Female bodybuilders have low libido

Practice Dr. Fountain of youth

Georg, 55 years old, can no longer. Georg was what women love in their dreams: strong, muscular, good-looking, also intelligent. He was very brisk and assertive, but also very logical and thoughtful. Georg complained of libido disorders, loss of erection and fatigue. "Maybe I've fucked too much in my life, maybe the battery is out," he said to me. He was very personable, open, not a handsome guy, more of a good buddy.

I told him that this can happen at the age of 55 and that it could be related to the male menopause, the so-called andropause, but that we had to measure it first. Georg was not very lucky in relationships. He loved beautiful women and liked to surround himself with them. This led to significant conflict in his marriage. His wife had accused him over and over again of being numb. According to Georg, this is more due to the fact that he has a very strenuous job as a manager, which catches him again immediately after sex.

Georg is a patient of Dr. Michael Klentze. The Munich doctor describes how he will help him in his book "Anti Aging - The Power of Your Own Hormones".

Michael Klentze, General Secretary of the European Society for Anti Aging Medicine, practices in an old apartment in Munich a few meters from the exclusive Maximilanstrasse. With its high, dark wooden coffered ceilings, the practice is more reminiscent of a law firm. There is no waiting room. If the patient has to wait, he can take a seat on an elegant leather couch in the reception room and take a glass of mineral water.

"My clientele, what can be found here, is actually across the board. I have self-payers who save their money to be here and are very, very motivated. And of course I also have middle-class people first and foremost, managers who are basically overwhelmed - that is precisely this middle management level, which is very highly demanded, so between two sides there is pressure from below and from above, and many women too - men / women 50/50. "

Michael Klentze's patients usually come to him with mental disorders. You feel exhausted, tired, exhausted. And you have what you need to be checked by him: a long conversation, a large number of blood tests, genetic tests.

"And the central issue is first and foremost prevention - how do I stay healthy? How do I manage to stay really fit until the end of my life?"

For Michael Klentze, the bill for a thorough health check including blood analysis and genetic test can amount to up to 4000 euros, the laboratory costs included are 3000 euros. Even private health insurers do this only partially or not at all. But anti-aging medicine is booming. Founded seven years ago, the German Society for Anti-Aging Medicine now has more than 1000 doctors among its members. More than half of them have obtained a certificate that is supposed to ensure the quality of the treatment.

"Basically, anti-aging medicine is a holistic program. This means that we naturally try to capture the entire human being, both diagnostically and therapeutically, starting with the psyche, with his physicality - that is, movement a very important topic, nutrition plays a major role, then what plays a major role in the aging process are the inflammatory processes, are the free radicals, intercepting free radicals with antioxidants (..) "

The Society for Anti-Aging Medicine describes itself as a medical-scientific specialist society. Scientific studies on the effectiveness and harmlessness of new methods are considered the gold standard for treatment in medicine. But it is precisely this basis that anti-aging doctors lack in many cases, criticizes andrologist Eberhard Nieschlag, director of the Institute for Reproductive Medicine at the University of Münster:

"Anti-aging is predominantly not evidence-based, but these are hypotheses, these are ideas, these are of course measures to earn money, to ask the patient to pay, disguised in measures that have not been scientifically proven."

Georg's food preferences were of course steaks, hamburgers, roast beef - everything that has to do with meat. But he also liked vegetables and sea fish. Fat, preferably animal fat, butter, that was what he liked, i.e. everything that is unhealthy. Sweets weren't his thing.
His androgen levels had dropped dramatically. Obviously, unconsciously, he wanted to keep his testosterone levels high with his meat consumption. His estrogens were rather high, and insulin and blood sugar were normal.
So it was clear that I was prescribing testosterone for him.

"In 1981 I began to work in anti-aging medicine and was one of the first practicing doctors in the field at the time."

Dr. Ronald Klatz, President of the American Association for Anti-Aging Medicine A4M.

"The origin of anti-aging medicine lies in the practices of sports physicians. The techniques used by competitive athletes were also used in anti-aging medicine. And when the American Society for Anti-Aging Medicine was founded , most of the doctors involved were there because of their background as doctors in competitive sports.

