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HRT for Men

With Robert Grafton, MD

When it comes to hormone replacement therapy, we often think about women, menopause, hot flashes, moodiness, bone loss and various other conditions that accompany the time in a woman’s life when HRT is necessary. However, when a man becomes more moody, loses muscle mass, puts on a few pounds, loses libido, we just chalk it up to old age and think there is nothing that can be done.

This just isn’t true.

In fact, hormone replacement – in this case, testosterone – is just as necessary for some men as estrogen replacement is for some women, according to Dr. Robert Grafton of Rochester Hills.

“Think about the crabby old man,” says Dr. Grafton. “You get the mental fogginess, the anxiety, you don’t sleep well, you have physical changes, each can be signs reflecting a loss of testosterone.”

According to Dr. Grafton, men are at the peak levels of testosterone at the age of 30, but testosterone levels decrease 10% each decade thereafter. The amount and severity is different with everyone but the only way to know how your hormonal levels are is to get a baseline value as part of a routine physical.

“You should check your levels in your 40s and if you notice certain levels are lower, and it is an issue get treatment, if not, then you are fine,” suggests Dr. Grafton. “Fifty year old men will get potbellys, skinny arms and have some breast growth, these are typical signs of decreased testosterone. If you haven’t gotten checked with these physical signs, you should.”

In some instances, Dr. Grafton points out that estrogen levels in men has increased due to diet. “Over the last 50 years we have had a decrease in testosterone, but an increase in Xeno-hormones; those that tend to be injected into beef, chicken, milk-producing cows, and our estrogen levels have gone up,” says Dr. Grafton. “Increased estrogen in our bodies is complicating the hormonal balance.”

There are an increasing amount of treatments now for men with low testosterone levels – from creams to pills and patches. These are generally synthetic hormones produced to be similar to your body’s hormones.

Dr. Grafton, and many other physicians, are now looking to treat their patients with biologically equivalent hormones that are engineered more like the hormones our body produces.

Testosterone has many benefits, points out Dr. Grafton. As a vasodilator, it opens your blood vessels, can help lower blood pressure, increase libido, raise your HDL (good cholesterol) and lower your LDL (bad cholesterol). With the many health benefits that go along with balanced hormonal levels, one can see the importance of knowing where you stand.

One treatment option is to have pellets of bioequivalent hormones injected under the skin, says Dr. Grafton. These pellets are similar to a small piece of rice and will last 4-6 months on average.

“These pellets are the same structure as what you’ve lost, put under the skin, and you don’t get the peaks and valleys that you can with other treatments,” says Dr. Grafton. “When you hit high peaks is when you get complications after injections.”

With the pellets, Dr. Grafton states they are released based on your body’s activity, you have a more balanced release. He adds that since the hormone replacement is necessary for the rest of one’s life, that the pellets simplify treatment compared to creams, patches and pills.

Normal hormone levels range between 200 and 1200, says Dr. Grafton, but he will generally start treatment on someone whose levels are under 650. “You want to be in the 80th percentile,” states Dr. Grafton. “You want normal levels, but you want optimal levels and you want to function to optimal capacity.”

As in every other health issue, good diet and exercise are the basic principles to adhere to, says Dr. Grafton. By using the bio-identical hormone pellets that are produced in compound pharmacies, you can simplify reatment and not have to worry about daily treatment regimens, he says.

So, if you are feeling some of the symptoms described, talk to you physician, have your hormone levels checked, and see what options fit the lifestyle that you want.