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THE RELATIONSHIP BETWEEN NIGHT SWEATS, HOT FLASHES, AND TESTOSTERONE


Written by Dr. Welsh, Article reviewed and edited by Dr. Fine M.D..
Published on 09 January 2019

The Relationship Between Night Sweats, Hot Flashes, and Testosterone

Hot flashes and night sweats are two of the many signs of Hormone Imbalance. While night sweats have long been associated with Menopause, these annoying night-time events are also related to Testosterone Deficiency. Men go through a change similar to women, commonly known as Andropause. While women experience the effects of Menopause suddenly and rapidly, Andropause is a relatively slow change in comparison. As Testosterone Levels fall, the frequency and severity of symptoms increases.

What Causes Night Sweats?

Night sweats are a very common issue which impact a large portion of men and women. Around 1/3rd of patients report night sweats in the last thirty days to their doctor. There are a wide variety of causes, including some scary things like cancer, addiction, withdrawal, and infection. Even consuming spicy foods, caffeine, or hot drinks before bed can contribute to night sweats.

Some medications contribute to night sweats, such as prescriptions for diabetes and depression. While night sweats are something you should talk about with your doctor, there's no need to panic! Some of the issues most strongly correlated with night sweats are breathing issues during sleep, stress, anxiety, numbness in the feet and hands, fever, poor sleep, and anxiety attacks.

Age-Related Hormone Imbalance Among Strongest Factors Which Contribute to Night Sweats

During Menopause, 7 out of 10 women experience hot flashes. The frequency of this symptom is strongly correlated with the severity of Estrogen decline resulting from the change. While Testosterone Levels fall continuously and slowly beyond age thirty in men, once Testosterone Production falls beneath a certain threshold, men are more likely to experience some of the same symptoms as women, including low libido, hot flashes, night sweats, depression, and unhealthy changes in body composition.

This propensity for hot flashes associated with Low Testosterone Levels is displayed clearly among those receiving treatment for prostate cancer. One of the primary components of prostate cancer is a drug that suppresses the release of Androgens into the blood stream. Severe androgen deficiency leads directly to a massive increase in reports of night sweats and hot flashes.

Even having children may lead to an increase in night sweats among vulnerable males. When couples have children, the male experiences a drop in Testosterone during the partner's pregnancy and during the early development of the child. This decline in Testosterone Production occurs in order to promote the father to devote more energy and resources toward protecting and raising the child than to trying to find a mate. While this Testosterone drop isn't enough to contribute to night sweats on its own, men that display more risk factors for Low-T are more likely to develop hot sweats and night flashes during this period.

Why Does Low-T Increase the Incidence of Night Sweats and Hot Flashes?

While there is a strong correlation between Testosterone Deficiency and the increased incidence of hot flashes, researchers haven't quite figured out how Low-T triggers night sweats. What we do know is that the Hypothalamus is almost certainly a central aspect of this process, because the Hypothalamus is responsible for bioregulation, which includes controlling the body's temperature.

Upon registering that the internal temperature of the body is too high, the Hypothalamus coordinates the dilation of blood vessels which speeds up blood flow to the skin. The transfer of this heat to the skin is followed by the release of sweat which helps cool the body down. Of course, even though the end goal of this process is a cooler body, it is interpreted by the mind as an increase in heat followed by the clammy chill of a night sweat.

It's hypothesized that Low-T triggers the hypothalamus to release the signal for night sweats during sleep, even when temperature regulation isn't an issue, causing men to wake up cold, sweaty, and uncomfortable. For men with Testosterone Deficiency, night sweats are one of the more common symptoms, and patients do report significant reduction in night sweats while taking Testosterone Replacement Therapy for relief from Low-T.

Testosterone Deficiency Relief with Hormone Replacement Therapy

Though night sweats don't pose any dangers to health, they are annoying and frustrating, and may be a sign of other issues. If you're experiencing night sweats in combination with fatigue and low libido, this is a powerful sign that you are currently suffering from Testosterone Deficiency. Our Board-Certified American Hormone Clinic can help you determine if Hormone Imbalance is contributing to your declining quality of life and we can determine whether Testosterone Replacement can help you overcome night sweats, increase strength and energy, and restore sexual desire and function.