Dietary supplements, interventions in the metabolism, some training methods - a lot of the laboratory analyzes can be used during the entire life span, whether it is a competitive athlete in their mid-20s or senior athletes with 50 or older. When you train for a competition, be it weightlifting or discus throwing, running or wrestling, it is always about maximizing physical performance. And that is also the core of antiaging medicine. It's about maximizing physical performance. "

Ronald Klatz, in whose association 15,000 American doctors are organized, therefore likes to show photos of 60-year-old bodybuilders at the beginning of his lectures:

"They are our best examples of ideal aging. They have been constantly exercising, dieting, taking supplements, sometimes hormone replacement therapy - and that's not the same as drug abuse - so they are the role models."

The second important stimulus for their work came from American anti-aging physicians from basic research: from people who dealt with flies and roundworms. These researchers discovered that certain genetic changes can greatly extend the life span of an organism. Experiments with monkeys that were placed on a low-calorie diet lived longer than their normally nourished conspecifics also became famous. Until then, says Rudi Westendorp, the prevailing idea was that every person has a fixed lifetime that runs like a clock. Professor Rudi Westendorp works at the University of Leiden on the genetics of aging processes:

"There is no program for the aging process; you don't have to be afraid of it. A person's lifespan can be extended by strengthening the body's repair mechanisms. Furthermore, the data collected over 250 years shows that there is no upper limit for our lifetime, there is no biological reason for an upper limit. And the demographic data also show a steady increase in human lifetime. Every year life expectancy increases by another three months. That is enormous! "

From this knowledge of geneticists and demographers, the view of anti-aging medicine derives that the aging process is a kind of disease that is curable:

"The gerontological establishment sees aging as a normal event that should be treated, but not a disease. And there's not much you can do about a normal event, right? There's no cure for something that's normal. That's why aging is incurable. In anti-aging medicine we have a different idea of ​​the aging process. We believe that aging is a constellation of degenerative metabolic processes that lead to degrading disease processes and ultimately to death. "

Anti-aging medicine aims to reverse or at least stop these destructive metabolic processes. The geneticist Rudi Westendorp does not think this is impossible. The crucial question, however, is how the aging process can be favorably influenced. What does the ideal diet look like, what is the right amount of exercise? There are few reliable findings and a lot of weak studies:

"Most of the studies on aging are a bit odd. We compare people who sit around in their armchairs and are at higher risk of death to other people who run marathons and live long lives. The simple interpretation of this data is that marathons are good for us The alternative interpretation would be that people who can still run marathons at 70 have better bodies than those who just sit in armchairs. "

The genetic makeup of the marathon runner is not taken into account in the study, but it certainly also has an impact on their lifespan. What does it take for a long life? Rudi Westendorp has several answers to this question. Answer number one: "Choose your parents carefully, especially your mother."

If the mother has longevity, that's the best thing you can do for yourself. Advice that goes no further in anti-aging medicine. That is why she takes care of the patient's lifestyle, nutrition, exercise, nutritional supplements and often hormone replacement.

With his meat consumption Georg [he] obviously unconsciously wanted to keep his testosterone level high. His estrogens were rather high, and insulin and blood sugar were normal.
So it was clear that I was prescribing testosterone for him. With regular Androtopgel applications, his libido improved significantly. Of course, I also tried to treat his erectile dysfunction with psychotherapeutic means, but there was only very little improvement. Testosterone was also unsuccessful. So I tried higher doses of DHEA. This succeeded. As a result, his blood estrogen level rose at the same time and he became more understanding for his partner.

"Daniel Rudman published a report on human growth hormone in the New England Journal of Medicine in 1990 that opened the eyes of many people. Rudman found that in those over 60 years of age, the signs of biological aging could be reversed by 10 to 20 years with just six months of hormone replacement with growth hormone. "

The Rudman study cited by anti-aging medic Ronald Klatz showed that human growth hormone caused muscle mass to swell and body fat to melt in 12 aging men. The test subjects' bones became harder and their skin thicker. Rudman himself never promoted the hormone for rejuvenation cures, but the anti-aging scene soon praised it as THE fountain of youth hormone. Ronald Klatz even dedicated an entire book to him in 1998: "Grow young with HGH" - Rejuvenate yourself with HGH - Human Growth Hormone.

