QUICK COLUMN: Enough already! Do aging men and women really need hormones?
There's nothing that makes me more squeamish these days than watching incessant commercials, including low-budget, local versions and overly long corporate ones, touting the benefits of drugs for “Low T” (T for testosterone), hormone replacement for women and other similar drug-related quick fixes.
I'm no prude, but when I hear old men boasting of sex drives being comparable to their teens and 20s, it makes me really pity their significant others. Similarly, I don't really want to see shirtless geezers with muscles like Barry Bonds.
It's just weird.
What happened to the notion of aging gracefully? What happened to accepting, to a degree, the idea of slowing down, having a few wrinkles and gray hairs and actually delighting in it?
I guess it faded away as society increasingly prizes and celebrates youth. You know, being between the ages of 15 and 21. Life ends at 30, right?
Hormone replacement therapy obviously helps some people, namely some women during menopause, but it seems like it's a new drug category that's getting out of hand.
But I wanted to know, so I called two local experts for answers.
A patient contract
Dr. Harry Fisch is an adjunct professor of urology at the Medical University of South Carolina, but he's more well-known as being a regular guest expert on “The Dr. Oz Show.”
“The truth is we've known about Low T for years, but we didn't have anything to treat it with. Now, the available treatments are bringing attention to the problem,” Fisch said.
He says the testosterone level in a man's blood should be between 300 and 1,200, and ideally in the range of about 600.
The minority of men suffering from Low T, he says, are men born with no testicles or undescended testicles, or have had testicular cancer or other similar problems. The majority of men suffering with it are obese and/or have Type II diabetes. In other words, the issue with testosterone usually goes back, as so many modern health problems do, to one of lifestyle.
“The bigger the belly, the lower the testosterone,” Fisch says.
Obese and/or diabetic men who have low testosterone often are too tired to exercise, which exacerbates the problem.
So Fisch usually has a “contract with patients” prescribing testosterone medications for men long enough to jump-start an exercise program while they correct eating habits. His mantra to them: “No bread, pizza, pasta, cookies or cake. And no added salt or sugar.” And get moving: Buy a $10 pedometer and log 10,000 steps a day.
Lose the body fat and testosterone gains will follow.
“As long as you are healthy, you should have normal testosterone for your entire life,” Fisch says.
Meanwhile, he doesn't discount a man's sex life, which he calls “a barometer of overall health,” and urges men to know five key numbers for the following health indicators: blood pressure, cholesterol, glucose, prostate-specific antigen and testosterone.
Dr. Steven Swift, a professor of obstetrics and gynecology at MUSC, says general confusion remains over estrogen replacement for women, mostly stemming from the massive Women's Health Study in the late 1990s.
The study sought to find out if estrogen replacement was good for cardiovascular health of women, but it found the opposite. He notes that while more heart disease was associated with women on estrogen therapy, actual death from heart disease was not.
Further review of the study, Swift adds, showed that some of the women ages 63 and older were part of the study and really don't need the therapy.
Swift also says that study, in combination with studies showing estrogen replacement increased the risk of breast cancer, turned “hormone replacement therapy into a dirty word.”
“Droves of women went to their doctors and said, 'Take me off of this,' ” Swift said.
Hormone replacement for women ages 50 to 55, Swift says, still holds a benefit for those in menopause, notably “hot flashes.” The time frame for the therapy can run from six months to six years and isn't necessary for all women.
“At the end of the day, hormones aren't any better than running and other exercise and eating healthy,” Swift says.