As men and women age we experience a natural decline in our hormones.
Women already know about this — they call it menopause, also known as the “change of life.” And that is truly what it is — life changes — and usually not for the better. Women have three important hormones (testosterone, progesterone, and estradiol) that progressively start to decline, usually in the late thirties to late forties. As these hormone levels drop, many women experience significant changes in their mental and physical well-being that can negatively impact their daily lives. Ultimately these hormones levels almost complete disappear and a woman enters menopause. Her reproductive years come to an end — usually her menstrual periods stop. However, a number of other bothersome symptoms and changes can occur in a women’s body both before and after menopause, including things like night sweats, hot flashes, poor sleep, moodiness, irritability, fatigue, lack of energy, weight gain, loss of muscle mass, difficulty recovering after exercise, loss of mental clarity / foggy thinking, depression, anxiety, decreased libido, vaginal dryness, and bothersome hair and skin changes.
Although men’s hormones don’t “suddenly” decline causing a menopause like women’s do, men’s testosterone levels decline as they age. And while the changes aren’t as immediately apparent or dramatic, they add up over time to causing significant worsening of quality of life. As a man’s testosterone declines, he experiences many symptoms but ofttimes so gradually he doesn’t even realize they are occurring. These symptoms may include fatigue, loss of energy, poor sleep, moodiness, irritability, weight gain, loss of muscle mass, depression, anxiety, difficulty recovering from workouts, decreased libido, and erectile dysfunction.
Although these changes are “natural” and occur to all of us as we age, modern medicine has given us convenient, safe, and effective ways to replace these critical hormones as we age. Much like any medical intervention, hormone replacement therapy must be correctly prescribed and carefully monitored, but done well, the effects can be life changing. While some argue that we should just “age naturally,” it’s worth pointing out what we do in medicine is to prevent “nature from taking it’s course’ When I was practicing Emergency Medicine and a patient came into the ER with a heart attack we didn’t just tell them “don’t worry, it’s normal aging.” We would intervene and do something. Although the decline in hormones is much less acute than a heart attack, the life changing effects of hormone loss with age can be similarly detrimental, and so why wouldn’t we want to intervene if we can do so safely?