The Impact of Testosterone Deficiency Syndrome (TDS)

Found in both men and women, testosterone is a hormone that plays an important role in health and wellbeing, as well as sexual function. In men, however, testosterone is the principal hormone that influences libido and energy levels, and is the most important male sex hormone.

Testosterone plays a different role at each stage of a man's life. In the uterus, the hormone is responsible for the development of the male foetus. During puberty, it plays an important role in the development of the male secondary sexual characteristics such as the deepening of the voice, and the growth of the beard, male body hair and pubic hair. In male adults, testosterone controls the reproductive functions such as sperm production, erection and sex drive. Besides that, the hormone also plays a crucial role in maintaining the male health and wellbeing.

Unfortunately, according to Corona et al., the levels of active testosterone decrease with age, starting from 40 years of age, by approximately 1.2% per year. A man would have lost approximately 35% of his originally active testosterone by the time he was 70 years old. Disease and ageing can lead to the development of testosterone deficiency which can cause a wide range of complaints and serious illness.

The inadequate production of testosterone in a man can lead to a condition known as Testosterone Deficiency Syndrome (TDS). Based on the Massachusetts Male Aging Study in 1991, symptoms of testosterone deficiency include loss of sexual desire, erectile dysfunction (ED), fatigue, poor concentration, increased body fats, reduced muscle mass and strength, and depression. It has also been observed that one in five ED patients have testosterone levels lower than normal.

In a study, published in the Journal of Urology, besides the obvious effect on the male sexual health, TDS may also severely affect a man's general health and is believed to be an important component of the metabolic syndrome. The latter is a medical condition characterized by obesity, insulin dysregulation, causing abnormal blood sugar level, high cholesterol levels and mild hypertension. Left untreated, it may lead to diabetes and heart diseases.

A recent report from the United States identified a clear relationship between low testosterone levels in men and metabolic syndrome. Results from Al Burnett's studies have shown that obese men who have metabolic syndrome have average testosterone levels 150 ng/dl (approx 5 nmol/L) less than men who do not have metabolic syndrome. Low testosterone levels have been associated with an increased risk of ED and coronary artery disease.

According to the European Association of Urology in Berlin, results from clinical therapy have shown the benefits of testosterone therapy in restoring healthy sexual desire and erection quality as well as having benefit on improving abnormal metabolic parameters such as glucose and lipid levels, waist circumference, body fat and blood pressure.

By normalizing a man's testosterone levels, the negative effects of TDS can also be reversed, thus improving blood pressure and fasting plasma glucose levels, lower 'bad' HDL cholesterol, as well as improving their sexual desire and sexual functions, muscle mass and strength, reduced body fats, better mood, and reduced fatigue and exhaustion.

Reference:

Corona, G. et al. Organic, relational and psychological factors in erectile dysfunction in men with diabetes mellitus. Europ Urol 2004; 46: 222-228.

Massachusetts Male Aging Study in 1991.

Makhsida, N. et al. Hypogonadism and metabolic syndrome: implications for testosterone therapy. Journal of Urology 2005; 174: 827-834.

Al Burnett. Metabolic syndrome, endothelial dysfunction, and erectile dysfunction: association and management. Curr. Urol. Rep. 2005; 6(6):470-5.

Behre, H. Testosterone Therapy: Nebido Proves Safe and Effective Treatment with High Satisfaction. European Association of Urology congress. Germany, Berlin.