[mtex]

Nowadays, when a person reaches 40 or 50, they may have only lived half their lives, unlike their ancestors, who even 100 years ago, were considered old. We expect to sit on the banks of the pond and see the reflection of a smooth-skinned, svelte young adult smiling back -- the person that exists within our psyche. But the mirror, unkind horror that it is, often reflects a different story.

Those who have taken good care to maintain their health and appearance don't look elderly, but both sexes begin to undergo a decline in hormone levels. Although men never come to the end of their reproductive lives naturally as do women, they still experience a great many changes.

Most are quite happy to be rid of baby diapers and other child-rearing chores. That's the good part. The bad part is that the hormones that control our reproductive systems also control a lot of other things that we'd love to hang on to, like being able to eat and drink whatever we want without paying the piper. Unfortunately, there is no way to turn back the clock -- you only go around once and you can either grow old or die young.

There is medical help available nowadays, but it is often a double-edge sword. For some reason giving estrogen to women was, and still is, acceptable, maybe because a bunch of male doctors were/are being driven nuts by their menopausal wives! Although it can relieve a lot of unpleasant symptoms, synthetic estrogen and progesterone replacement has been linked to breast and cervical cancer.

The opposite opinion was held when it came to giving men the equivalent, i.e. testosterone, because everyone knew they would morph into King Kong, chasing innocent women through the streets. Although attitudes have now changed, there are still many doctors who refuse to prescribe it, or prescribe it at such low levels that it's a waste of the patient's time and money. Testosterone definitely helps a man's libido, but does many other things as well, including promoting feelings of well being. The downside is that given in too high a dosage, it can promote oily skin and blemishes and convert to estradiol (a form of estrogen).

Men and women naturally produce both testosterone and estrogen, albeit in different amounts. Small amounts of additional testosterone given to middle aged women can increase sagging libidos. Men shouldn't let their estradiol levels drop below a certain percentage because they can suffer bone loss and other problems, so the "macho" fear of some physique community proponents about men's estrogen levels is totally incorrect and dangerous to a man's health.

Many people live their entire lives never requiring any sort of hormone replacement therapy whatsoever. Those who feel they might be candidates for HRT need to understand that they must find a happy medium for their individual bodies. Before you begin, even if your doctor thinks you should, do yourself a favor and become self-educated first. For those whose doctors won't hear of such a thing, you need to know the facts so you can talk about the subject with some intelligence and find out how to locate a doctor who understands the problem.

Excellent discussions on this topic are outlined in articles (1) by Karlis Ullis, M.D. (2) and his associate, Joshua Shackman, M.A. (3). These articles and Dr. Ullis' and Mr. Shackman's books are written for the lay public. A quite lengthy and somewhat scientific dissertation can be found on the Life Extension Foundation Website (4, 5). Readers are reminded that LEF sells supplements, thus the latter part of their discussion promotes their products.

This is understandable because often the hardest part for both sexes is locating a doctor who really understands hormone replacement therapy. LEF provides a list of physicians who specialize in this field (6). You may have to travel outside your locality to visit one, but once your protocol is established, you shouldn't need to visit that person more than a couple of times a year. Your chosen physician should insist upon having, and be able to interpret, hormone blood levels so that your treatment is on an individual basis according to your needs.

Because HRT is more acceptable now than previously, many insurance companies will pay for some, or all, of both doctors' visits and the hormones themselves. However, before you assume that yours will, check with them to be certain.

A Short Overview

It is recommended that you read the referenced articles for a more in-depth understanding of the changes your body undergoes and what steps you may be able to take to retain your youthful vigor (this is not just about looking good). The following is not medical advice. It is for informational purposes only.

Karlis Ullis, M.D. states in his Muscle Monthly articles (1) that his approach is really "hormone balancing, [i.e.] keeping [a person's] sex hormones (testosterone, estrogen and progesterone) at the same levels that they were [when that person] was in their mid-twenties."

As men age, their bodies naturally manufacture less testosterone or convert it to estradiol. This throws off the youthful ratio, causing many side effects that may include depression, fatigue, a female-type fat distribution pattern, muscle wasting, diabetes and prostate enlargement. Many of these conditions can be reversed by proper exercise and diet, but this strategy only goes so far for someone who truly needs medical intervention.

