An Interview with our Friend, Dr. Eugene Shippen

about the Power of Hormones

Author of "The Testosterone Syndrome"

Patty Satalia - In medical school you were taught that it was a fact that menopause did not exist. What made you change your mind about that?

Dr. Shippen - I heard a lecture from a foreign doctor that described the male menopause. It seemed to give a lot of information that I was seeing in my patients regularly, so I started researching it on my own and the medical literature I found a wealth of studies showing that testosterone had remarkable benefits for both men and woman. The male menopause, because males don't have periods, doesn't really exist in that sense, but the decline in hormones really does and long-term study does show gradual decline in groups of men. But some men may actually go through a rather sudden change in hormone levels that might duplicate the hormone that women go through. This is associated with signs and symptoms that are sometimes quite similar. Men may get hot flashes, but generally they get a change in energy, strength, stamina. They notice that their sharpness is slipping, their aggressiveness, and mental aggressiveness or get up and go is starting to slip away. It may also effect their sexuality. Their sex drive may drop or they may start having difficulty with performance.

Patty - Why and how do testosterone levels decline?

Dr. Shippen -They probably decline naturally as a course of the aging process. Primarily in men, there is a change in how the pituitary glands send signals to the testicles to produce hormone. We are not sure why this occurs differently in different men. For example, we might find that hormone levels are maintained in quite a high even into the 70's and 80's and yet in the 40's you may start to see a kind of significant decline that is associated with these symptoms. So it is different in men and woman, mostly around age 50 plus or minus a few years, we can expect that to happen. In men it is totally unexpected somewhere between 40 and 80.

Patty - How long in men does the menopause or andropause , over what course of time does it take place?

Dr. Shippen -It can be a very gradual decline. I call it in the book the "gray zone" because it doesn't necessarily mean anything is wrong. In fact, we may not feel that anything specifically is wrong, it is kind of a vague sense of change, in your energy and get up and go. You may have some depression, you may not be as interested in outside activities, and you may become more of a couch potato. These things creep up on us and we tend to say I'm stressed, I am overworked, this is what burnout is, I am having a mid life crisis, this is what to expect, but it doesn't happen to all men.

Pat - If the average man went into his physician and I heard this program about testosterone on Channel 3 and I am feeling many of the symptoms and I think that I should be tested for my testosterone level. How would most physicians respond to that?

Dr. Shippen - Physicians are beginning to change partly because we now have testosterone patches, which are a prescription item. There is more information in the medical literature about changing testosterone levels and the symptoms. Like myself, many physicians were taught there is no male menopause and that hormones are not that important or there are some bad effects of testosterone that it might increase your chance of a heart attack. Exactly the opposite is what I found in the literature.

Pat - In fact you call it the heart protector hormone.

Dr. Shippen - The heart protective hormone in women is estrogen and in men is testosterone. Actually, in the heart some testosterone is converted into estrogen. So it may be that men get their estrogen to protect it from actually creating testosterone first. The heart as a muscle, we all know the athletes seem to benefit from taking these anabolic agents, the steroids they call them. I am not for that by the way, but it builds muscle, it does have an increasing effect on muscle strength and vitality. Likewise, the heart is probably our most athletic muscle, it is beating every minute of the day. The heart has more testosterone receptors than any other muscle in the body, so it makes sense that as testosterone levels decline the energy to the heart, to programming, to be an athletic muscle, to maintain its function starts to decline with declining hormone levels.

Pat - You talked about this as being a natural decline, and yet you say that many of the things that we associate with aging, diminished muscle and bone mass, diminished flexibility, all sorts of things. You really say are not normal and that if testosterone levels were at their peak levels that these things might not be happening.

Dr. Shippen - What we now know through doing a special test that can identify cellular receptors for hormones, we find that every tissue in the body has hormone receptors. So although we call these sex hormones because they provide a certain level of sexuality and the ability to make us man or woman when we go through puberty. Actually these hormones are programming every cell in the body to do its normal function. So in aging we can kind of see a gradual decline in almost every part of the body. We become a little stiffer, a little weaker, a little bit more short of breath when we go up a hill. Our minds are not quite as sharp, although as you think about it, not everybody loses those functions to the same degree and if you look at hormone levels you will find that those individuals that age the best are the ones that continue to manufacture their hormones at more normal levels.

