The Other Pause

[Guest guest]

" HSI - Jenny Thompson " <HSIResearch

 

HSI e-Alert - The Other Pause

Thu, 28 Apr 2005 10:30:40 -0400

HSI e-Alert - The Other Pause

 

Health Sciences Institute e-Alert

****************************************************

April 28, 2005

 

 

Dear Reader,

 

With all the attention given to the health challenges that come with

menopause, it's important to remember that midlife isn't exactly a

cakewalk for men. Andropause is the male counterpart of menopause,

complete with hormonal changes that present a number of key health issues.

 

I recently received an e-mail from an HSI member named Ron who wrote:

" Can you please do an article on hormone replacement therapy for men?

I see a lot of conflicting information and yet it seems to help a lot

of people. "

 

Right on both counts, Ron. Some men swear by hormonal treatments. But

according to a major report from the Institute of Medicine, various

factors of this treatment represent unknown quantities that are

potentially dangerous.

 

-----------

Strange changes

-----------

 

Here's what we know about andropause: As men grow older, their

testosterone levels drop a little more than one percent each year

after the age of 40. This can trigger a variety of symptoms, such as

moodiness, memory loss, a decline in sex drive, and a lack of energy,

strength and endurance. Other less obvious problems include the

decrease of lean muscle mass and bone mineral density in the spine.

Taken together, these conditions sometimes cause men to experience a

gradual passivity and disinterest in life.

 

But going gentle into that good night is not acceptable to many men.

For those who choose to address the problem there are several

therapies available, including exercise regimens, a variety of natural

supplements that help your body raise its own testosterone levels, or

testosterone replacement therapy (TRT). About three years ago the FDA

approved TRT for the treatment of low testosterone production called

hypogonadism. Since then, many doctors have exercised the option of

off-label usage to prescribe the therapy for other andropause

symptoms. And they've had some help.

 

In the e-Alert " Who's on First " (8/22/02) I told you about a campaign

to promote andropause as a condition requiring medical treatment. That

campaign has been aggressively promoted by Unimed, makers of AndroGel,

a TRT formula that's rubbed on the shoulders daily and costs about

$250 per month. AndroGel dominates the TRT market of testosterone

gels, creams, and patches, which accounted for 2 million prescriptions

in 2002.

 

-----------

Not going long

-----------

 

In late 2003, a committee of the Institute of Medicine concluded a

one-year review of existing TRT research. They found only 31 trials

that focused on older men. Most of those trials used fewer than 50

subjects, all but one lasted less than a year, and many were not

placebo-controlled.

 

In light of the quickly growing TRT market, the committee determined

that the risks and benefits of TRT have not been adequately tested,

especially in older men. And because some studies have also shown that

testosterone therapy may increase the risk of prostate cancer

(especially in those men who are already in a high-risk group),

committee members called for doctors to immediately take greater care

in prescribing TRT.

 

In addition, the committee recommended careful planning for upcoming

trials in order to assess how TRT may increase the prostate cancer

risk in older men, while excluding potential subjects who are already

at high risk. They also recommend that short-term studies should

begin, specifically designed to determine benefits of the therapy.

They suggest that long-term studies should follow only if the shorter

studies reveal clear benefits of TRT.

 

This strikes me as " short-term " thinking. If researchers conclude that

long-term studies aren't needed, doctors will certainly continue to

prescribe the therapy and men will continue to demand it. Meanwhile,

one of the problems with TRT right now is the fact that we don't know

exactly what problems may come with long-term usage. What we do know

is that some studies have already revealed certain unpleasant side

effects, including testicular shrinkage, abnormal enlargement of the

breasts and an elevation in circulating blood cell level, which can

lead to stroke and heart failure.

 

-----------

Don't rush in

-----------

 

Apart from the existing research, there are many testimonials from men

who have reported a boost in energy and libido while using TRT. But

the use of this therapy as an anti-aging tool is scientifically

unproven. In fact, committee chair Dan G. Blazer, M.D., told WebMD

Medical News that, " the evidence is almost nil. " So in many ways, our

knowledge of TRT now is similar to our knowledge of HRT a few years ago.

 

And if we knew then what we know now, the prudent advice to women

would be the same as the Institute of Medicine committee's advice with

TRT: Tread very carefully with this therapy.

 

As I mentioned above, there are alternatives, including supplements,

which have been shown to help men cope with andropause symptoms. For

instance, Tribulus terrestris Linn is a botanical used in India for

centuries to treat sexual dysfunction and promote rejuvenation in men.

Formulas containing this herb are available in health food stores and

through Internet sources.

 

Whether or not andropause should be accepted as a normal part of aging

or regarded as a medical condition that requires treatment is a

question that can only be answered individually by each man

experiencing the symptoms of these changes. If you're a man who's

40-something or older and you've noticed changes in energy levels,

sexual desires, or moods, share your concerns with your doctor.

 

Most importantly, weigh your options carefully before deciding which

course to take. Because as we've learned too often, for better or for

worse, short-term solutions can have long-term effects.

 

****************************************************

 

 

....and another thing

 

If you've got a passion for kiwifruit, your heart may love you for it.

 

Kiwifruit is packed with nutrients, including plenty of vitamins C and

E and polyphenols; the antioxidant and anti-inflammatory plant

compounds that have been shown to provide cardiovascular benefits. So

researchers at the University of Oslo designed a test to evaluate the

effect of kiwifruit on heart health.

 

During a 28-day trial, cholesterol, platelet activity and triglyceride

levels were measured in healthy volunteers who ate two or three

kiwifruits each day. Subjects who ate kiwifruit didn't have any

changes in cholesterol levels, but platelet aggregation was reduced by

nearly 20 percent, and triglyceride levels were lowered by 15 percent,

compared to a group that didn't eat kiwifruits.

 

And an added bonus: A UK research institute recently reported that a

daily intake of kiwifruit may provide protection from cancer-causing

DNA damage, while also stimulating DNA repair.

 

Most of us who live outside of New Zealand probably don't eat 15 to 20

kiwifruits each week. But it seems that adding this nutrient-dense

item to a diet that already includes plenty of fruits and vegetables

may provide a welcome boost to heart health benefits.

 

To Your Good Health,

 

Jenny Thompson

Health Sciences Institute

 

****************************************************

 

 

Sources:

 

" Testosterone Therapy Studies Should Determine Benefits First, Then

Risks; Study Participants Should Be Limited, Carefully Screened "

Committee on Assessing the Need for Clinical Trials of Testosterone

Replacement Therapy, News Release, 11/12/03, nationalacademies.org

" Testosterone: Benefits, Risks Unknown " Jeanie Lerche Davis, WebMD

Medical News, 11/12/03, webmd.com

" Testosterone Derided As a Health Supplement " Marc Kaufman, Washington

Post, 11/13/03, washingtonpost.com

" Effects of Kiwi Fruit Consumption on Platelet Aggregation and Plasma

Lipids in Healthy Human Volunteers " Platelets, Vol. 15, No. 5, August

2004, ncbi.nlm.nih.gov

" Kiwis Make for Healthier Arteries " NutraIngredients.com, 9/8/04,

nutraingredients.com

 

**********************