The ads tout testosterone treatments for “low T,” but surprising new research shows a different hormone may play a role in less sex drive and more fat as men age. Estrogen — the female hormone — is needed by men, too, and the study gives the first clear evidence that too little of it can cause certain “male menopause” symptoms.
“A lot of things we think are due to testosterone deficiency are actually related to the estrogen deficiency that accompanies it,” said Dr. Joel Finkelstein of Massachusetts General Hospital. He led the federally funded study, which appears in Thursday’s New England Journal of Medicine.
Testosterone is the main male sex hormone. Men’s bodies convert some of it into estrogen, and levels of both decline with age. Until now, there was no way to tell which hormone was responsible for complaints of diminished libido, strength and energy.
Millions of men have been prescribed testosterone gel, patches or shots for these problems, but it’s not known how much they need or whether this hormone replacement therapy is good, bad or neutral, Finkelstein said. Doctors don’t usually prescribe estrogen to men; the way to remedy low estrogen is to give them testosterone and let the body convert it.
The study didn’t test hormones as therapy, but explored which ones had which effects. It involved 400 healthy male volunteers, ages 20 to 50, who were given monthly shots of a drug to temporarily reduce their testosterone production to pre-puberty levels. They were then given various doses of testosterone gel or a dummy gel to use. Half also were given another drug to prevent testosterone’s conversion into estrogen.
Designing the study this way allowed researchers to compare the effects of different levels of each hormone on things like strength and body composition.
After 16 weeks, researchers saw that muscle size and strength depended on testosterone, body-fat mass depended on estrogen, and both hormones were needed to maintain normal sex drive and performance.
The results mirror animal research — mice altered so they don’t make estrogen grow fat and have no sex drive. And in male-to-female transsexuals, “there’s actually evidence that when those men are given estrogen, it helps their libido,” Finkelstein said.
The new study was too short to see long-term benefits or risks, such as the effect of testosterone supplements on the heart, mental sharpness, prostate enlargement or cancer. Also, abruptly and artificially depriving men of testosterone the way the study did may not be the same as when it falls off naturally and gradually over time.
Some people call this midlife decline “male menopause” although men don’t menstruate and testosterone doesn’t fall off as sharply with age as estrogen does in women after menopause.
“Andropause would be more reasonable,” since testosterone is an androgen, a male sex hormone, said John Morley, an expert on hormone therapies and aging at Saint Louis University.
He said the study shows a big variability in the amount of testosterone men may need. Doctors tend to try a lower dose and abandon it if it doesn’t work, but some men may need more.
Further research is needed, but the results may boost the case for giving testosterone to prevent frailty in older men, the authors write. Low testosterone may contribute to less muscle and bone strength and mobility, impaired thinking skills, heart disease and other problems.
“This is a big public health issue,” Finkelstein said. “If the changes with aging are due to these things, then potentially replacing these hormones in men might ameliorate these changes.”
Dr. Peter J. Snyder of the University of Pennsylvania called the new work an excellent study, but noted it was not intended to determine whether hormone therapy is beneficial. He is leading a study that will — a National Institute on Aging study testing testosterone replacement in 800 older men. He hopes for some early results late next year.
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This Week’s Celebrity Instagrams (11/26-12/2)
30 photos Launch gallery
1. Little Legend and Puddy 😍😍😍😍
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2. "You on point Phife?" "all the time,Tip". 💥 #bannedfromnormal
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3. Vegan! The Impossible burger at Crossroads
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4. Lawrence #BeforeandAfterEpisodes 1-4: 184lbs 13% body fatEpisode 8: 196lbs 8% body fat S/O @coachdaveboxing with the works outs and @kildareriordan with the nutrition
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5. Jus haaaanngin out
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6. Meanwhile back at home in Atlanta GA someone mad they not on the 🛳. 😳
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7. No limits... Photo cred: Chris Bridges @ludacris
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8. new new
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9. Apparently my 260lbs is too much for the actual vines in the Hawaiian jungles to hold me without breaking and me falling hundreds of feet. So for safety purposes, I'm forced to swing thru #Jumanjj on wires strong enough to hold 12 adult buffaloes and 1 adult Rock. #OnSet #Jumanji #IronicallyIEatBuffaloDailyForLunch #MoreManThanNatureKnowsWhatToDoWith
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10. hey ma! 🎎#wcw 💙
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11. Surprise visit to our factories!!! #GoodAmerican #USA
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13. Peachy Keen 🔥✨⚡️
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14. If this don't look thankful I don't know what does. Happy Thanksgiving to you and yours. #UltraBlessed #24kMagic #SweetPotatoFly
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15. Late nights @nbcmarlon with the writers... we in here!!!
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16. There goes my baaaaaaaaabbbbyyyyy #QueenKingMagic!!! We're up to something! Ira BIG!!! Stay out our buisness -
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17. You want to win every game you play but when you come home to these faces... who cares. #ILoveYouGirls best part of my day, everyday!
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18. Steady,steady..... full size jenga.. "I got this one "???? Or do I ?
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19. Cornrows kind of day 😉@dontaysavoy2 you convinced me and I love. ❤️️
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20. #BrotherlyLove #tbt
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22. #basel #TeamLOVE @kingcombs
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23. Just introduced a special screening of @directher 's groundbreaking (must see) documentary @13thfilm with my brother @themichaelealy | @unitedblackout #blackoutblackfriday
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24. Me & Vanessa Williams giving #DuckLips #Pose on the set of #DaytimeDivas @vh1 - Coming Soon to a tv near you. Lol. - My make up done by @makeupsurgeon
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25. This picture just makes me wanna praise the Lord, you hear me!!!!!! Yes Lord brotha #TEDDYCAMPBELL What a #man !!! You are everything right on this picture husband ......... #gorgeous #stylish #classy #strong #masculine #king #sexy #debonair #gentlemenstyle And that #bible in your hand just seals the deal for me (probably cause i know that, that is what helped you become just as amazing as you look😘). While my heart and mind experiences the goodness of God at #church on Sundays, my eyes experiences the goodness of Teddy😍. Amen somebody🙌🏽. "Bless the Lord oh my soul and all that is within me bless his holy name" #myman #myhusband #goodman #blackman #dapperman #godlyman #goodfather #mybestfriend
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26. Yesterday was my mama's 53rd birthday!!!!! Got to celebrate with her all day. If this is what I have to look forward to I can't wait. Looking like a soft bucket a cocoa butter. Yaaaaaaaaaas! 😍😍😍 love you mommy!
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27. "Shout out to @PureAtlanta for getting the family right"....I'm loving this jogger. 😍😍
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28. This pic warms my heart ❤️ #myLogiebeans and aunt aunt umba @itowandabraxton 😘
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29. You will always be my baby😜. #HappyBirthdayReginae #mybaby18
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30. GC "Gods Child" Red on Red SweatSuit available now at www.MonicaApparel.com ... Take Your Crown wherever you go!! I'm pictured in a Medium... Go to the site now for other options ... cc: @trukernell
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