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What's the Deal with Andropause?

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What's the Deal with Andropause? What’sF.A.Q. the Deal Troches and Bio-Identical With HormonesAndropause? Compounding Without WrittenWritten and Edited ByBy CompromiseCompounding Since Without 1962 LisaLisa Everett Everett Andersen, Andersen, B.Sc B.Sc Pharm, Pharm, CCN, CCN, FACA, FACA FIACP Compromise Since 1962 and Shana Curtis Webb, Pharm Tech In the beginning, it can be difficult to recognize and easily and Dobs of Johns Hopkins University recommend that dismissed. It might start with lowered immune function, elderly men with symptoms of hypogonadism and a total Whatmaybe aIs little a Troche irritability? and unexplainable fatigue, or perhaps testosteroneOther Dosage level of Forms 300ng/dl or less should start hormone difficulty sleeping. Slowly, the symptoms can increase and A troche is a French dosage form that dissolves between the replacement.Besides troches, But dosagewhat about forms young for hormones men with include those sameoral others appear, including hair loss, depression, the typical levels? They are also being told by their physicians that upper cheek and gum, allowing the medication to absorb tablets and capsules, sublingual lozenges, topical creams and actions of a “mid-life crisis,” and erectile dysfunction. This their lab values are in range and therefore just fine. After directly into the blood stream. Born out of the need to address ointments, suppositories, pessaries, injections, implanted cascade of events is often due to andropause (AKA the “male all, testosterone is now a controlled substance and some the problems associated with other dosage forms, troches pellets, and patches. menopause” or hypogonadism). It is the decline of androgens, practitioners don’t want to go there unless they have to. were adapted to systemic bio-identical hormone replacement such as testosterone and dehydroepiandrosterone (DHEA) However, many men need interventions long before their therapy (BHRT) due to their superior absorption, bioavailability, Orally ingested hormones, in the form of tablets, capsules, in men. Although andropause does not appear as abruptly levels become that low. Most men feel best and are healthiest and metabolism. and sublingual lozenges, undergo first pass metabolism as as menopause does for women, it is just as devastating. And when their testosterone is somewhere between 700-1500 ng/dl. they are directed to the liver. Because of this, only 10% of the what’s more, practitioners are noticing the appearance of low The Benefits of Using Troches hormones reach the blood stream, creating a need for higher hormone symptoms earlier and earlier in life, sometimes in DHEA youngThere are teenagers. several reasons troches are preferred for BHRT: dosing. This means 90% of the dose is converted in the liver 1) They are not shunted directly to the liver (avoiding first Theto other age related unwanted falling hormones, off of the causing adrenal damage hormone, to the DHEA, liver is another cause of andropause and of low testosterone, since Butpass), let’s which start protects with the the roles liver of and testosterone gallbladder and from DHEA. damage Libido and gallbladder. Hormone molecules from the first pass effect the latter is made from DHEA. In fact, DHEA is a precursor oftencaused comes by hormones to mind, whenand although swallowed. important, 2) Eliminating it is only first one of are the source of many side effects traditionally attributed to as much as 50% of the testosterone produced by the body. manypass liver biological metabolism expressions of the ofhormones these two prevents hormones. some of to hormone replacement therapy, such as high blood pres- the most common side effects. 3) Absorption through oral Mensure, make formation twice ofas bloodmuch clots,DHEA reduced as women. insulin However, growth byfactor, the time a man is 40, his DHEA level will most likely be 1/2 TmucosaES TOS allowsT ERONE a higher percentage of the desired hormones weight gain, liver formed carcinogenic hormones, gallbladder of what it was at 20! By the time a man is 80 years old, the to reach the blood stream so lower doses can be employed. disease, and more. Testosterone is anabolically the most powerful of the chances are good his DHEA production will be less than 5%. 4) Multiple hormones can be compounded into one troche, androgenic hormones. In men, it is produced in the adrenals making it possible to receive a full compliment of BHRT in Topical applications, in the form of creams and ointments, are and testes. It is the hormone that gives men the feeling of DHEA is produced in the adrenals, testicles, and brain of one prescription. 5) The hormones are cleared from the system difficult to absorb through the skin, though ideal for application comradery and compassion, and one of the reasons they men. It is one of the most important stress-busting hormones. in 8 to 15 hours, allowing for rapid dosage adjustments. to mucous membranes such as those of the vagina and pelvic are less susceptible to autoimmune diseases than women. It is also the second most anabolic hormone. It is necessary 6) The patient is in control of dosing, which is typically twice floor. This is because the skin is a natural protective barrier Of course, testosterone is vital in keeping many other for tissue stamina and function. Among so many other daily, 12 hours apart. 