Anabolic steroids at advanced age

It is established that general testosterone begins to decrease at men from 50─55 years by 0,8─1,6% a year, at the same time bioactive (free) testosterone decreases from 30─35 years with a speed of 23% a year. According to the Mayo Clinic, however, by age 70, man's testosterone level can drop by as much as 50 percent. The problem of decrease in level of testosterone is one of the most urgent in medicine with age, and became a primary subject of the fifth World congress on problems of the aging men in Salzburg. It is at the moment precisely established that the male body enters a condition of an andropauza similar to a female menopause with age.

Hypophyses-hypothalamuses-testicles, and also growth of concentration of the globulin connecting sex hormones refer lowering of function of an axis to the reasons of reducing level of natural testosterone. Please pay attention to Prostalamin.

Earlier believed that the role of Testosteron-Depotum is important only in formation of secondary sexual characteristics, a libido and in production of a semen, now it is proved that this hormone influences practically all vital systems of an organism. According to the famous specialist andrologist, the leading researcher of the Scientific endocrinologic center Russian Academy of Medical Science Svetlana Kalinchenko, Testosteron-Depotum affects genitourinary system, a brain, muscular, osteal, fatty tissues and cells of a skin. Quite recently communication of depression of level of Testosteron-Depotum with risk of development of a diabetes mellitus was taped. A series of researches shows that Testosteron-Depotum ответствен for blood supply of tissues as its low level can lead to disturbances of a blood flow.

Сlinical picture of andropauza

Deficiency of Testosteron-Depotum leads to disturbances practically in all systems and tissues. The head of a chair of clinical pharmacology of MGMSU, professor Arkady Vertkin describes a clinical picture of deficiency of Testosteron-Depotum as follows: "are broken memory, concentration of attention decreases, quick-wittedness vanishes. At the patient as though the view goes out, the head and shoulders are lowered, muscles become more flaccid, the stomach is enlarged, the breast becomes more similar on women's. Because of the low level of Testosteron-Depotum there are more fragile bones, the skin becomes thinner and dries. The man is concerned less by pleasures of communication with an opposite sex: the libido disappears, sex opportunities decrease, there are pavors and a depression. It is logical to assume that these signs can appear as a result of other diseases. And then it is necessary to receive confirmation, having measured the level of Testosteron-Depotum and other hormones and proteins participating in its metabolism.

Main signs and symptoms of an andropauza:

Genitourinary disorders:

• depression of sexual desire and disturbance of an erection
• decline in the ability to a fertilization
• the speeded-up emiction

Vegeto-vascular disorders:

• sudden hyperemia of the person, neck, top part of a trunk
• feeling of fever ("inflows")
• fluctuations of level of arterial pressure
• pains in heart
• giddiness
• feeling of shortage of air

Psychoemotional disorders:

• acrimony
• bystry fatigability
• weakenings of memory and attention
• sleeplessness
• depressions
• depression of overall health and working capacity

Somatic disorders:

• decrease of number of muscle bulk and force
• fragility of bones
• gynecomastia
• obesity
• decrease of quantity androgenzavisimykh of hair
• thinning and dystrophia of a skin

Laboratory shifts:

• depression of level of the general and bioavailable Testosteron-Depotum
• rising of levels of Oestradiolum and globulin binding sex hormones
• anemia
• rising of level of a cholesterin, lipoproteins of low (LPNP) and very low (LPONP) density.

Age of andropauza

The probability of offensive of an andropauza is enlarged with age. There is the following age statistics of men in a phase of the come andropauza:

Andropauz's age

40-49 years of 2-5%

50-59 years of 6-40%

60-69 years of 20-45%

70-79 years of 34-70%

80 90% are more senior

Side effects of anabolic steroids at advanced age

Tumors

For more elderly athletes risk of developing of a hypertension, atherosclerosis of vessels, ischemia of a myocardium and malignant tumors (a prostate, thoracal glands, an intestine, etc.) are much higher and is enlarged with age. As anabolic steroids increase rate of cell fission, the opinion was popular earlier that these drugs are capable to enlarge the frequency of mutations. If in youth the quantity of mutant cells are lower, and the immune system is more active - the organism copes with this problem. But after 40 years immunity weakens, the number of the mutating cells begins to grow promptly - the tumor naturally is result of this process. However modern experimental data disprove cancerogenic effect of steroids, except for a prostate and a liver (in case of use the gepatotoksichnykh the 17-alkilirovannykh of drugs).

