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 Testosterone Level and Libido: Why Older Men Need to Increase Their Testosterone Level

The importance of increasing and maintaining testosterone levels in older men

Improve Your Sex Life And
Protect Against Heart Attack
By J. Phillip Vogel
Le Magazine, May, 2003
http://www.lef.org/magazine/mag2003/may2003_cover_test_03.html

 Libido

 Sexual stimulation and erection begin in the brain where neuronal testosterone-receptor sites are prompted to ignite a cascade of
 biochemical events that involve testosterone-receptor sites in the nerves, blood vessels, and muscles. Free testosterone promotes sexual
 desire and then facilitates performance, sensation and the ultimate degree of fulfillment. Without adequate levels of free testosterone, the
 quality of the male sex life is adversely affected. Studies have found that men with low testosterone routinely suffer from a decreased sex
 drive, genital atrophy, and impotence. Upon re-establishing youthful levels, subjects commonly report increased feelings of vitality, a higher
 sex drive, better sexual performance and even penile enlargement and increased genital sensitivity. Low testosterone levels achieved in men
 on androgen deprivation therapy are associated with decrease in size of the testicles and penis. These findings are reversible and men on the
 off-cycle of androgen deprivation therapy who have testosterone recovery note a return towards normal in the size of their genitalia.

 Recently, researchers in Taiwan examined the relationship between low testosterone levels and the male libido. In that study, the serum total
 testosterone levels of 53 symptomatic men older than 50 years were measured and compared to a control group of 40 young,
 asymptomatic men. The results showed that men with a diminished libido had a significant decrease in testosterone levels (mean 268 ng/dl)
 as compared with the control group (553 ng/dl). Furthermore, 89 percent of the subjects suffering from low testosterone reported a lack of
 energy; 79 percent reported erectile dysfunction; 70 percent reported a loss of pubic hair; and 66 percent reported a decrease in sexual
 endurance. From this data, the researchers concluded that low levels of testosterone are directly related to both advanced age and
 diminished sex drive.

 Why do testosterone levels fall?

 Aging in males involves a torrent of hormonal, biochemical and physiological changes that accompany the down-regulation of the brain's
 ability to initiate testosterone production.

 In some men, the testes lose their ability to produce testosterone, regardless of how much luteinizing hormone (LH) is being produced. In
 such cases, the pituitary gland is signaling the testes (via LH secretion) to produce testosterone. But since the testes have lost their functional
 ability, no testosterone is forthcoming. The pituitary gland, however, continues to secrete LH because there is not enough testosterone in the
 blood to provide a feedback mechanism to shut down LH production.In other cases, it's the pituitary gland that malfunctions and fails to
 produce sufficient amounts of LH, thus preventing healthy testes from secreting testosterone. In either case, blood tests can determine the
 levels of free testosterone and estradiol to help determine the appropriate therapeutic approach.

 Other causes of low testosterone result not from faulty feedback mechanisms, but rather because of the aromatization (conversion) of
 testosterone to estrogen. Studies have found that in many aging males, the already diminished levels of free testosterone are further
 compromised by being converted to estradiol-a high potency form of estrogen-via the action of the aromatase. One recent report even
 found that the estrogen levels of the average 54-year-old man are higher than the average 59-year-old woman. While estrogen is a
 necessary hormone for men, at high levels it has been associated with an increased risk of heart attack or stroke.46 Furthermore, high
 serum levels of estrogen trick the brain into thinking that enough testosterone is being produced, thereby reducing the natural production
 and availability of testosterone even more. This happens because at high levels, estrogen saturates testosterone receptors in the
 hypothalamus, which subsequently stops sending hormone signals to the pituitary gland. Another consequence of estrogen production is
 stimulation of sex hormone-binding globulin (SHBG) by estrogen. An increase in SHBG further binds testosterone and lowers the free
 testosterone level.