"Its best-known effect, which also gave it its name, is that small children grow up with the help of growth hormone, and that children who are deficient in growth hormone do not grow adequately tall."

Professor Christian Strasburger from the Charité in Berlin is Germany's leading endocrinologist on the subject of growth hormone. Even in adults, the hormone still controls various metabolic processes, but the level drops with advancing age. Because of its muscle building effect, it is often misused in competitive sports. Strasburger has therefore developed a doping test for HGH.

"The other abusive area of ​​use is that growth hormone is given to patients outside of the indications that have been tested for safety and efficacy, for example in the wake of this anti-aging hysteria that is currently affecting our country, and that is something that has spilled over to us from America."

In Germany, as in the USA, HGH is only approved for the treatment of children with stunted growth and adults who are no longer able to produce enough of their own HGH due to damage to the pituitary gland. This is a disorder that occurs very rarely. Anti-aging doctors only recommend HGH if the level of the hormone is too low, but they define that a deficiency condition already exists when a 60-year-old does not have as much growth hormone in the blood as a 40-year-old normally does.

"As we get older, we don't need as much of it, but a level close to zero is not good either, because the hormone maintains the health of all tissues in the body. By replacing the hormone until the level equals that of a 45-50 year old , we can achieve significant health improvements in the elderly. "

That is exactly what the endocrinologist Christian Strasburger denies.

"For example, there was a study by Hennessy and coworkers who compared the benefits of simply doing strength training for patients and the benefits of giving patients growth hormone in addition to strength training. And it was found that strength training in aging people it has a very beneficial effect on performance and other health parameters, but the additional administration of growth hormone has no additional effect.

There have also been placebo-controlled studies, including those conducted by the American National Institute on Aging. And here growth hormone was given for half a year without any functional benefits being found. "

No functional benefit - this means that while the muscle mass may have increased, it did not make the patients stronger. It is therefore also unclear whether competitive athletes really benefit from HGH doping. Both athletes and anti-aging patients, on the other hand, risk damage to their health. In too high a dose, growth hormone triggers joint pain, water retention in the body, carpal tunnel syndrome and pre-forms of diabetes.

For all that is known, growth hormone can also ensure that damaged cells that the body normally kills in a controlled manner continue to live.

"If you use growth hormone to change the readiness of the individual body cells to go through this programmed death and ensure that the cells continue to grow, even if they have strand breaks and other errors in the genetic information, then the risk of malignant neoplasms increases Getting cancer.

And so, in my opinion, it is extremely important that before you propagate the use of growth hormone in the aging population as a so-called fountain of youth hormone, you first see whether this can even happen with an acceptable risk. And there are no such studies. "

What is known, however, is that some breast cancer cells produce their own growth hormone. Under the influence of the hormone, in animal experiments, the cancer metastases from New Zealand, among others, more quickly, which spread throughout the body.

"You can imagine that. A growth hormone is of course a growth hormone, a growth factor."

Says the German anti-aging doctor Michael Klentze. But for him no reason to forego growth hormone altogether.

"The question is always, here too, the dosage. Are you in the physiological range? (..) You just have to achieve a personal value where the patient notices, or we can see objectively: Something is happening very low hormone levels. "

Little does little harm - argues Michael Klentze and immediately refers to conventional medicine, which after all also produces side effects. His American colleague Ronald Klatz, on the other hand, flatly denies the risk of side effects of hormone therapies and the often lack of long-term experience. What is healthy for him is what optimizes blood and performance values ​​for the moment. After all, only a healthy person can grow old.

