Surge or shrink

I’ve been working on a research project looking into young people’s use of “chemicals”—medicines, supplements, cosmetics—on their bodies, and one of the more alarming findings was the use of testosterone, including injectable forms.

We didn’t actually find too widespread a use of these hormones, and I suspect it’s mainly because they’re expensive. But the Internet is full of advertisements for testosterone products, with claims of anti-aging, body-building and virility-enhancing properties, and I do worry about the people—young or old—who use these products.

Just last week, the journal PLoS (Public Library of Science) ONE published results of a large study involving almost 56,000 men who have used testosterone products between 2008 and 2010. The researchers, headed by William Finkle, reported a doubling of the rate of heart attacks in users aged 65 and older, as well as in younger men who had a history of heart disease at the time they used testosterone. I must mention the study has been criticized, but it has prompted the US Food and Drug Administration (FDA) to investigate the many testosterone products being promoted and sold.

Let me first explain what testosterone is. People often use the term “male hormone” but testosterone is actually produced in both sexes, the levels being much higher in males than in females. The hormone is produced as early as during fetal development, allowing the male genitalia to develop after birth. After birth, testosterone retreats to the background, then production picks up again as puberty approaches, allowing secondary sexual characteristics such as further development of the genitalia, the appearance of body hair, a lowering of the voice… even body odor.  The body goes through dramatic changes, too, with the lanky teenager taking on muscles.

‘Raging hormones’

An invisible but important development is fertility. Testosterone is responsible for stimulating sperm production and also for driving the libido, which is why we have all these dire accounts of “raging hormones.” Testosterone is blamed for male recklessness, especially around adolescence, wonderfully captured by the expression “his brain is behind the zipper of his pants” because testosterone production is in the testes.

Testosterone is used to explain strong libidos, competitiveness, and aggressiveness, all of which are said to be male characteristics, almost believed to be inborn by virtue of the hormone. There’s controversy in some of these claims since more gender-equitable societies do produce women who can be as competitive, aggressive, and libido-driven as men. Society, and not just hormones, “authorizes” our behaviors.

But yes, testosterone can be powerful. Our surveys found that even transgenders are beginning to use the products. For many years we’ve had male-to-female transgenders using contraceptive pills to “grow” breasts, but now we’re also beginning to see female-to-male transgenders using testosterone to grow body hair and get some of the “masculine” physical characteristics, some of which can be quite dramatic and which I can’t write about in a general-readership column.

Let me get back to testosterone in a person’s life cycle. The hormonal levels drop as a person ages, with growing suspicions that we have an andropause, too, a male “menopause,” marked by a decline as well in the sex drive and fertility.

The biggest markets for testosterone would probably be younger men who want to build their bodies (and become more “attractive”) and middle-aged men worried about flagging virility. This demand is worldwide, but the problem is that in countries like the Philippines, there’s a lot of self-medication, especially with testosterone so readily available through the Internet. I worry about the lack of professional advice for the use of these drugs, and I’m referring here to all kinds of testosterone, including one type which is approved in the United States only for horses!

Horse shampoo

What is it about horses? Have you seen those shampoo products in supermarkets claiming they were first developed for horses, with the pitch that you’ll end up with hair as nice as manes? I guess there’s something similar with horse testosterone: You, too, can be like a stallion (visions of Sylvester in the background).

Use the horse shampoo, if you want, but be very careful with testosterone. There may be a good reason for the decline in testosterone levels in men as we grow older. Some years back there was a study conducted by Northwestern University and the University of San Carlos in Cebu, where they found that testosterone levels drop in men who participate in fathering, meaning taking care of their children. The researchers proposed that the drop in testosterone is actually advantageous because such fathers are less prone to adventurous behavior.

Moreover, the drop in testosterone also means lower risks for heart attacks, now supported by that study published in PLoS ONE. There’s a paradoxical situation here: Testosterone increases the numbers of red blood cells in our body, which is good when you need more oxygen for physically strenuous activities and for fighting and aggression. But that increase also means greater risks for heart attacks because larger numbers of red blood cells mean more clumping together and blood clotting.

Endocrinologists—specialists in hormones—also worry that once a person starts using testosterone products, their own body’s production can shut down, permanently, which means you have to keep using the testosterone for the rest of your life.

There’s a good article in the New York Times (Don’t Ask Your Doctor about “Low T”) giving some very good advice on alternatives to testosterone products. One is to avoid too much alcohol. Note how men actually booze up, going on drinking sprees, to build self-confidence and courage when they go out “hunting.” Well, it seems the alcohol actually lowers testosterone, so by the time you find a partner, you might not have the drive, or stamina, to go on.

Another advice is a bit circuitous. I mentioned that women also produce testosterone. Conversely, men also produce some estrogens or “female” hormones.  So, the advice is to blunt the production of estrogens by taking cruciferous vegetables. The New York Times article mentions broccoli, which some of our men might find wimpy. Actually, it can mean any of the cabbage family of vegetables, including, get ready for Super Macho—pechay!

Waistlines

The best advice, though, is simple: Lose weight. A paper presented in 2012 at an Endocrine Society meeting reported results of a study involving men with prediabetes and found that a loss of 17 pounds in the men increased testosterone levels by 15 percent.

I’m always amused at how numbers are tossed around in these articles and should warn you against imagining some linear relationship—for example, losing 112 pounds will mean a 90-percent increase in “the big T.”

But here’s another statistic that should be useful. Ideally, a man’s waist should be half his height. It’s not as silly as it first sounds. If you’re 5’6 or 66 inches high, your waistline should be less than 33 inches.

So, whip out the tape measure now and decide: Surge or shrink.

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