. The results demonstrated that sex drive, physical activity and vitality were improved when Testosterone Replacement Therapy (T.R.T.) was given to men with low total or low free testosterone.

The E.A.U. guidelines for treatment of low testosterone in men presented at the World congress for aging men held in Prague in October 2015 suggested that a Total testosterone of less than 12.1 n/mols /L or a free testosterone of less than 243 pmols/L benefited ageing men. Weight is related to Total testosterone, an increase in weight lowers testosterone, but a loss of weight increases testosterone.
Ref. Corona 2014 J. Sexual Medicine.

In older men obesity is a cause of Secondary Hypogonadism, waist circumference of 94-102cms., if over 104cms this is one of five risk factors for coronary heart disease, obesity increases oestrogen levels in men, and decreases central hypothalamic control. A 40% weight loss increases testosterone levels by 12nmols/L.

The risk of diabetes is reduced with weight loss and prescribing testosterone. In summary lifestyle adjustments will improve endothelial function and erectile function. Low free Testosterone and Erectile Dysfunction often precede the advent of coronary heart disease by 2-3 years. Testosterone improves insulin transport, glycolysis and mitochondrial function for glucose metabolism.

The myth that Testosterone replacement therapy increases the risk of prostate cancer was commented on by Professor Claude Schulman of Brussels University. “The evidence does not support increased risk of prostate cancer with T.R.T.”
T.R.T. on a normal prostate has no effect. Men with low Total and Free Testosterone levels are at an increased risk of prostate cancer (Ref. Statin net al. Int. Cancer 108 418-424, 2004).

An increase in oestrogen and low vitamin D is one of the possible promoters of Prostate disease. Insulin increase is a growth promoting factor that also increases the risk of prostate cancer.

Zinc is an important element for prostate health and also for the DNA of sperm. The prostate gland via the ejaculate 2-6 cc on average, is rich in Zinc, over 500 times more than plasma levels and ten times more Magnesium than blood. Zinc is important for sexual health.

Professor Stefan Arver, Karolinska University Hospital Sweden stated at the world Congress for aging men that the prostate gland is a collection of over 50 different glands, and can be considered as a separate endocrine organ.
Over 21 ejaculations/month lowers the risk of Prostate cancer.