"As for hormone replacement therapies - not just with HGH but also testosterone, estrogen, progesterone, pregnenolone, melatonin, whatever hormone - our goal is to bring the hormone level to an optimal level at which the patient has no symptoms or hardly any Has symptoms that have to do with the hormone deficiency. So it is nothing unusual for someone in their 60s or 70s to be replaced with growth hormone or testosterone or its precursor, DHEA, until the level is around that of a person 20 years younger. "

The German Society for Andrology only recommends giving testosterone if the testosterone level is actually low and all other possible causes for the patient's discomfort have been ruled out. This could be the onset of cancer, for example. For the administration of DHEA, says Prof. Eberhard Nieschlag, there is no basis at all:

"DHEA - we are of course strong opponents - except for people who have no adrenal glands. And some women who have no ovaries and no adrenal glands; DHEA makes perfect sense here.But we are very much against the basic administration of DHEA. There is no scientific basis for it. "

But Ronald Klatz does not contest it; a man of conviction. He swallowed 60 pills every day.

"Yes, 20 with each meal. Most of it is nutrients, but also hormones, antioxidants, I take aspirin and a lipid-lowering drug every day."

You can tell by looking at him. Ronald Klatz has a beefy body; unclear what is muscle mass and what is overweight. In addition, an open, sympathetic face, which, however, looks tired. He fights for this medicine, in which he firmly believes, against opponents whom he describes as the medical establishment and who seek to prove medical misconduct. Even the more athletic Michael Klentze sees established conventional medicine as an opponent who tries to defend his benefice. The massive pill-swallowing that his colleague Ronald Klatz practices is simply the American version of anti-aging medicine for him.

"They are the friends of huge amounts, both in the area of ​​vitamins and hormones and all that kind of thing. They are the friends of the extreme physique and all those things that don't really matter to us.

Anti-aging in America really means building up the muscles very strongly and using this identity of a muscular person to regain the joy of life, that's different with us. We focus more on prevention, the prevention of age-related diseases, which is an important topic for us in anti-aging medicine. "

Klentze advocates swallowing or injecting hormones, but rather as a time-limited cure. He combines growth hormone with a sports and nutrition program.

"That you say this treatment for a maximum of six months and then simply get an improvement. If by then he has neither lost weight nor changed or changed anything in his diet, then he is actually not suitable for this therapy. You have to be very clear: for me, only those who are motivated are suitable.

Since growth hormone is expensive, most of course also have a motivation to do something about it. "

Georg had to change his diet completely, as the cholesterol and uric acid levels in particular had risen high due to the high consumption of meat and sausage consumption. It was difficult for him to convert from his "male" steak meal to muesli, salads, vegetables and whole grain noodles. But thanks to the help of his partner, this succeeded. She could prepare the whole thing hearty and tasty for him as casseroles.

Many of Michael Klentze's patients are very motivated to improve their lifestyle. The expensive treatment, he makes it clear to them, can only be of benefit if they cooperate themselves, overcome their weaker self, eat better and do sports.

The fact that a lot of exercise and a balanced, vitamin-rich diet promote health is one of the few confirmed findings that have emerged from decades of nutritional research. The United Nations nutrition organization FAO declared in 2003 that the connection between cardiovascular diseases, cancer, diabetes and osteoporosis on the one hand and diet on the other hand has only been convincingly proven in the following points: A lot of fruit and vegetables protect against cardiovascular diseases. Likewise low-salt food with little saturated fatty acids or trans fatty acids. Calcium and vitamin D strengthen the bones of the elderly. Regular exercise prevents all ailments. The second tip from the geneticist Rudi Westendorp for a long life is to take care of your body after choosing the right genetic makeup.

"If you do things that are harmful to your body, you are less likely to live long: for example, if you smoke, drink too much, and are overweight."

The fact that the trained gynecologist and psychiatrist Michael Klentze brings his patients closer to a healthy lifestyle is recognized by his critics as a merit. What only annoys conventional doctors like the Berlin endocrinologist Christian Strasburger is that the anti-aging doctor sells a truism at a high price. He tailors the nutrition tips to the individual patient after extensive discussions and tests - sometimes he recommends more soy, sometimes a little red meat - but ultimately it always boils down to whole grain foods and fresh vegetables.

