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Johns Hopkins Health - Hormones and Health Risk

Summer 2013
Issue No. 21

Hormones and Health Risk

Date: July 16, 2013

Low testosterone affects more than sexual dysfunction


hormones

Thanks to pervasive drug company advertising, erectile dysfunction as a sexual disorder is now common knowledge.

What’s less appreciated, experts say, is the role that low testosterone, a contributing factor for erectile dysfunction, can play in other serious diseases, including some of the biggest killers of men: heart problems such as high blood pressure and cholesterol, obesity-related illnesses and diabetes.

The link is a tendency to put on weight as we age. Belly fat is killing more than our sex lives, it turns out.

Low testosterone and weight play a chicken-and-egg routine, says Kevin Billups, M.D., director of the Men’s Health and Vitality Program at Johns Hopkins. Getting older means your testosterone level will decline. But being overweight and inactive can make it worse.

“Diabetes, high blood pressure, high cholesterol—those are all associated with low testosterone,” Billups explains. “I always focus on those big three, the ones associated with insulin resistance and the cluster of risk factors around that. For men seen with those chronic medical conditions, it is important to screen for testosterone deficiency.”

Early testing matters: Low testosterone and the associated symptoms—erectile dysfunction, decreased sex drive, lack of energy and fatigue—can show up years before more serious health issues are evident, Billups says. One study estimates that the prevalence of symptomatic low testosterone is close to 6 percent, with nearly nine in 10 of those symptomatic men not treated. Many men, Billups says, will say they have never been checked for testosterone.

“I think it’s an underdiagnosed condition,” Billups says. “I see a lot of men coming in with other chronic medical conditions, and the first thing I do is look at their waist circumference and ask if anyone has checked their testosterone.”

‘Low T’ Treatments
Concerned about low testosterone? Consider these steps from Kevin Billups, M.D., a urologist at Johns Hopkins.

  • Get checked. If you have symptoms, or if you have a chronic disease, have a testosterone panel performed. If it’s normal, repeat in a few years. If it’s not, discuss next steps with your physician.
  • Lose weight. Diet and exercise can help resolve erectile dysfunction, reduce risk of heart disease and diabetes, and perhaps even help raise your testosterone level.
  • Apply a topical gel. After men have been appropriately evaluated and diagnosed, Billups sometimes jump-starts a patient with testosterone gel rubbed on the skin.
  • Opt for gel alternatives. Men might prefer a slow-release patch or periodic injections. Under-the-skin pellets last up to four months.

For more information, appointments or consultations, call 877-546-1872.

Watch a Video on Low Testosterone
Johns Hopkins urologist Kevin Billups, M.D., discusses how diabetes, high blood pressure and high cholesterol may be associated with with low testosterone. Learn how early testing can help and what treatment options are available in the video: Hormones and Health Risk - What Men and their Partners need to know about Low Testosterone.

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