When the phrase “biologic clock” is mentioned, most think this is in reference to women who experience a loss of hormone production at the time of menopause. But men also have a clock that starts to slow down around age 35. It is at this time that men experience decreasing hormone production, decrease in fertility potential, as well as an increase risk of genetic problems in children born to men who are older.
The theory that men go through a change in life, similar to what women experience, could be taking hold. We know for certain that the cause of the slowing of the biologic clock in women is due to a decrease in the production of estrogen. If less estrogen in women leads to the end of menstruation, moodiness, hot flashes, loss of sexual interest and osteoporosis, couldn’t male versions of these symptoms be caused by less testosterone?
How common is male hormone deficiency? Currently in the U.S., at least 6 to 10 million men suffer from the effects of extremely low testosterone levels in their bloodstream. Sadly, only 1 out of 6 of these men will ever receive treatment to resolve this problem.
Infertility and aging
It has been noted that more men, and women, are deferring parenting until they are older, finished their education, and are more financially stable. As a result the number of children born to fathers older than 35 years has increased considerably in the past few decades. This creates a problem as there is a decrease in fertility in men with increasing age. Since it takes longer to achieve a pregnancy in older men, they should be counseled and may consider starting their family sooner before their clock completely winds down.
Since there is evidence of the existence of a male “biological clock,” the likelihood of taking more than a year to conceive doubles when the man is over 35. The implication is that a man’s age should be another factor that is taken into account when looking at the chances of conception in couples who are having difficulty conceiving.
In addition, as men age, the genetic quality of their sperm declines significantly. According to the Centers for Disease Control and Prevention, the number of babies born to parents older than age 35 more than doubled from 1970 to 1999, from 6 percent to 13 percent. This trend has led to the rise in the rates of infertility in the past decade, and to increased miscarriage rates and the possibility of a baby born with Down Syndrome (in addition to other genetic abnormalities).
When testosterone levels drop
In women, menopause generally marks the end of youth, hence the idea of a “mid-life crisis.” Some women get hot flashes, are moody, irritable and/or depressed. Male menopause, or andropause, is not as clearly defined for men as it is for women. There probably is a syndrome of testosterone deficiency in aging men, and that testosterone deficiency is manifested by a diminished sexual drive, difficulty in getting or maintaining an erection, lack of energy, even irritability and grumpiness. There are even changes in a man’s height, caused by bone loss and osteoporosis.
If a man is experiencing any of the symptoms of testosterone deficiency, they need to see their physician and undergo an evaluation which includes a blood test to measure the testosterone level. Not all male mid-life crises are a result of testosterone deficiency. First, the doctor must be sure that the symptoms are not due to depression. Many of the issues in testosterone levels could be confused with the effects of depression. If you’ve got symptoms that may be suspicious, the first thing is to have a thorough physical and laboratory work and make sure you rule out other medical conditions such as diabetes, which also affect testosterone levels. Treat those conditions first, before you consider looking at testosterone.
There is also a useful questionnaire, ADAM-Androgen Deficiency in the Aging Male, that is helpful for men to identify testosterone deficiency.
The ADAM questionnaire asks you to check for the following symptoms:
- Decrease in sex drive
- Lack of energy
- Decrease in strength and/or endurance
- Lost height
- Decreased “enjoyment of life”
- Sad and/or grumpy feelings
- Erections less strong
- Deterioration in sports ability
- Falling asleep after dinner
- Decreased work performance
Men experiencing Loss of morning erections depression, tiredness, memory loss, decreased muscle mass and increased weight, more fragile bones, or a diminished sex drive might be candidates for testosterone replacement therapy. Treatment of testosterone deficiency is easily accomplished with injections of testosterone, patches placed on the skin that transmit the medication from the skin to the blood stream, or topical gels applied to the upper arm or lower abdomen can quickly restore a man’s libido and sex drive.
So if you are over 35 and are feeling less than your best, you should talk with your doctor about your symptoms. A complete medical examination that includes laboratory tests can help show whether testosterone supplements might help you feel better. If treatment is suggested, then I encourage men to try it for a period of a few months while keeping track of the changes. If low testosterone is the cause of their symptoms, men will not have to wait long to see the effects of treatment. Bottom line…men, you may not be able to turn back the clock of time but you certainly can reset your biologic clock with hormone replacement therapy.
Dr. Neil Baum is a urologist at Touro Infirmary. For more information, contact Dr. Neil Baum at (504) 891-8454 or go to his Website, http://www.neilbaum.com