Our Fully-Licensed HRT Clinic has helped hundreds of guys throughout the country feel better about their lives. Generations of research and refinement have vastly increased the safety and effectiveness of Bio-Identical Testosterone Therapy. If you'd like additional information about starting a quality Testosterone Regimen with a trusted Hormone Provider, our HRT Specialists are available to respond to your questions and concerns!


TESTOSTERONE OVERVIEW


Written by Dr. Welsh, Article reviewed and edited by Dr. Fine M.D..
Published on 10 April 2017

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Testosterone Overview

What is Testosterone?

Testosterone is one of the building blocks of human life. Without Testosterone, humans couldn't exist, because Testosterone is the male sex hormone which contributes to the growth, development, and maintenance of male form and function. Testosterone is also produced by women, but in much lower amounts.

Testosterone belongs to a class of hormones known as Androgens, which are hormones (primarily associated with the male physiology) which activate Androgen Receptors. Testosterone is the most important Androgen, and the most potent.

Testosterone and Male Development

Prenatally, Testosterone is responsible for the formation of primary male sex characteristics, most notably the seminal vesicles, prostate, scrotum, testicles, and penis. Exposure to Testosterone during this period is absolutely necessary for full and total normal male development.

Testosterone exposure in late-childhood leads to male puberty, contributing to the physiological changes which turn a boy into a man, including the deepening of the voice, changes in body fat, increase in muscle mass, stimulation of bone growth, the full development of the sex organs, and more.

Whereas Testosterone is responsible for growth and development during the earlier stages of human life, after puberty has concluded, Testosterone no longer encourages growth, but is necessary to maintain health, wellness, and sexual function. Normal Testosterone Levels are directly associated with healthy libido, high fertility, balanced mood, high energy levels, strong bones, and a strong heart.

Types of Low-T

Low-T is a condition in which the body does not have the means to produce the levels of Testosterone necessary to meet the needs of the male body. This condition is also referred to as Hypogonadism or Testosterone Deficiency. If Low-T occurs during adulthood as a result of aging, it is called Age-Related Hypogonadism or Somatopause.

There are many causes of Testosterone Deficiency, but all of these causes can be grouped into two categories: Primary Hypogonadism and Secondary Hypogonadism.

Primary Hypogonadism is any condition which directly affects the function of the testes and/or seminal vessicles.Secondary Hypogonadism is any condition which suppresses the release of Testosterone Precursor hormones (Luteinizing Hormone and Follicle Stimulating Hormone), which impedes normal Testosterone Production or fertility.

Causes of Low-T

Hypogonadism can be the result of a wide number of causes. Cancer, surgery, and trauma can impair physiological function. There are also some congenital defects which prevent the normal release of Testosterone or development of the male sex organs. The most common cause of Testosterone Deficiency is aging, though it can be exacerbated by other factors, such as sedentary lifestyle and obesity.

In children, Testosterone Deficiency leads to weaker bones, stunted growth, smaller muscles, and inhibited sexual potency. It can even have a major effect on personality development, as Testosterone is associated with many masculine traits such as confidence and assertiveness.

In adults, Low-T does not have effects which are immediately as noticeable, but they can still be significant and can strongly impact health, wellness, longevity, and fertility. Men with Low-T are more impacted by fatigue, low sex drive, loss of bone mineral density and strength, and increase in body fat than their peers. Beyond that, they are more likely to experience erectile dysfunction and cardiovascular complications such as heart disease and stroke.

Disorders and Conditions Associated with Testosterone Deficiency

Types of Congenital Testosterone Deficiency

  • Klinefelter Syndrome This is a genetic disorder in which the male is born with two X chromosomes. This leads to symptoms related to increased Estrogen Levels and inhibited Testosterone Production, including shrunken testes, breast development, feminine hair patterns, and infertility.

  • Kallmann's Syndrome Inability to produce Gonadotropin Releasing Hormone

  • Luteinizing Hormone Releasing Hormone Deficiency Insufficient production of the Testosterone Precursor Luteinizing Hormone.

  • Cryptochordism Partially-descended or undescended testicles.

  • Anorchism Completely undeveloped testes.

