Sunday, July 13, 2008

T plus Eight Weeks

Copyright (c) Andy Singer; noncommercial use only

I see that a number of people have found my blog because they were googling on terms like "low testosterone." If you aren't interested in my health issues, you might want to skip this post. If you're reading my blog for the first time, I write a lot about bicycling and living west of Portland, Oregon. However, I found in the spring that I was suffering a hormonal deficiency, and both the ailment and its treatment have been life changing. When I mentioned this to my primary care physician, she said she believes it's one of the most under-diagnosed ailments in older men.

Since I started getting the shots about two months ago, my quality of life has altered drastically, mostly because of the treatment. Testosterone therapy is a risky and scary thing. The potential side effects can be life threatening, which actually caused me to delay seeking treatment for about half a year. I want to discuss the flip side today, which is that if you need it, you should seriously consider trying it.

You know, when you think about it, if women's ovaries can wear out, why not men's testicles? However, I think the similarity stops there. Women have these whip-saw once-a-month hormonal swings, whereas men have fairly constant androgen levels that slowly decrease with age. My point is that while menopause has positive as well as negative health benefits, male andropause seems, according to my research, to have mostly negative results.

The remainder of this entry is a presentation of the perceived effects to date. They're mostly positive, and-of course--YMMV (your mileage may vary). The list is so huge that I've had to make a list before seeing my specialist next month. That in itself should give you a pretty good sense of how significant this treatment is. I want this message to get out because testosterone deficiency is such a gradual thing that it's easy to dismiss the effects until you wake up one day with an acute symptom.

The web sites that say "do you have low testosterone? take the test" didn't really help me very much. All of the questions were "gimme's", things like you're not happy with your weight or your athletic performance, or you're more tired, or wondering about your sexual performance. Excuse me? How am I supposed to distinguish between the normal effects of aging and all the things you're talking about?

Instead, I'd like to share my personal experience with this treatment, to give you an idea of how dramatic the changes can be. Again, this treatment isn't for everyone. I'll be on blood tests for the rest of my life, and the shots are a pain in the butt, both figuratively and literally. It might even kill me. However, the quality of life difference has been immense, and I hope if your doctor has diagnosed you with low testosterone (below 300 ng/dL) and you think you're having some quality of life issues, that you'll seriously consider at least trying the treatment.

One section deals with urogenital effects. If you're uncomfortable hearing those things, you might want to skip to another one of my posts.

