Masculinity, Others, Sex, Testicular

By Dr. Salvatore J. Giorgianni and Dr. Stephen M. Giorgianni

Surprise, surprise guys! Average testosterone levels in men have declined over the past two decades. And this is no secret – scientists and physicians have known about this for almost a decade.

A highly regarded 2006 report from the authoritative Endocrine Society clearly showed that in 1988 men who were 50 years old had higher (average) serum testosterone concentrations than comparable 50 year old men in 1996. This alarming fact was also demonstrated by the mega-trial of more than 1500 men, the Massachusetts Male Ageing Study that compared among other things testosterone levels in three groups of men (1987-89, 1995-97 and 2002-04). Here again the results showed that for men 65-69 years of age, the average total testosterone fell from 503 units in 1988 to 432 units in WHEN, almost a 15% drop in just one generation. This was such an unexpected finding that even the scientists were surprised to learn the facts In both studies the scientists concluded that neither ageing nor other health factors, such as obesity or smoking, (both of which can themselves lower testosterone levels) could account for these stunning findings.

There is no doubt about the fact that more and more men in their 20s, 30s and 40s are showing signs of low testosterone during their medical visits. Symptoms such as fatigue, loss of libido, inability to lose weight and forgetfulness are the most frequent complaints men have when they come for a medical visit. These are otherwise healthy guys who have normal lifestyles and no other medical conditions. Some cynics will say this is all in their head and a product of high-pressure and inappropriate advertising – but the science suggests otherwise. When tested, many of these men have low testosterone levels and no medical reason can be identified. Their hormonal deficiency must be addressed, just as abnormally low levels of the thyroid hormone must be addressed. Both issues have a compelling impact on overall wellness and life-functions and thus need to be treated.

Yes, there are many important medical reasons why a guy’s testosterone levels may be low, particularly for someone younger than 50. These potential medical causes can be evaluated by a physician and can often be corrected. Sometimes the patient needs male hormone replacement therapy to restore testosterone to natural levels. This is something your personal physician can address.

Now back to the SOAP part of this matter. Over the past three decades there has been a dramatic increase in the use of anti-bactericidal chemical additives in personal care products. Many soaps, shampoos, dishwashing liquids, deodorants and even some toothpaste preparations contain anti-bacterial additives. The agents are in these products to kill bacteria and other microbes and presumably enhance daily cleansing. Unfortunately, some of these anti-bacterial agents also have a chemical structure that looks like testosterone – but are not biologically active – meaning they do not do anything except take up space. These anti-bacterial chemicals function as sort of a Trojan Horse Testosterone. When these faux-testosterones get into the blood stream, our body systems recognize them as the real biologically active testosterone and they signal the body to turn off the natural “testosterone pump”. This can cause the individual to develop a deficiency in real testosterone levels and demonstrate symptoms of Low-T. It is true that the amount of bactericidal agents found in personal care products is only absorbed in small amounts at any given application. But few of us wash just once. In reality, those who use anti-bacterial products get multiple applications of multiple products over long periods of time (years really). We wash, shower, shampoo and brush our teeth with personal care products that contain these chemicals day-in and day-out – sometimes up to 10 times a day. Small amounts over time will cause enough adsorption to suppress testosterone levels and cause a substantial decrease in real-testosterone. When we consider that some men, such as food service workers, health care workers and mechanics, commonly wash their hands and arms up to 50 times a day, we quickly recognize the concerns raised by the chemical additives. Similarly, athletes and those who are showering more frequently are rubbing their entire skin surface area (16-21 square feet for the average guy) with this testosterone-wanna-be laden soap a couple of times a day.

So what to do?

If you have symptoms of low testosterone, at any age, but particularly if you are younger than 50, see your family physician. He or she will be able to diagnose your condition and treat you then and there or refer you to another specialist if needed.

If you are worried about the potential long term effect of bactericidal-containing personal care products, simply stop using any personal care products that are labeled as anti-bacterial (particularly those that contain triclosan in liquid soap or triclocarban, used in solid soaps). There is a real concern about these products, so much so that Minnesota has recently banned these chemicals in personal use products. Several other states are considering a similar ban and the Federal Food and Drug Administration is also reevaluating its safety. If you wash properly and thoroughly, these chemicals do nothing to enhance cleansing. Proper washing (30-45 seconds of washing – or enough time to sing the “Happy Birthday” tune) with a good quality soap or shampoo product is enough to remove surface microbes and maintain your health. We recommend using a good quality castile soap product. It is a product with a vegetable oil base. Not all brands may be free of non-natural preservatives or even anti-bacterial agents so make sure you read the label to confirm it is high quality and does not contain a bactericidal agent. If you have any doubts, you should call or write to the manufacturer.

Salvatore J. Giorgianni, PharmD, is the Science Advisor to the Men’s Health Network, and the Chair of the American Public Health Association Men’s Health Caucus.

Stephen M. Giorgianni, DO, is a Board Certified Family Physician practicing In Melbourne FL, and is a member of the Board of Advisors of Men’s Health Network.