Causes of Acquired Testosterone Deficiency during Childhood and Adulthood

  • Testicular, Hypothalamic, and Pituitary Tumors

  • Radiation from Chemotherapy

  • Head Trauma or Testicular Trauma

  • Damage from Radiation

  • Damage from Chemotherapy

  • Aging

Symptoms of Aquired Testosterone Deficiency depend upon the age in which the symptoms appear. Childhood Hypogonadism is associated with late puberty or partial puberty, and can lead to symptoms of feminization such a gynecomastia and impaired hair development, as well as abnormally low muscle mass, increased body fat, and incomplete masculinization of the genitals.

How is Testosterone Produced?

The secretion of Testosterone by the testes and adrenal glands is the end-result of a number of cyclical hormone interactions which originate and end at the brain. The delicate balancing act occurs on the Hypothalamic-Pituitary-Gonadal Axis. Upon stimulation, the Hypothalamus starts the process by releasing Gonadotropin-Releasing Hormone, which travels to the Anterior Pituitary Gland. Upon pituitary response by GnrH, Leuteinizing Hormone is released and flows through the blood stream to the adrenal glands and the testes. Upon reaching these target sites, LH interacts with Androgen Receptors in the Leydig Cells and this leads to Testosterone secretion.

All of these hormones are released in short bursts. In fact, the body doesn't produce much Testosterone, because Testosterone is such an incredibly potent Androgen. In a healthy male, it only takes four to seven milligrams of Testosterone to meet the functional needs of the body.

Onset of Testosterone Decline and Deficiency

Testosterone Levels after birth remain low until around the time puberty begins. Puberty is triggered by an increase in Testosterone, which increases rapidly and remains high through the teens and twenties. It isn't until the late twenties that Testosterone Production starts to fall into a state of slow and steady decline. By the time that a man reaches his eighties, free Testosterone Levels drop to as low as 20% of what they were in his twenties, and that's in the case of healthy men.

Adult-Onset Testosterone Deficiency can become symptomatic as early as the thirties in male patients with comorbid conditions such as diabetes combined with a sedentary activity level. In these cases, treatment can often be postponed and Testosterone Levels elevated simply by making healthy lifestyle changes, exercising, and losing weight. Men than smoke and drink are also more likely to experience Testosterone Deficiency, and at an earlier age.

Prevalence of Testosterone Deficiency

Low-T is very common in the United States and around the world. It may even be more common in America than most other countries because of the high incidence of obesity in our society. Researchers believe that around 13 million males in the country have symptomatic Low-T, but only around one in ten reach out to a professional for medical treatment. There is double the rate of Testosterone Deficiency among men with hypertension, diabetes, and obesity.

Partially because so few eligible men commonly reach out for treatment and partially because of the rapid increase in advertising and information about Low-T, Testosterone Therapy for Andropause is being prescribed more than ever, with few signs of slowing down in the coming years.

Adult males with Testosterone Deficiency are very likely to experience symptoms such as anxiety, depression, fatigue, loss of muscle mass, sexual dysfunction, and low libido. Furthermore, they are more likely to experience dangerous health conditions such as heart attack, cardiovascular disease, osteoporosis, stroke, and diabetes.

Research has shown that over two thirds of men with Low-T experience significant muscle fatigue. Around 1/3rd of men with Testosterone Deficiency have changes in bone mineral density which lead to increased risk of fractures and breaks.


CLOMIPHENE LOW-TESTOSTERONE ANDROPAUSE TREATMENT


Written by Dr. Welsh, Article reviewed and edited by Dr. Fine M.D..
Published on 07 August 2014

Clomiphene Low-T Andropause Treatment

Low-T is a medical condition that affects men of all ages. Age-Related Testosterone Deficiency begins to become an issue for many men as young as thirty years of age, and remains problematic all throughout the lifespan. Testosterone Replacement Therapy has long been used as a useful means to restore Testosterone Concentrations and foster improved health, but there are other options available to patients.

