Andropause
Andropause, often described as the male menopause, is associated with the natural, age related, decreased in the male hormone, testosterone, and associated symptoms of lower testosterone levels and aging.
Unlike female menopause, which is much more well-defined, there is no single factor which determines the life change of andropause for men.
The term and the condition itself is controversial and debated within the medical community. However, the replacement of testosterone for men showing symptoms of andropause have reported improvement in the symptoms associated with this condition.
The most commonly accepted factor associated with andropause is a decrease in the testosterone, often described as low testosterone. This is considered a normal process unless associated with another medical condition, such as diabetes, obesity or hypothyroidism.
- Decrease in sexual desire, libido or worsening sexual performance
- Difficulty in obtaining an erection, maintaining proper strength of the erection, or new onset of premature ejaculation
- Decreased bone density
- Decreased fertility
- Depression
- Fatigue
- Gynecomastia
- Hair loss
- Hot flashes or flushes
- Increase in percentage of adipose tissue
- Insomnia
- Irritability
- Loss of muscle mass
- Memory loss
- Mood Swings
- Muscle weakness
- Night sweats
How Is Andropause Diagnosed?
- Perform a physical exam
- Discuss signs and symptoms of andropause
- Rule out other medical conditions that may produce the same symptoms as andropause
- Order screening tests to include: Cholesterol and Lipid Panel, Complete Metabolic Panel, Complete Blood Count with Platelets, Hemoglobin A1-C, Thyroid Panel, Free and Total Testosterone and Prostate Specific Antigen (PSA)
- Electrocardiogram (EKG)
Can Andropause Be Treated?
If testosterone levels are found to be decreasing or “sub-physiologic”, testosterone replacement therapy may help relieve symptoms associated with andropause.
Just as with estrogen therapy in women for the management of menopause, testosterone replacement therapy has potential benefits, risks and side effects. Replacing testosterone may worsen the risk of prostate cancer and increase the risk of heart disease.
Treatment and Prevention
There is no specific preventative management for andropause, but a healthy life-style, exercise, proper diet, “normal” body weight, adequate amounts of sleep and reduction of stress are all good behaviors for minimize the effects of aging. The use of testosterone replacement therapy, either in skin patch, gel, tablet, pellet or injection are all effective, although each has its benefits, risks and potential side-effects. These will be discussed with Dr. Novoa prior to making recommendations and decisions.
Hair Growth
PRP (platelet-rich plasma) therapy for hair loss is a three-step medical treatment in which a person’s blood is drawn, processed, and then injected into the scalp.
PRP injections has been shown to trigger natural hair growth and maintain it by increasing blood supply to the hair follicle and increasing the thickness of the hair shaft. Combined with other hair loss procedures or medications, hair growth has been proven in men.
PRP therapy process
PRP therapy is a three-step process. Most PRP therapy requires three treatments 4-6 weeks apart. Maintenance treatments are required every 4-6 months.
- Step 1 - Your blood is drawn, typically from your arm, and put into a centrifuge (a machine that spins rapidly to separate fluids of different densities).
- Step 2 - After about 10 minutes in the centrifuge, your blood will have separated into in three layers:
- platelet-poor plasma
- platelet-rich plasma
- red blood cells
- Step 3 - The platelet-rich plasma is drawn up into a syringe and then injected into areas of the scalp that need increased hair growth.
Penile Fillers
The advancement in the technology of dermal fillers has allowed improvements in penile enhancement procedures without the need for surgery and with minimal downtime.
FDA approved dermal fillers, commonly used to enhance lips and cheeks, are now being used to enhance the size of the penile shaft and glans (head) to significantly increase penile girth.
Depending on the natural anatomical size of the male penis, small increase to the length of the penis may also occur. Clincial studies show that the circumference or penile girth appears to be more important as compared to the length of the penis and the use of dermal fillers has the greatest effect on the girth of the penis.
The enlargement procedure is performed fully conscious using a combination of topical and local anesthesia. On average, the procedure takes approximately 10 minutes.
The Procedure
- In most cases, two injection sites, are used near the base of the penis and near the head (glans) of the penis. After numbing the penis, microcannulas are placed below the skin and the fillers are placed in multiple criss-cross patterns which uniformly spread the fillers.
- Microcannulas, similar to needles, which are blunt ended are used because of their safety as compared to needles and are less likely to cause trauma, bleeding or bruising.
- After the procedure, the penis is wrapped and the patient can generally return to normal activity the same day. Sexual intercourse can resume in 48-72 hours, although 1-2 weeks is recommended. Mild to moderate swelling, which is the most common temporary issue, may occur until the body gets use to the filler.
Results are generally immediately noticeable. The number of fillers range from 10-15 fillers and are dependent on the natural length and girth of the penis before filler is placed. Dr. Novoa will advise you of the recommended number based on your natural anatomy.
The most popular and longest lasting hyaluronic acid penis enlargement injection is Juvederm Voluma XC. It is also one of the best fillers based on bulk enhancement as compared to other fillers and is one of the safest to use.
In the rare case that the filler needs to be removed, hyaluronic acid based fillers can be dissolved using hyaluronidase which is specifically designed to dissolve a filler in less than 24 hours.
Although other products are available for penile enlargement, Dr. Novoa recommends hyaluronic acid products, specifically within the Allergan Juvederm series, for their proven safety as general fillers and their ability to be removed without surgery using hyaluronidase.