Tumor and hypertrophy of a prostate

Use of inhibitors 5 - alpha reductases highly effectively in case of the good-quality giperplaziya of a prostate gland (GQGPG). With respect thereto, the assumption of possible negative influence of exogenous androgens on a prostate gland was made. Along with it it was noted that the most often specified diseases arise at advanced age, i.e. against the background of decrease in level of androgens.

Numerous molecular researches showed that the major pathogenetic factor of development of DGPZh is intracellular increase in activity 5 - alpha reductases, leading to increase in level 5 - alpha dihydrotestosterone in cells of a prostate gland, but not increased plasma level of testosterone. In case of application of replaceable doses of testosterone deterioration in indicators of an urofluometriya, and also indicators of questionnaires for assessment of symptoms of DGZhP of the American Urological Association wasn't noted.

Thus, it is considered that DGPZh isn't a contraindication to purpose of therapy. In many researches correlation between testosterone level in plasma and the frequency of development of a prostate cancer wasn't noted. Similar data were obtained in other research when the level of a pro-static specific anti-gene (the DOG, a marker of a prostate cancer) wasn't changed in case of therapy at healthy men.

In the presence of prostatitis or a hypertrophy of a prostate in quality hormone replacement therapy is applied testosterone in combination with inhibitors 5 - alpha reductases (Finasterid). These are reduces efficiency of a rate a little, however considerably reduces development of androgenic side effects, including on a prostate gland. Besides, 2 times a year, and also laboratory measurement of a pro-static specific anti-gene are recommended to carry out routine inspection.

Alopetion (baldness)

Loss of hair on the head is also connected with increase in dihydrotestosterone, thus the combined therapy with Finasterid can effectively prevent a hair loss.

Testosterone secretion suppression

It is known that when using androgens oppression of endocrine function of testicles and a spermatogenesis via the mechanism of negative feedback is possible. Especially this effect is noted in case of prolonged use of anabolic steroids in big dosages.

At the same time, acceptance of 240 mg of testosterone of an undekanoat (ANDRIOL) within 6 months wasn't followed by decrease in initial normal level of a spermatogenesis. In other researches essential suppression of normal level of gonadotrophins or endogenous testosterone in case of acceptance of this medicine is also not shown that it is probably connected with a short half-life period of testosterone of an undekanoat.

Thus, adequate post course therapy can eliminate this complication if the andropauza didn't come yet. After approach of an andropauza fixed hormonal therapy is recommended.

Atrophy of testicles

Due to suppression of secretion of gonadotrophins on a feedback mechanism, at prolonged use of anabolic steroids, the atrophy and a desensitization of testicles can develop. In other words, at the termination of introduction of exogenous medicine testicles don't restore ability to sekretirovat own testosterone. This is insignificant after approach of an andropauza. To an andropauza long courses have to be followed by application of a gonadotrophin.

Eritremiya

Therapy by testosterone often gives to increase in a gematokrit above of physiological values because of continuous stimulation of an eritropoez (it is connected with the increased production of erythropoietin under the influence of androgens). Most of authors recommends decrease in a dose of medicine at achievement of indicators of a gematokrit higher than 51% and cancellation of medicine at indicators more than 54%. It is noted that elderly people often have a reaction in the form of sharp increase in level of a gematokrit at purpose of rather small doses of testosterone. Especially expressed increase in level of a gematokrit at androgenzamestitelny therapy occurs at patients with chronic pulmonary diseases.

At medicine cancellation the level of a gematokrit usually comes back to normal values.