After performing a thorough medical exam and comprehensive hormone panel (blood test), Dr. Ullis determines the best approach for each patient. He bases his conclusions on the following:

1. A deficiency or imbalance that has been shown by lab tests results.
No sign of cancers that might be exacerbated by hormones.
Subjective responses to questions, i.e. whether the man has been depressed, is suffering from low-self esteem, lack of sex drive, has had problems gaining muscle even when he's been working his butt off in the gym, etc.
Because male "andropause" is a slow process, Dr. Ullis may not start a patient on testosterone immediately because doing so could "potentially shut down his sex hormone production completely, especially if higher than normal testosterone levels are maintained."

Many readers are very familiar with what occurs in men who take high doses of anabolic steroids, of which testosterone is really the basis. Often their libidos sag and if they stay on too long, they end up in a doctor's office in an attempt to jump start their natural hormone production. In between the time they stop the AAS and the time their bodies decide to function properly, they experience a host of problems that can include sore joints, gynomastica (painful fatty deposits beneath the nipple area that often require surgical removal) and symptoms of withdrawal and depression.

This is also true when someone who uses supplemental testosterone for anti-aging purposes decides to stop. According to Dr. Ullis, it can take six to nine months for normal production to resume after discontinuing HRT and many "may find that they need to stay on it the rest of their lives." If you have to stop for some reason, what then?

Thus no reputable medical doctor will prescribe more testosterone than what a patient needs to maintain normal levels for good health. If you want to pack on muscle legally, you're simply going to have to do it the old fashioned way, although raising testosterone levels to what they were in men who had normal mid-20's levels will help a great deal in the endeavor.

If you are tested when you are fairly young and keep the results in your medical file, you will easily be able to track the variations in later years. If your doctor refuses to order these tests, you can order them yourself through the Life Extension Foundation (7).

Dr. Ullis employs several options for balancing a man's hormone levels. The first is what's known as an "aromatase inhibitor." When testosterone "aromatizes," it converts to estrogen, one of Mother Nature's chemical magic tricks. This also happens in women and for those who have breast cancer, which is exacerbated by this situation; several pharmaceuticals have been developed as protocols for this condition.

The best choice currently is a drug called anastrozole, which is marketed under the brand name, "Arimidex." What this does is keep a man from converting his endogenous (naturally produced) testosterone to estradiol. Often this is all that's required because "Arimidex may actually increase [the body's] release of lutenizing hormone from the pituitary gland. Lutenizing hormone is the main hormone responsible for signaling the testes to produce more testosterone."

So not only does an anti-aromatase not shut down a man's normal testosterone production, but the dose can be structured to his individual requirements. This is an expensive prescription medication, although it can be purchased through mail-order pharmacies in Canada at about half the cost of what it sells for in the U.S. (8). Often, however, a man does not need to take an entire tablet each day, but can take a half or quarter tab, or structure the dose in some other manner.

From time to time, Dr. Ullis has also encouraged certain patients to try the over-the-counter prohormones, androstenedione and 4-androstenediol because they do boost testosterone, albeit on a temporary basis. The article from which this information has been extrapolated was written just as ErgoPharm's® product, 1-AD™ was hitting the market. Although there is no evidence that this will work, Dr. Ullis theorizes that "it might make a useful supplement for men with low testosterone levels and high estrogen levels . . . as a good alternative to [prescription] testosterone in that it may have many of the same effects on improving mood, energy and libido . . . without conversion to estrogen."

Although Dolfzine® in no way endorses any supplement,1-AD™ was designed by chemist Pat Arnold, who figured out a way to put a prohormone into an oral product in a structure that bypasses the liver, which is the biggest problem with other orals. Sprays and sublinguals were designed in this manner as well, but many people do not like dousing themselves with an alcohol-based spray twice a day or sucking on a rather bad tasting tablet for 30 minutes.

Unless your doctor recommends you use prohormones as a way to boost your natural testosterone levels, it is recommended that before you try them you do adequate research on the subject to make sure they will not cause unwanted side effects or other problems, such as disqualification from certain sporting competitions. Younger men absolutely do not need them, no matter what the supplement manufacturers say, and for women of child-bearing age they are even more of a "no-no." (Please keep in mind that the purpose of this article is to present information, not to encourage you to turn yourself into a living lab experiment. These products are being sold. It is wise to understand what they are.)