What should men be paying attention to during Men’s Health Month in June?
Plenty, says Jeff Morrison, MD, assistant professor of urology in the University of Colorado Department of Surgery.
“To me, Men's Health Month is a month to normalize men seeking care and getting in with their doctor or health care provider,” he says. “We know that, compared to women, men are significantly less likely to go to the doctor or to seek preventative care. Only about 60% of men see a provider on an annual basis, and 40% of men don't even have a doctor. When you look at overall health metrics, men have a 40% higher risk of mortality than women, year over year.”
In the realm of mental health, Morrison adds, men are much more likely to than women to suffer from overdoses, alcoholism, and suicide and are less likely to seek preventative mental health care services.
The testosterone problem
As a urologist, Morrison is especially focused on men’s reproductive and sexual health, counseling patients on, among other conditions, low testosterone levels.
“Testosterone is the quintessential male hormone, very important in a man's overall health,” he says. “It drives several functions, including energy level, sex drive, and muscle mass. We see that even vitality and mental clarity can be associated with testosterone.”
Though lower levels of testosterone are a normal part of aging, it’s an issue that’s easily correctable, Morrison says.
“Lots of men will experience about a 1% decrease in their testosterone each year once they hit age 30,” he says. “I'm a big advocate of screening for that and then treating when necessary. We use gels, injections, and pellets, plus lifestyle changes, to normalize a man's testosterone level.”
Testosterone gels are typically applied every day, while injections are self-administered once a week. Many men prefer the pellet therapy, in which small pellets are placed under the skin and release a controlled dose of the hormone over time.
“The pellets maintain testosterone levels over the course of three to six months and keeps them stable,” Morrison says. “They're not going up and down, so the men can set it and forget it.”
Addressing other issues
Many of these testosterone treatments are available at private testosterone clinics, but such clinics may not be as thorough when it comes to looking at underlying factors that contribute to lower testosterone levels, Morrison says.
“There are a lot of risk factors for testosterone deficiency that sometimes we can correct,” he says. “If we can get to the root of the problem, then many men may not even need testosterone therapy. That means screening for things like sleep apnea, obesity, diabetes, and metabolic syndrome, which are all associated with low testosterone.
“We look at lifestyle factors as well,” he adds. “If guys are stressed out, not sleeping, working night shifts, things like that just kill your testosterone. If we address some of those lifestyle changes, sometimes we don't even need testosterone therapy.”
No heart complications
Morrison, who has been administering testosterone therapy for years and is fellowship trained in men’s health, is especially gratified by a 2023 report, in the New England Journal of Medicine, that showed the therapy has no adverse effects on the heart.
“There used to be some concern or lack of clarity regarding the safety of testosterone replacement therapy,” he says. “Is it safe for your heart? Does it cause adverse cardiovascular events? We didn't have great data to answer these questions, but there was an exciting study called the TRAVERSE trial, published in New England Journal of Medicine, which was the largest randomized control trial ever in men receiving testosterone replacement therapy.
“They took about 5,000 men with low testosterone who were at risk for adverse cardiac events, and they randomized them to testosterone therapy vs. placebo. They followed these men over time, and their number-one takeaway was there was no increased risk of cardiovascular events like heart attack or stroke. It felt good to put that concern to rest once and for all.”
Game-changer
For those men who do need testosterone therapy, it can be a game-changer, Morrison says.
“I'm fairly aggressive with testosterone. We’ll try it for three to six months and see how they feel,” Morrison says. “Oftentimes, guys come back high-fiving me, and they're much better after that. Sometimes we've turned around their whole life. “Their partners say, ‘My husband is more patient with the kids, he's got more vitality, he’s getting more things done around the house.’ It's an exciting time to be involved in testosterone therapy that can really empower men.”