What Are the Symptoms of Low-T

Low-T affects male health in a wide variety of ways. When most people think about Testosterone Deficiency, they think about Erectile Dysfunction and Low Libido. These are indeed two of the most prominent and noticeable symptoms, but Low-T impact the entire body in a variety of ways. The following are some of the symptoms of Testosterone Deficiency that men might experience:

  • Weight Gain

  • Loss of Muscle Mass

  • Osteopenia

  • Anemia

  • Muscle Pain

  • Fatigue

  • Loss of Quality of Life

  • Depression

  • Anxiety

  • Increased Susceptibility to Prostate Cancer

  • Enhanced Risk of Alzheimer's Disease and other Neurological Disorders

  • General Increase in Mortality Risk

Now, sexual health is important, but it's clear that Andropause impacts far more than simply sexual health. It can literally take years off of your life.

Primary Vs. Secondary Testosterone Deficiency

You may not realize it, but there are multiple forms of Testosterone Deficiency, based upon the source of the deficiency. Primary Hypogonadism refers to Low-T which is caused by medical issues which suppress the ability of the testes to provide Testosterone to the body. This can be caused by testicular cancer, testicular removal, mumps, genetic disorders, or other medical issues which impact the testes.

Because these forms of Low-T are caused directly by Testicular Malfunction, the only effective form of Testosterone Restoration is directly via Bio-Identical Testosterone Treatment. The body effectively loses its ability to produce Testosterone in the case of Primary Testosterone Deficiency.

On the other hand, Adult-Onset Testosterone Deficiency is not caused by issues with the testes, but with issues with signaling from the Pituitary and Hypothalamus. The testes retain their ability to produce all of the Testosterone that the body needs, they are just under-active due to a lack of stimulation.

Lifestyle Choices Can Make Andropause More Severe

Andropause is exacerbated by conditions related to lifestyle which further suppress Testosterone signaling. The following are some examples of physiological circumstances which suppress the body's ability to meet its own needs for Testosterone:

  • Lack of Sleep

  • Diabetes

  • Steroid Abuse

  • Excess Iron

  • Brain Injuries

  • Anxiety

  • Depression

  • Certain Medicines

The most common form of treatment today for all forms of Low-T, including Age-Related Hypogonadism, is Bio-Identical. There are a variety of effective forms of Bio-Identical Low-T Treatment, including Testosterone Injections, Patches, Pellets, Gels, and Creams.

Side-Effects of Testosterone Restoration

Each of these forms of treatment have their own particular advantages and disadvantages amongst themselves, but all are generally effective. Of course, Testosterone Therapy in general comes with its own unified list of side-effects, including:

  • Increased Red Blood Cell Count

  • Reduced Fertility

  • Gynecomastia

  • Shrinkage of the Testicles

Some of these side-effects can be treated effectively. For example, increased RBC can be mitigated by blood donation, and the risk of gynecomastia can be controlled through the use of Arimadex, an estrogen blocking medication. But what options are available for patients that want to benefit from Testosterone Therapy while also preserving and retaining their fertility?

Bio-Identical Testosterone Fine For Men that Don't Want Kids

For older patients that have no interest in bearing children, Testosterone Replacement meet their needs effectively, but for younger men in their thirties and forties that are suffering from issues related to Low-T, but are also looking to have children in the near future, Testosterone is simply not an option, unless they freeze sperm before initiating therapy.

Clomiphene Helps Men That Want Children Experience Testosterone Restoration

Luckily, men that want children don't have to avoid Testosterone Restoration, because HCG and Clomiphene Citrate have both been shown to be highly effective at providing the same great benefits as Testosterone Therapy with Injections, Patches, Etc., while also preserving fertility.

In fact, Clomiphene and HCG not only preserve Fertility, they actually enhance fertility, because they supplement the mechanisms which lead to the production of Testosterone, which also lead to the healthy production of sperm.

How Does Clomiphene Work?

When a man's body is working properly, the hypothalamus sends signals to the pituitary to produce a Testosterone Precursor Hormone known as Luteinizing Hormone. This hormone is released in the blood, where it circulates down to the testes and activates the production of Testosterone.

Some of the produced Testosterone is then converted into Estrogen. Like women need a little Testosterone, men need a little Estrogen, and Estrogen actually acts as a negative feedback mechanism to the production of Testosterone, circulating back to the brain, encouraging the pituitary to halt Luteinizing Hormone Production.

