Both males and females have hormonal changes in the course of the natural life cycle, called menopause and male menopause (andropause). Estrogen levels and testosterone levels are highest between the teens and the early 30’s.
They decline slowly as we age. In females there is a more defined menopause, which is noticed by the fact that the menstrual periods stop. However, with balanced nutrition and soy bean protein supplements that contain natural estrogenic substances many women report that they are not bothered as much with menopausal symptoms. Andropause, which is the male equivalent of menopause, seems to not be experienced that commonly. If andropause becomes a problem, it is usually detected first by their female partners who complain that there is a lack of sexual interest. The male patient at that time sees the doctor and testosterone blood level tests are usually ordered. In the female FSH/LH tests are obtained. For more details see the links under “meno- and andropause”.
In recent years an attractive alternative to impotence pills like Viagra has come into the forefront. Testosterone treatment with bioidentical hormone has been found to be safe (Ref.16). However, this should not be looked at in isolation as testosterone derives from progesterone and in Ref. 17 estrogen and progesterone combination therapy is suggested rather than testosterone treatment alone, in the sense of an anti-aging approach. I have reviewed this in a separate chapter (“Antiaging for women and men“) in more detail.
If all of these measures do not help, an impotence pill such as sildenafil (brand name: Viagra) and others of that type can be considered. However, there are a significant number of side effects with this medication such as headaches and clotting problems that limit the use for certain patients. As already stated bioidentical testosterone replacement therapy, which can stimulate libido significantly (Ref. 17), can be very useful. In the past, with the use of synthetic testosterone, hepatic toxicity and with longterm use the risk of liver cancer existed.
Dr. Morgentaler has shown that prostate cancer is not a risk with longterm use of bioidentical testosterone (Ref. 16). Also, with synthetic testosterone blood could get thickened (secondary polycythemia), which could cause a stroke. Patients on synthetic testosterone need to be monitored for these side effects accordingly, but not on bioidentical testosterone. Viagra might be useful in some patients, if cardiovascular problems allow this and erectile dysfunction is a prominent symptom. Consult a physician who is knowledgeable about this and is open to treatment with nature identical hormone replacement.
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