Hormone Replacement

There is a progressive decline in testosterone production in men with age.

Testosterone is also improtant in menopausal patients. Testosterone is a crucial hormone for women, playing key roles in energy, mood, libido, and muscle maintenance. Women's bodies usually produce more testosterone than estrogen, and similar to estrogen and progesterone, levels decline with age. Most testosterone is produced in the ovaries, with a smaller amoutn from the adrenal glands. 

Los testosterone in women can lead to symptoms akin to those in men such as fatigue, low libido, irritability and depression, and reduced quality of life. 

For men, testosterone can decline with age. These changes can be dramatic, such that 50% of men >60 years old have low levels of testosterone. Although the rate of decline varies widely, a general rule of thumb is that testosterone levels decrease about 1% yearly after age 50. Despite the fact that it is not as rapid a drop in hormones as women get with menopause, it certainly is just as real. This has been termed male menopause, male climacteric, andropause, or more appropriately, partial androgen deficiency in the aging male (PADAM). Serum testosterone levels in men fall progressively from the third decade to the end of life, mainly due to a decline in the cells in the testis that make the hormone (Leydig cells). This decline may also be due to changes in hormones (GnRH, LH) and proteins (SHBG, albumin) that regulate testosterone production.

Normal Testosterone Levels

One issue with testosterone that complicates matters is the fact that it exists in several different forms in the blood, and each form has different hormonal activity.  “Free” or unbound testosterone is a fully active hormone, but protein-bound testosterone are