How Do We Diagnose Andropause?
To determine if you have andropause, a blood test is necessary and while it’s true that decreased testosterone levels is a factor, other issues may weigh in. For instance, more sex hormone-binding globulin may limit testosterone from traveling to the tissues. Also, where testosterone levels would rise and fall when you were younger, you may now be experiencing a flattening and lower level of production.
A few issues you should know:
- The definition of low testosterone varies. Generally, two standard deviations below the usual rate for a younger man is considered deficient
- It’s important to look at your testosterone levels over a period of time because they may vary from one day to the next
- In older men, affected organs may respond differently to androgens
Also, there is no one “right” level of testosterone for all men. You and your doctor need to work together to establish the level that’s right for you. It is accepted that if your testosterone is below 200 ng/dl it’s considered low. If it’s over 600 ng/dl then low testosterone is probably not be the cause of andropause.
What’s the best way of measuring testosterone levels and diagnosing andropause? Opinions vary. The analog free testosterone method is most widely used by large commercial U.S. labs. We feel that a more accurate measurement is either free testosterone or bioavailable testosterone done in a specialty laboratory setting. While there is some variation in what tests should be used, it’s widely accepted that blood work should be done prior to 10 a.m. to capture peak values.
Interpreting testosterone levels is complicated. That’s why it’s important to see a physician experienced in this field who has a relationship to a specialty lab. It makes interpreting the results that much easier.
To learn more about andropause, and testosterone therapy please call Dr. Werner's office at (646) 380-2700 in NYC, (914) 997-4100 in Westchester, or (203) 831-9900 in Connecticut, or send us an email at info@wernermd.com.