Low T and Low E: What does it mean to me?

You can’t watch a sports event or a late-night television show without having to sit through commercials touting the newest product available to help “balance your hormones.” Whether for low testosterone or low estrogen, hormone-replacement is being marketed as the modern-day Fountain of Youth.

Of course, when you learn the effects of these special chemicals, the sex hormones estrogen and testosterone, it’s a wonder why everyone of a certain age isn’t taking HT — that’s short for hormone-replacement therapy — along with their daily vitamin pill.

So, what exactly are hormones? Our bodies make quite a few of these special chemical messengers. Hormones are made in special tissues called endocrine glands. The messengers are sent through the bloodstream to “target tissues.” Only tiny amounts are needed to effect big changes. An example of these changes is what occurs at puberty, the time when the blood levels of the sex hormones estrogen and testosterone rise from childhood to adult levels.

In the case of puberty, the major endocrine glands are the ovaries or testes. These glands send pulses of estrogen and testosterone day and night. Almost overnight little boys develop muscles and hair on their faces and bodies while girls become curvy, the result of fat deposition on their hips and breast formation. Interestingly, men and women produce both estrogen and testosterone in varying amounts.

As we age, the levels of our sex hormones decrease. Women eventually go through menopause as the ovaries stop ovulating and estrogen levels fall fairly rapidly over several years. Male menopause or “andropause” is a more gradual decrease in testosterone levels. A 70-year-old man will have a testosterone level half that of his earlier days. Although the male’s decrease in hormone levels is more subtle, there are signs of this decline including changes in sexual function such as decrease in libido, changes in sleep patterns and mood disorders.

Many of the physical changes that occur as sex hormone levels fall are shared by both men and women. A recent study in the New England Journal of Medicine found that symptoms that had been attributed to testosterone deficiency in men, such as an increase in body fat, especially around the waist, muscle loss and erectile dysfunction, were actually the result of decreases in male estrogen levels.

The average age of menopause is 51. In women, the lower level of circulating estrogen is associated with hot flashes, night sweats and vaginal dryness or discomfort. Decreases in testosterone are thought to be the explanation for waning energy and loss of libido.

Should we all call our doctors for a prescription for the latest pill, cream, gel, shot or suppository? What about the supplements that we hear about on TV and in the backs of magazines? Hormone replacement does have a place in the treatment of some deficiency states, including that related to aging, but first a complete physical and discussion with your doctor is in order. Many of the symptoms that are attributed to decreasing hormones may actually be symptoms of a major medical problem, and it is important to rule that out. Hormone replacement is not without serious side effects, such as increased risk of cardiovascular events and some cancers. Many of the supplements are not FDA approved and have not been thoroughly investigated.

If you are depressed, don’t be afraid to ask for help. It is also important to make healthy lifestyle choices; losing weight, exercising and tossing the cigarettes will all help to alleviate many issues related to age-related hormone decrease.