Pat - Ok, is there sometime we can do that are lifestyle things can keep that testosterone level at a healthy level?

Dr. Shippen - It's kind of a vicious cycle forward and backward. If hormones decline we become less active, we gain more weight, as we gain more weight our hormone levels will further decline. By the same token, if we keep our bodies fit and keep the weight down and keep our natural energy systems, our circulation to the brain, the pituitary, probably keeps all hormone levels higher. So a healthy lifestyle has been shown to be associated with higher levels and higher levels seem to induce a more active, healthier lifestyle.

Pat - When would a testosterone replacement therapy be indicated, for whom, what kind of men and women?

Dr. Shippen - Ok, all hormones whether they are taken over the counter like DHEA, which is available, and now you hear about androstenedione that our baseball players are taking. These are precursor hormones that are available and can stimulate your body to make hormones in different parts of the body. I don't advocate taking those without testing. So in every case you should always tests those levels to understand whether or not you are deficient and if you are deficient, how deficient and if you take hormone to correct within the normal range. As long as we stay within the normal range, there are very few documented side effects from any of the hormones that you hear about, estrogen, testosterone, DHEA, thyroid, cortisone. Everyone knows that cortisone is bad, but you would die without it. And so there is a window of health that is important for everyone. We all have a different fingerprint of those hormones. It is like a big symphony that one part or another can get out of tune if that hormone or a group of hormones starts to decline.

Pat - Testing can be done in one of two ways, salvia or blood. Which do you recommend or do you recommend both?

Dr. Shippen - Blood testing is quite accurate, but blood tests tend to have more variability or daily diurnal rhythms have peaks and valleys so those levels may jump around a little. Still they are accurate and are abilities to measure very tiny amounts of hormones has improved in the last few years. Salivary testing is actually measuring the hormones out in the tissues and so it represents the bio-available or the active hormone that are circulating around and it smoothes out those peaks and valleys, so a lot of individuals are beginning to favor the salivary testing for screening purposes or monitoring therapy.

Pat - So if you are feeling any of the symptoms we mentioned earlier, fatigue, weakness, those sorts of things men should go to their doctors and ask for these kinds of tests?

Dr. Shippen - Yes, and if they don't, get a doctor that is open to that concept. They can find another doctor or now there are some companies that will do salivary testing for screening purposes only so that individuals can find an answer at least to where they are in the normal range or below the normal range.

Pat - In fact, I want to give a telephone number. This is a for profit organization, but if you are interested in getting a testing kit you can call Aeron Lifecycles at 800-367-3296. You touched on viagra a moment ago. Most doctors have a 5 percent success rate in treating sexual impotency with testosterone, yet you claim a 50 to 60 percent success rate. How so?

Dr. Shippen - One of the problems was in the early days our ability to replace testosterone was really restricted to injections and doctors used too much hormone in order to get things going again, they would give large doses of injectable hormone. Unfortunately when you give large doses of hormones they get converted into other things. In this case testosterone gets converted into estrogen. That has a neutering effect and you may end up blocking the thing you are trying to activate. So you may get an initial response followed by failure and that says to the doc that it is not going to work. By using normal low dose physiological replacement we see a steady improvement in function and the studies now with the patches and other forms of replacement that don't have these large dose peaks and valleys are much more successful at improving sexual functions.

Pat - So it is a delicate balancing act.

Dr. Shippen - It is, keeping in that window is critical to treatment and health.

Pat - You advise readers to read this book, take it to their physicians and in fact you say take action. There is no reason why you should allow yourself to become a characterture of the person you once were. If the information in this book were heated how in your opinion would it change the overall health of American men in this country.

Dr. Shippen - Since hormones impact every part of our body, our bones, our muscles, our strength, our stamina, our energy, our moods, our sexuality and our heart. It even impacts on blood pressure, diabetes, metabolism, blood sugar, almost every medical condition is associated with some changes in testosterone. Every risk factor for dying is linked to declining level of hormones. So we hear a lot about cholesterol, but cholesterol starts to fall when testosterone starts to fall and replacing may help all of these risk factors, improve your quality of life as well as risk for dying.

Pat - Ok, thank you so much. We have been talking with Dr. Eugene Shippen