What does male hormone health guidance include?

The core of male hormone health guidance is the adjustment of overall hormone homeostasis around the "hypothalamic-pituitary-gonadal axis", covering the entire process from accurate assessment, lifestyle intervention, reasonable medical support to long-term follow-up and cognitive correction. It is by no means as one-sided as the "single testosterone supplement" or "testosterone-boosting supplements" circulated on the Internet.

I recently treated a 27-year-old Internet operator who went to bed after 2 a.m. for half a year. He always felt that he couldn't get up, lost muscle during exercise, and had fewer morning erections. He watched short videos and saw others saying that testicle-stimulating supplements are useful. I bought two products from overseas and ate more than two of them. In August, acne broke out all over his face, and his temper became irritable. After checking his sex hormones, he found that his prolactin was twice as high as the normal value. His own testosterone secretion was suppressed by high prolactin, and blind supplements to stimulate testicles disrupted the negative feedback of the endocrine axis. The more supplements he took, the more chaotic he became.

In fact, the first step of formal guidance must be to conduct a hierarchical assessment. It is not enough to just draw a tube of blood to see the total testosterone value. It is necessary to check all indicators such as luteinizing hormone, follicle-stimulating hormone, prolactin, estradiol, free testosterone, and sex hormone binding globulin. If necessary, thyroid function and cortisol must also be measured. After all, thyroid abnormalities and excessive cortisol caused by stress will indirectly affect the metabolism and utilization of androgens. Moreover, the evaluation cannot only look at the reference interval on the test sheet, but must be combined with age and symptoms - a 30-year-old male whose total testosterone is stuck at the lower limit of the reference value is actually in a state that requires intervention, while a 60-year-old male may have normal physiological decline, which is easily ignored by many non-specialist clinics.

After the evaluation, 90% of people with mild abnormalities do not need to take drugs or supplements at all. If they adjust their lifestyle first, most of their hormone levels can be restored. Don't think that lifestyle adjustment is just an empty talk of "exercise more and stay up less late". There are actually many ways to do it: for example, many people do not dare to touch any fat when losing weight. Instead, they lose testosterone quickly because the raw material for the synthesis of testosterone is cholesterol. It is helpful to eat high-quality fats such as nuts, deep-sea fish, and avocados appropriately. ； For another example, some people always say that leg training can stimulate testicles, but if you train with heavy weights every day to the point of overtraining, or run ten kilometers a day to do aerobics until your body fat rate is too low, it will inhibit testosterone secretion. ； There is also abdominal obesity, which is most easily ignored. Aromatase in fat secretly converts testosterone into estradiol. Many men with big bellies feel that their testosterone is low. If they lose 10 pounds of visceral fat first, their indicators can rise a lot.

Only if there is no improvement after two or three months of lifestyle adjustments, or if you are suffering from primary hypogonadism, do you need to consider medical intervention. This part is currently the most controversial. For example, exogenous testosterone supplementation. Supporting scholars believe that standardized supplementation can significantly improve the energy, mood and bone density of this group of people, and significantly improve the quality of life. ； The opposing view is that if supplementation is not appropriate, it will inhibit the secretion function of one's own gonads. After stopping the drug, the hormone level will be lower than before, and even affect fertility. Therefore, whether you are supplementing testosterone or using drugs that regulate the gonadal axis such as clomiphene or estrogen, you must use them under the guidance of a specialist. If you secretly buy injections or folk prescriptions yourself, there is a high chance of being cheated. As for testicle-stimulating supplements such as Tribulus Terrestris and Maca, which are popular online, current research conclusions are also very inconsistent. Some people can slightly increase free testosterone levels after taking them, while some people have no reaction at all. On the contrary, they may increase the metabolic burden on the liver and kidneys. They should be used as supplements at most and cannot replace lifestyle and formal treatment.

Another very important aspect is cognitive correction. Many people think that male hormones are only responsible for sexual function. In fact, they are also responsible for muscle synthesis, bone density, mood regulation and even metabolic levels. Many people suffer from inexplicable depression, fatigue, and osteoporosis. After a search, no problem was found, and finally they found that it was caused by low testosterone levels. There is no need to talk about "hormone" discoloration. You think hormones are a scourge, and don't pursue testosterone as high as possible. Testosterone levels beyond the physiological range will increase the risk of hair loss, prostatic hyperplasia, and dyslipidemia. After the age of 35, men's testosterone will naturally decline at a rate of about 1% per year, so adjustment is not a once-and-for-all matter. There was a 40-year-old corporate client who adjusted his hormones for three months to return to the normal range. Later, he socialized, drank, and stayed up late for business trips for six months. When he was reexamined, his testosterone dropped back to the pre-intervention level. Pay more attention to your energy, morning erections, and changes in body fat, and do a one-time hormone screening every year. If there are problems, you can make timely adjustments.