Common in Older Men

doctor1Since I’ve been on Medicare, it happens like clockwork.   December comes and my doctor’s office calls to tell me it’s time for my senior assessment.  Yes, my doctor calls me.  He’s a very good doctor but it’s not altruism.  It turns out that the Medicare program authorizes a complete physical once a year in the interests of preventative medicine and I suspect that the increase in senior exams and related tests brings a small financial windfall.  Still, it makes a lot of sense, which is more than you can say for most government administered programs.   The assessment begins with a questionnaire designed to convince you, if you have any doubts, that you are indeed a senior.   How many times have you fallen this year?  How many times do you get up to go to the bathroom at night?   Have you been sad or depressed over the the last few months?  Do you know that you are really old?  I made up the last one.   Then I get to be poked and prodded in all the right (??) places for assessment of my senior health.  One of the less desirable physical characteristics I inherited from my Dad is the growth of assorted moles, skin tags and age spots on my shoulders and chest.  The senior assessment provides a regular opportunity for the doctor to look at my current crop and tell me that they’re Common in Older Men and nothing to worry about.

Since my doctor is so concerned about my senior health, I feel obligated to bring him a gift each year, one senior malady that he can ponder.  Two years ago it was marginally high blood glucose.   That’s Common in Older Men, my doctor said, before prescribing Metformin.  Last year it was a testicular swelling.  It’s pretty Common in Older Men, he said.  It’s probably a hydrocele, which is harmless.  I have patients with hydroceles as big as grapefruits.  Yikes!  Still, he authorized an ultrasound to be sure, a somewhat embarrassing experience I posted about last year in Senior Karma.  This year, my complaint was fatigue.  People have always thought I’m younger than I am, not because of my appearance but because I am very energetic.  This year, too often that’s come from a coffee cup or a Five Hour Energy.  My doctor ordered a complete blood panel which revealed very low testosterone.  That’s Common in Older Men, he said when he saw the results.  You should come in to discuss therapy.   At least he doesn’t say Old Men.

So now, I’m considering testosterone replacement therapy.  According to a webmd article, Is Testosterone Therapy Right for You?, the positive effects can include improvement in energy level, libido, and mood. Testosterone also increases bone density, muscle mass, and insulin sensitivity in some men.  However, the degree of improvement varies dramatically from man to man.   And, of course, there’s no free lunch.  While webmd says, Testosterone replacement so far seems to be generally safe, it adds, Experts emphasize that the benefits and risks of long-term testosterone therapy are unknown, because large clinical trials haven’t yet been done.  Of particular interest to older men are the links to prostate ailments like prostate enlargement and cancer.  In fact, men on testosterone replacement therapy should have a PSA test (a marker for prostate cancer) twice a year.  The whole thing sounds suspiciously like what they said about estrogen replacement years ago when Muri started it, and we are both fairly certain that was a factor in her breast cancer.  That makes me very nervous.  But my doctor says given my health, he thinks it’s safe.

I’m considering it.  I have an appointment with an endocrinologist on Monday.  I’ll let you know when I make up my mind.  Indecision is Common in Older Men.


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One Comment on “Common in Older Men”

  1. He might dislike my sharing this with you, since he got mad at me for saying on Facebook that he’d taken a Z-pack for a respiratory infection and accused me of “releasing private medical information” (he’s testes… I mean testy)… Anyway, I dated a man who had “low T.” He was about 37 at the time, I think. He used Andro-Gel 1.62%. And at the risk of being a little indiscreet, his libido seemed fine to me. Not only that: he’s a marathoner and a triathlete. He’s also incredibly driven in those endeavors, so the insistence on doing them might not entirely be down to the Andro-Gel, but if nothing else, it didn’t seem to be a detraction.

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