Interference with this signaling is actually one of the ways that lifestyle inhibits Testosterone Production. Body fat has the ability to convert Testosterone into Estrogen, and the more body fat a patient harbors, the larger the strain on his Testosterone Balance.

Clomiphene helps to encourage the increased production of Testosterone by inhibiting the negative feedback mechanism caused by Estrogen. Clomiphene Citrate reduces the influence of Estrogen upon the hypothalamus and pituitary, encouraging the body to produce more Luteinizing Hormone.

Because Estrogen signaling to the brain is reduced, it keeps the pituitary happily churning out enough Luteinizing Hormone to meet the needs of the body.

How do HCG and Clomiphene differ?

Whereas Clomiphene increases the body's production of Luteinizing Hormone, HCG imitates the function of Luteinizing Hormone in the body, encouraging the production of both sperm and Testosterone.

Bio-Identical Testosterone Replacement Therapy, on the other hand, increases Testosterone by directly replacing the body's own Low-T Production. This causes the body to produce more Estrogen and other Negative Feedback Mechanisms, which slows down the body's release of Luteinizing Hormone, eventually to the point where the patient is ultimately infertile. Luckily, this is temporary, and will relieve itself given enough time without Treatment, but this still poses a direct problem for younger patients of child-bearing age.

How Does Bio-Identical Testosterone Interfere with Testicular Function?

With standard Low-T Treatment, the pituitary and the hypothalamus receive signals from the body that Testosterone Levels are normalized, and take this to mean that the testes are producing ample Testosterone for the body. When it receives these signals, the hypothalamus tells the pituitary to stop making Luteinizing Hormone, which in turn both suppresses the production of Testosterone by the testes and prevents the manufacture of sperm as well.

This is the biological mechanism by which Testosterone Therapy leads to reduced fertility and the shrinkage of the testicles. Because the testes are no longer active, they go into a state of dormancy, which can also cause the testes to recede.

How do HCG and Clomiphene Preserve Testicular Function?

Human Chorionic Gonadotropin and Clomiphene Citrate both have the ability to simultaneously increase Testosterone Levels while also sustaining the normal function of the testes. In fact, HCG is very commonly used as a mechanism to return the testicles to normal function after Testosterone Therapy has been completed. HCG is commonly used in a process known as cycling.

Many men that do not produce enough Testosterone can benefit greatly from short-term use of Clomiphene, especially those that have other factors suppressing their Testosterone Production. Under these circumstances, treatment usually lasts from three to six months. Men with Age-Related Low-T caused by Andropause, however, require long-term therapy to keep their Testosterone Levels at a healthy concentration.

Because Clomiphene increases Testosterone Production naturally, in a way which is in congruence with the natural hormonal cascade of the body, Low-T Treatment with Clomiphene has a significantly lower risk of side effects as compared to Bio-Identical Testosterone Treatment. Clomiphene also does not carry the same potential for Testosterone Abuse, because the patient cannot easily receive more Testosterone than they actually need.

Clomiphene was originally thought to only be effective for the treatment of Testosterone Deficiency and Infertility in younger male patients, but over the course of the last decades, a growing body of evidence has shown that Testosterone Restoration with Clomiphene is a highly effective method of treatment for men that are suffering from Andropause that are 30, 40, 50, and beyond.

What Makes Clomiphene such a good choice for men with Low-T Caused by Andropause?

Let us quickly break down the benefits of Clomiphene:

  • Clomiphene produces fewer side effects than Bio-Identical Low-T Therapy.

  • Clomiphene is available in generic form, and can be obtained for a very reasonable price.

  • Clomiphene can be taken orally, bypassing the need for Testosterone Patches, Creams, and Injections.

  • Clomiphene restores Testosterone Production to normal levels without risk of overdose, infertility, or testicular shrinkage.

  • With Clomiphene, it is possible to encourage your body to produce its own natural Testosterone.

Why Isn't Clomiphene More Commonly Prescribed?

Although Clomiphene is a highly effective alternative to Testosterone, it is very under-utilized in today's pharmaceutical climate. There are a number of reasons for this:

  • Because Clomiphene is generic, pharmaceutical manufacturers don't advertise the product heavily, which leads to a reduced level of awareness.

