Unsubstantiated Claim 4:
Andropause doesn’t exist
Data:

While andropause, the progressive decline in testosterone production in aging men, unquestionably does exist and warrants treatment, whether the term “andropause” per see is a good descriptor for this phenomenon has been debated.

The terms “andropause” or “male menopause” are not completely accurate because androgen secretion does not cease altogether, as the term “pause” indicates 83, 84. The term menopause is correct in that in women the reproductive cycle invariably ends with ovarian failure and an abrupt cessation of estrogen production and onset of symptoms. In men however, the reduction in testosterone levels is a gradual process and the appearance of its clinical manifestations is more subtle and develop over time. This has unfortunately led to a tendency among many suffering older men to ignore the symptoms and accept it as an unavoidable and untreatable result of aging. In a survey of health care professionals, half reported that their patients rarely or never asked about low testosterone 85. Several prominent scientists have strongly recommended that awareness of andropause and its consequences be increased 83, 86, 87.

The term “male climacteric” is more appropriate as it suggests a decline and not a precipitous drop in hormones levels 88. The term “male climacteric” refers to the syndrome of endocrine, somatic, and psychic changes that occur in normal men with aging. This term is good in that it emphasizes the multidimensional nature of age-related changes, including age-related decreases in other important hormones such as growth hormone (GH), insulin-like growth factor-1 (IGF-1), dehydroepiandrosterone (DHEA), and melatonin 89-91, and not only relates aspects of the male aging syndrome specifically with testosterone levels.

Andropause has also been referred to by some medical professionals as “androgen deficiency in the aging male (ADAM),” “partial androgen deficiency in the aging male (PADAM),” or “aging-associated androgen deficiency (AAAD)” 84. However, andropause is the term that is used commonly by experts in the field and by lay persons alike because it retains some analogy to the term menopause in women 83. After all, what’s in a name?

Unsubstantiated Claim 5:
Estrogen replacement in post-menopausal women turned out to be bad, and therefore testosterone replacement in men must also be bad.

Reality:

This claim is screams irrational logic and an unwarranted extrapolation.
Unsubstantiated Claim 6:

Bad Kharma: It’s All about Sex

Reality:

Testosterone therapy is a touchy topic because it improves sexual capacity and enjoyment. Even in the times of Viagra, attitudes to sex remain embarrassingly silly “imagine if you give an older man testosterone, he may want to have sex!!” The use of testosterone in women is facing a similar issue 92-95.

Unsubstantiated Claim 7:
If testosterone becomes mainstream treatment in elderly it will become abused by younger adults

Reality:

Abuse of testosterone will occur whether or not it is available for older men.

Conclusion

Testosterone deficiency in older men (hypogonadism) is very common 52, 96, 97 (up to 50% of men over the age of 50 are deficient in free testosterone when compared with peak morning concentrations in young men 91), and yet only a small proportion of hypogonadal men are receiving testosteone replacement therapy 98. In the end, a particular political viewpoint is in the eye of the beholder. Nevertheless, it is obvious that the political climate is working against testosterone replacement therapy in older men despite overwhelming scientific data supporting this appropriate pursuit as a strategy to prolong healthy longevity.

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