"It obviously makes sense to give people tips on nutrition and exercise in the lifestyle sector - I do not think that this is a thing that is acceptable to the general public, because it is not and cannot be given on a sick note, although it is undoubtedly correct in terms of content And all the gimmicks that are made around it with abstrusively expensive hormone measurements of levels, which are partly wrong and partly not interpretable and partly measured correctly, but then proven with the wrong consequences - that is a program to make the patient easier not only in terms of your body weight, but also in terms of your wallet. "

In the success of anti-aging medicine, her two endocrinologists Christian Strasburger and Eberhard Nieschlag also recognize a failure of conventional medicine:

Strasburger: "Many people feel that they are not treated and understood appropriately, and the principle certainly also applies: He who heals is right.

I think that there is a lot going on in paramedicine, in which patients get the feeling for the first time: Here is finally someone who is really listening to me; here's someone who doesn't want me out of the treatment room after five minutes, but who takes time for me. "

Nieschlag: "Medicine is classically a repair service. We treat patients when they are sick. Prevention is actually a new facet of medicine apart from certain areas and is something that doctors have to learn more and more about prevention is often more important than treatment when the disease has occurred. And in this vacuum, if you will, doctors and non-doctors have of course settled down who want to do something in the direction of prevention. "

Karla had entered menopause. I recommended that she have certain genetic tests carried out to determine whether there was any risk with hormone therapy. With these tests, with the help of a molecular genetic examination, the base frequency of the DNA can be determined for each individual enzyme, the risk of thrombosis and the risk of developing breast cancer during hormone treatment are precisely determined. Then we could decide whether it makes sense to start estrogen replacement therapy.

Patients who come to Michael Klentze's elegant Munich practice rarely have diseases with clear symptoms. They feel limp, sometimes depressed, miss the energy they used to have. In order to track down the cause of such disorders, the anti-aging doctor offers a method that is not available anywhere else in medicine. The polymorphism test, which costs up to 1500 euros. He looks for variations in the genome that should provide clues as to how a patient converts hormones, metabolizes drugs, and what kind of disease risks he bears. Klentze has 50 such genetic variations checked.

"You cannot create a profile of a person based on 50 genes, you can only ask specific questions. If I have the specific question of hormone replacement therapy and the question is: is it a benefit or a risk for breast cancer, stroke, thrombosis, I can see very well. The factor 5, factor 2, the blood coagulation factors are very well documented, the ACE factor is also very well documented, so there are excellent interesting stories where I can say: It is related to a risk or that and then I go purposefully. "

Westendorp: "Big laughing"

Big laughter, says longevity researcher Rudi Westendorp.

"I like the idea, but I don't know how it should work. I like the idea because we will have to think precisely in this direction with our future health strategies. We all want to age healthily and we want to find the weak points in our bodies If you could find them with genetic testing, what would be bad about it? It would be brilliant, because then you could invest in your weak points at the age of 30 or 40 and strengthen this mechanism so that you live longer and healthier. "

Geneticists now know that people who turn 110 differ from those who die at the age of 70 in how well their cells' repair mechanisms work. They have beneficial genes for the metabolism of sugar and fats. However, Westendorp does not have a genetic test that can show where a person's old age is.

What medicine already offers are tests for gene variants in the hormone receptors of the cells. For example, they help to decide whether hormone blockers should be used after cancer. But even the President of the American Society for Anti-Aging Medicine denies that a genetic test could predict a risk of stroke:

"The picture that a gene chip conveys is still too incomplete. What really counts is what is. A blood pressure measurement today says more than a genetic predisposition for future high blood pressure."

Nonetheless, the anti-aging pioneer Ronald Klatz believes that genetic testing will be part of his guild's repertoire in just a few years. And not just genetic testing. Also nanotechnology, stem cell therapies, regenerative medicine, cloning technology - for him all of these are nothing more than technologies for the life-lengthening therapies of the future. He calls them anti-aging sciences, with the help of which he himself hopes to live to be 150 years old.

But how long we live will hardly depend on such anti-aging therapies; and even of our lifestyle only to a limited extent. "If you have chosen parents with good genes," says longevity researcher Westendorp, "and if you have lived healthy, then you need a third thing: happiness."

"The happiness factor plays a bigger role in aging than people think. This partly explains that we all know people who have smoked and drank and still turned 80. How is that possible? They were lucky."