  • Medical professionals are also victims of these issues of awareness. In spite of the fact that Clomiphene is clinically shown to increase Testosterone Production effectively for men with Andropause, the majority of physicians are not fully cognizant of the safety profile and the effectiveness of the treatment.

  • Another reason for this reduced awareness is that Clomifene is not approved by the Food and Drug Administration for Male Testosterone Deficiency. There is research that proves the effectiveness of the treatment, it simply hasn't been fully evaluated by the FDA.

This is because Clomid, the brand name form of Clomiphene Citrate, was originally designed to treat women with fertility issues. In the female body, Luteinizing Hormone plays an important role in the normal menstrual cycle, whereas in men it encourages healthy sperm and Testosterone production. As a result, most physicians are aware of the FDA-Approved usage of Clomiphene, and are under the false impression that Clomiphene is only effective as a treatment for women.

HCG vs Clomiphene

Human Chorionic Gonadotropin is more commonly used than Clomiphene as a treatment for Adult-Onset Hypogonadism and Andropause, because of the increased level of awareness and the older research profile. But for men that can benefit from either treatment, Clomiphene is the better option for most patients because it is much cheaper than HCG, and it is also easier to administer. To date, HCG can only be prescribed via injection, whereas Clomiphene can be effectively used orally.

Side-Effects and Issues Related to the Use of Clomiphene Citrate

Clomiphene does indeed have a safety and side-effect profile that is better than Bio-Identical Testosterone Therapy, but there are some risks to consider, as there are with any other form of Hormone Therapy, or medical treatment in general:

Pyrospermia – Among older patients taking Clomiphene Citrate, patients can experience an increased concentration of white blood cells in the semen. To date, there is no evidence that this causes any health issues, and this increase in WBC Count is not the result of infection.

Changes in Vision – There is a very low risk that eyesight issues can occur as a result of the use of Clomiphene. These side-effects are not permanent, and are fully reversed upon the suspension of treatment.

Clomiphene is a Synthetic Drug – Unlike other forms of Hormone Restoration such as HGH Injections and Testosterone Therapy, Clomiphene is not naturally reproduced by the human body. Bio-Identical Hormones are naturally occurring, they are simply created in a laboratory environment. This means that there is a potential risk for side-effects to be uncovered in the future, because Clomiphene could have some unintended function outside of its intended uses because of its unique and abiological structure.

On the other hand, Clomiphene has been prescribed and tested on male patients for over forty years, and the above risks are the only ones that have become manifest.

Some men may not respond to Clomiphene for Andropause – Because Clomiphene encourages the youthful production of Testosterone via the Hypothalamus and the Pituitary, men with Primary Testosterone Deficiency will not respond effectively to Clomiphene. There are also other factors of the endocrine system which can lead to inhibited effectiveness.

Is Clomiphene Citrate Right For You?

For many patients, Clomiphene is an incredibly viable form of Testosterone Restoration, and may even be the ideal form of treatment. It can be used for patients that need Testosterone Therapy for a brief period of time, as well as for patients that suffer from chronic Low-T resulting from Andropause and Age-Related Hypogonadism.

Of course, like any form of Hormone Therapy, Clomiphene should only be used as prescribed by a licensed and board-certified medical professional. If you are interested in Clomiphene, or any other form of Hormone Replacement Therapy, we encourage you to contact our clinic for more information.


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Three sided solution: Testosterone + HCG + Arimidex

If your doctor only prescribes testosterone by itself, you will probably have a rough ride. The tendency is for you to feel great the first couple months, while you increase testosterone levels, followed by a slow deterioration, once your estrogen creeps up.

High estrogen negates a lot of the positives from testosterone therapy, resulting in the same symptoms of low testosterone you had in the first place!

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5608 PGA Blvd Palm Beach Gardens, FL 33408.

Disclaimer: The board-certified American physician specialists at our reputable medical clinic do not provide prescriptions and HRT treatments unless there is a clinical necessity for the patient at the time of the assessment. Clinically based hormone deficiency is determined by blood testing, physical exam, related symptoms evaluation, medical history documentation, and doctor-patient consultation. These statements presented here at our website have not been evaluated by the FDA.

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