Mental Effects

I'm listing these first because the mental symptoms had the earliest onset.
  • greater visual erotic stimulation, [+1 day] Yeah, I like looking at women again. I mean, for a while there, it was the weirdest thing: "yes, she's pretty, but I just don't care." Is this a positive or a negative? Well, let me put it in a way that women understand: do you like looking at cute animals? You like looking at children? Yeah, it's kinda like that; it's one of those small daily pleasures in life.
  • more assertive [+4 days] No, I don't mean aggressive; I mean standing up and getting my point across.
  • more sexual thoughts [+2 weeks] One point last winter I realized that I could go for a day or more without thinking about sex. Women might wonder what the big deal is, but I'm sure men out there know that that just ain't right.
  • clearer thinking [+2 weeks] Me hunter. You mammoth. Me chase mammoth. Seriously, though, my ability to follow complex reasoning seems to have improved.
  • less grumpy [+3 weeks] I don't normally use the word "grumpy" to characterize my bad moods. Anxiety is term I would more commonly use. But over the winter my problems went beyond any sort of anxiety or seasonal afflictive disorder syndrome.
  • more competitive [+4 weeks] Just the sort of thing women roll their eyes about. Guy pulled up to me on another bike at a stop light and blew by me as it just turned green. I wasn't about to seem slower than him. Oh, yes, I last saw him half a block behind me.
Athletic Performance:
  • Faster cycling [+1 day] There is an immediate effect on my cycling performance, both overall and the day after a shot. (Sorry, Floyd Landis.)
  • Reduced recovery time [+4 weeks] After the Birkenfeld Brevet I was sore the second day after the ride. I'd never had that before, and I don't now.
  • Stronger (25% more power in 6 weeks just bike commuting). Let me explain this. When I commute around town, I don't make it an athletic event. I ride at a comfortable pace. I start coasting when I see I'll have to stop because of a light or a stop sign. All of these things mean that my average speed, as measured by miles traveled divided by total on-saddle time, is not going to be very impressive. Every two weeks or so I copy those two numbers off of the cycle computer on my thirty pound monster and enter them into my training log. Imagine my surprise when I saw this dramatic increase in average speed.
  • Faster running [+6 weeks] I suck at running. But it's good for you. All winter long I just could not get my mileage up, and my perceived exertion was pretty high. I still suck, but I suck less bad at it now.
Not for the squeamish, but since one of the major indicators of low testosterone is low sex drive, it's not fair for me to omit this.
  • stronger orgasms [+4 weeks] I just wasn't enjoying sex as much. This changed surprisingly quckly.
  • more frequent orgasms [+4 weeks] Kinda goes with having a greater sex drive.
  • spontaneous erections (with sexual thoughts) [+6 weeks] Man, I haven't had this symptom since, well, my twenties.
  • frequent morning erections [+6 weeks] It's actually an annoyance since usually you need to urinate.
  • more semen [+6 weeks] This needs some discussion. I had discounted the decrease in semen as a side effect of another drug I'm on. As soon as I noticed this change from the the therapy, another light bulb went off: PSA == Prostate Specific Antigen, a rapid increase of which may indicate prostate cancer, which in turn means runaway metabolic activity (cancer cells). And, my specialist is avidly looking to find a new baseline measure for my PSA level because of the treatment. Aha! It all makes sense!
  • possibly more hesitation when urinating, esp. at night -- I can't even say for sure this is happening, but all the medical geeks say that increased urinary problems are possible.
  • no more hot flashes [immediate] Waking up at four in the morning covered in a cold sweat for no apparent reason was not enjoyable.
  • higher heart rate (both resting and max [+1 day] This is not reported in the literature, but my resting heart rate had dropped about 15 beats per minute over the last year or two before the treatment started. My maximum heart rate has also risen close to its previous levels.
  • More energy (perceived tiredness, amount of sleep) [+2 weeks] I'm still lazy and I still procrastinate, but I'm not so flippin' tired all the time.
  • oily face [+3 weeks] It seems like whenever I wash my hands in the bathroom, I also wash my face now.
  • scalp fungus [+4 weeks] Way back when dinosaurs roamed the earth, I went to my doctor and complained about acne on my scalp. He said it wasn't acne, it was fungus brought on by my body chemistry. He prescribed a shampoo back then, which I use on an as-needed basis, typically in the spring and fall. However, I realized when this symptom recurred that I hadn't had it in about five years. I'm betting this is closely related to the oily skin.
  • sleeping much better [+4 weeks] I wasn't expecting this one. I fall asleep faster and I awaken less frequently. My middle-aged male visit to the bathroom in the middle of the night is much less annoying now. It goes without saying that I am also much more rested upon arising in the morning.
  • improved sense of smell [+6 weeks] Hunh? Hey, I'm just reporting it. I can smell again. Probably not good for any weight loss attempts, since I enjoy eating again.
  • increased beard growth [+8 weeks] I know, this is frequently reported in the literature, but have I very little beard to begin with (my Cherokee ancestry, I'd like to think), so I wasn't really expecting anything dramatic here. However, I simply can't skip a day of shaving any more.
What have I not seen? Well, no "roid rage", but I think my emotional demeanor was pretty decent to begin with, and the medical geeks believe this is actually an exacerbation of existing emotional problems. Also, I haven't lost any significant weight yet (drat!), but I would expect that to be very gradual. Finally, I have so little hair on my head that any hair loss would be imperceptible. I'm not a "chrome dome", but it's already very thin, so I doubt this will ever be an issue for me.

Copyright (c) Andy Singer; noncommercial use only

1 comment:

Derrick Waker said...

Thanks for your article. Very informative in an average guy kind of way, which was helpful for me. Do you have any recommendations on who to go to about this?