7) Troches are dispensed in a convenient while mucous membranes are designed to transport a multitude physiological functions working properly as well, including attributes, it is an antioxidant, antidepressant, helps produce purse or pocket pack. (Note: They are designed to melt of substances, such as nutrients, macromolecules, and water, the cardiovascular system, spontaneous erections, normal and maintain energy, facilitates proper cellular functioning, at 98.6 degrees Fahrenheit, so it is not advisable to leave them in into the blood stream. Applied to the skin, hormones undergo libido, and ejaculation. preserves ocular health, prevents type II diabetes and your hot car, near a heater, or out in the sun!) change as they pass through to the underlying layer of fat, cardiovascular disease, and is neuro-protective. OnAvoid average, sucking, a man’s chewing, testosterone or dissolving level thebegins troche to declineunder the at a where an immeasurable amount are converted into unintended ratetongue of 1%to assure per year maximum once he absorption reaches the and age to of diminish 35 or 40. the One Manysteroids. patients From have there, never they heard either of enter DHEA into and the soblood will stream not mayswallowing be considered of the hormones. hypogonadal If a dose(having is missed, low testosterone) take the askor becomefor it to trappedbe tested in as the they fat age.cells. Many This spawnsdoctors unfavorabledo not atmedication any age if as his soon total as bloodremembered level of unless testosterone it is almost is less time than for thoroughlyaftereffects understand from the steroidsDHEA, thereforeand makes they it difficult may not linkto achieve 200ng/dl.the next dose. Unfortunately, Do not double patients up on are doses frequently unless otherwise told their decreasingtherapeutic levels hormone as the levels. culprit However, of many whenaging used symptoms. vaginally It blooddirected levels by your are fine,practitioner. even when they are between 300 and isor also on trickythe pelvic to know floor, which proper DHEA formulations lab to request, achieve as systemic only the 500. These levels may be considered “normal” because unconjugatedabsorption and DHEA treat testlocalized will give tissue the conditions best picture such of aswhat is they are “in range,” but may still represent up to an 80% happening.vaginal dryness A little or atrophy.indication of low DHEA: the lower 1/3 of reduction from youthful peak testosterone levels. Basaria the arms / legs will have decreased amounts of hair. 5453 W. 61st Place . Mission, Kansas 66205 (913) 322-0001 . (913) 322-0002 fax . (800) 627-4360 . www.obrienrx.com S YMP TOMS OF A N D ROPAUSE minimizes several important risk factors for heart attack as well, including reducing cholesterol and triglycerides, • Erectile Dysfunction • Low Sperm Count reducing blood glucose levels, decreasing visceral fat mass, • Reduced Libido • Prostate Problems and normalizing blood clotting. The degree of atherosclerotic • Hair Loss • Weakness, Fatigue disease, as measured by the mean percent coronary artery • Disturbed Sleep • Insomnia occlusion, increases significantly with declining levels • Reduced Cognitive Function • Memory Impairment of testosterone. Visceral fat accumulation is connected • Osteoporosis • Reduced Muscle Mass with increased vascular risk, and studies have shown that • Obesity, Type II Diabetes • Irritability androgen administration can decrease this fat accumulation. • Depression, Anxiety • Apathy • Heart Disease • Atherosclerosis, Hypertension D EPRESSION • Impaired Blood Cell Formation • Hyperlipidemia The presence of testosterone in the brain elevates serotonin • Slow Wound Healing • Immune System Impairment and dopamine levels, helping its antidepressant properties. B ENIGN P ROS tat IC H YPERPL A SI A Standardized measurements of depression are worse when (BPH) A N D P ROS tat E C A NCER levels of active testosterone are low. In the Rancho Bernardo More than half of American men have microscopic signs Study, which examined the association between levels of sex of BPH by the age of 60. By age 70, over 40% of men will hormones and depressed mood in 836 men ages 50-89, active have an enlarged prostate to the point that it can be felt on a testosterone levels were 17% lower for depressed men. The physical examination. BPH is caused by diet, environmental results suggest that testosterone treatment might improve toxins, genetics, and, of course, hormone imbalance. depressed mood in older men who have lower levels of active testosterone. To help avoid prostate cancer and allow the prostate to be at its healthiest, the body needs adequate levels of testosterone Testosterone is also vital for reducing stress and anxiety, and DHEA. When men are younger and their testosterone promoting proper sleep patterns, stimulating mental acuity, levels are high, the prostate functions normally.
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