Atherosclerosis

Controversial issue is influence of exogenous androgens on the level of lipids of a blood. Traditionally it is considered that the increased risk of development of an atherosclerosis and coronary heart disease in men in comparison with women of genesial age is bound to negative influence of androgens on a lipide profile. Nevertheless, in several researches it was shown that purpose of Testosteron-Depotum leads to depression of level of atherogenous LPONP and LPNP at rather invariable level of anti-atherogenous LPVP.

In other population research it was taped that the risk of development of coronary heart disease decreases at increase of plasma level of Testosteron-Depotum. It can be bound to positive influence of Testosteron-Depotum on expression of a visceral obesity.

Other side effects and complications

Infrequent complications when performing androgenzamestitelny therapy is the liquid delay in an organism, physiological rising of appetite, predilection to clottages. Due to the last side effect careful purpose of Testosteron-Depotum is recommended to men with recently undergone operations, injuries. The clump of liquid can be eliminated with aromatase inhibitors.

At the patients receiving replacement therapy by Testosteron-Depotum the augmentation of frequency of development of a syndrome in a dream is noted. Perhaps, this side effect arises generally at persons with obesity or chronic diseases of lungs.

Read also: Side effects of steroids and how to reduce harm

Rates for elderly

The main medicines for performing therapy at men are testosterone medicines. Today medicines for oral, injection and transdermalny application are created. Now C17-alkilirovannye testosterone medicines (methyltestosterone) having the expressed toxic and cancerogenic influence on a liver in case of oral application are almost withdrawn from the use. Hormone of growth which is capable to rejuvenate skin gains popularity, and also to strengthen joints and ligaments.

Medicines of the choice are drugs on the basis of unmodified (natural) testosterone molecules, most often testosterone air.

Testosterone and testosterone are the most widespread medicines of testosterone in the USA. Thus, the adequate mode of dispensing is intramuscular entering of medicine in a dose of 1 ml of 1 times in 3 weeks. Appointment within 3 months of a replaceable dose of medicine with the subsequent cancellation for a period of up to 3 months is often carried out.

According to most of authors, efficiency of therapy shall be estimated first of all on dynamics of clinical manifestations of an andropauza. In most cases efficiency of therapy in clinical practice is estimated by subjective criteria.

Therapy performance indicators testosterone and at the same time the purposes of the carried-out treatment are:

• increase in a libido, general sexual satisfaction;
• reduction of expressiveness or disappearance and mental disturbances;
• in case of long-term treatment - increase in density of bone weight, reduction fatty and increase of muscle bulk;
• laboratory parameters: increase in level of hemoglobin or quantity of erythrocytes, decrease in level of LPONP and LPNP in case of not changed LPVP level.
• control of arterial pressure and periodic research of a prostate gland is necessary

Ginekomastiya who developed owing to change of a ratio of level of androgens to the level of estrogen seldom is eliminated by means of conservative methods of treatment (aromataza inhibitors).

For control of the state of health the following laboratory indicators are studied:

• general blood test (quantity of erythrocytes, level of hemoglobin, gematokrit)
• lipidic range of blood (level of general cholesterol, triglycerides, LPONP, LPNP, LPVP)
• level of the pro-static specific anti-gene (PSSAG)
• densitometry of bones of a forearm, backbone urofluometriya / ultrasound examination of a prostate gland, an aim biopsy (in case of suspicion of pathology).

New medicines

Scientists look for more and more perfect medicines. Now, for example, injection medicine of Nebido which it is necessary to prick only four once a year is brought to the market. Specialists of the Shering company managed to find the successful formula including oil fraction which allows to maintain rather stable concentration of necessary testosterone within three months: it is gradually released from "oil depot". Some earlier medicines weren't so convenient as they could give "splashes" in hormonal level: there is too much it, a little. It is brought to the market and new gel of the Solvey of Pharm company allowing to apply medicine on skin once a day. Rather recently medicine in the form of a tablet under language was created, clinical tests are passed also by such form as plates which fasten on a gum.

Gains popularity such dosage form as testosteron plaster which fastens on skin and provides fixed intake of medicine in blood.

The publication from the Ekspert magazine No. 9 (503)/06 of Mar, 2006 is taken as a basis of this article, besides data of the last researches, and also modern experience of doctors and athletes were entered.