Don't take testosterone deficiency lightly

Low testosterone causes symptoms that can adversely affect a man's quality of life and disrupt his daily routines.

Men with low testosterone also have a strong likelihood of developing the various conditions of metabolic syndrome, which increases the risk of heart disease and diabetes.

Previously, we have emphasised the message that testosterone deficiency is not to be taken lightly or to be brushed off as a side effect of aging. This message is also underscored in a new book by consultant urologist Datuk Prof Dr Tan Hui Meng, Testosterone: Secret To Healthy Aging For Men, which takes a comprehensive view of testosterone deficiency, its effects, the safety and efficacy of testosterone replacement therapy (TRT), and how TRT complements general health maintenance.

We need to change our mindset regarding testosterone - from thinking of it merely as a sex hormone to accepting its role in influencing overall men's health.

In the book, Prof Tan reiterates that men lag behind women in terms of health status and outcomes. This discrepancy is the result of healthcare policies and resource distribution that disadvantage men, as well as men's own attitudes that put themselves at risk. It is a universally-known fact that men practise poor preventive health or health maintenance. Many men only seek healthcare when they are severely ill, as a result of years of unhealthy lifestyle practices.

Men have to realise that there is no shortcut to maintaining good health. Staying healthy and well begins as early as young adulthood (between 18 and 39 years), through middle age (40 to 64 years), and well into old age (65 years and beyond).

Prof Tan also emphasises that nothing occurs in isolation in health. That is why testosterone deficiency and its treatment have to be viewed within the overall context of health maintenance.

As Prof Tan explains in great length in his book, the hormone has effects on many systems in the body, travelling as far as the brain and bones. In fact, one of the most significant effects of testosterone is on the heart. Research shows that there is a strong link between men's sexual health and the heart.

For instance, we now know that erectile dysfunction (ED) and testosterone deficiency are not just sexual dysfunctions, but are also risk factors for heart disease and metabolic conditions. Heart disease and metabolic conditions are serious problems for men today, therefore, testosterone deficiency and ED, as markers for heart disease and metabolic syndrome, should be instantly recognised and treated.

The good news is that low testosterone can be treated, and it will have benefits beyond the bedroom. Improving testosterone levels can reduce abdominal obesity, improve cholesterol levels, improve insulin sensitivity, and help men better control their diabetes.

Studying and treating low testosterone has given doctors the opportunity to take a revolutionary approach to men's health - by looking at sexual dysfunctions as central aspects in managing the overall health of men.

In his book, Prof Tan also hypothesises that normalising testosterone levels not only contributes to good health throughout life, but may one day even be able to prolong life. His proposal is based on research that reveals that mortality risk increases with lower testosterone levels. Many studies have demonstrated that low testosterone "spells shorter lives".

At the same time, many studies have also proven that TRT has positive effects on cardiovascular disease, metabolic syndrome and osteoporosis. Therefore, men who receive TRT to treat their testosterone deficiency would be prolonging their lives by delaying premature deaths from these conditions.

Will TRT be able to increase life expectancy or delay the effects of ageing? Prof Tan writes that research around the world is looking into this, and the answers may appear in the near future.

There is no doubt that testosterone plays a crucial role in men's general health. Therefore, having healthy testosterone levels is central to maintaining good health.

Before considering therapy, men should realise that they can maintain normal testosterone levels through lifestyle changes. They should make the effort to reduce the amount of fat in their body, as fat cells suppress the production of testosterone.

However, TRT may be necessary in many men who are unable to improve their testosterone levels through lifestyle changes. Additionally, TRT complements a healthy lifestyle, because it increases energy levels and lean muscles, enabling men to become more physically active.

As more research is done on TRT and further advances are made to enhance its efficacy and safety, we may see this therapy playing an even bigger role in men's health.

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