Hormonal obesity- this is a set excess weight due to hormonal imbalance in the human body. If diets and sports training do not give the expected weight loss effect, and the weight, on the contrary, continues to grow, it is worth thinking about hormonal reason obesity.

"Hormonal obesity can occur at any age in both women and men."

How to recognize hormonal obesity?

Hormonal obesity differs from nutritional obesity not only in origin, but also in some external signs. Due to hormone failure, fat is deposited unevenly in certain areas of the body for which one or another hormone is responsible.

1. Fat deposits on the upper back and breast area

An increase in the size of the back and breasts can cause hormonal obesity in women due to prolactinemia.

Prolactin- a hormone of the reproductive system responsible for preparing the mother’s body for breastfeeding. An increase in the production of this hormone without pregnancy leads to edema and excess fat deposits.

Other possible signs of increased prolactin

1. Increased appetite.

3. Swelling and tenderness of the mammary glands. Sometimes there may be discharge from the nipples.

4. Violation menstrual cycle due to decreased ovarian function.

5. Infertility (due to lack of ovulation).

2. Excess fat around the waist

The accumulation of fat folds on the belt may indicate problems with the pancreas or thyroid gland. The human body with this type of hormonal obesity in the waist area resembles the folds of a caterpillar. The culprit may be thyroid hormones or insulin.

Insulin obesity

Improper production of insulin (usually insufficient) causes disruption of sugar metabolism. Glucose, which enters the body with food, is not used to produce energy, but to form fat deposits. At the same time, a person feels lethargy, loss of strength and decreased performance.

Obesity due to thyroid hormones

Disorder in the production of thyroid hormones reduces metabolic processes in the body. As a result, energy is not fully utilized and is stored as excess fat. People suffering from such hormonal disorders feel constant fatigue and apathy. A characteristic sign of thyroid obesity is puffiness of the cheeks.

3. Fat on the thighs and buttocks

The presence of a large butt and thighs can be caused by estrogens - female sex hormones. Recognize estrogen deficiency possible by characteristic manifestations:

1) mood swings, depression, irritability;

2) lack of attraction to the opposite sex;

3) lethargy, fatigue;

4) forgetfulness, inattention;

5) disruption of the reproductive organs.

4. Gain muscle mass

Sometimes we may notice an increase in muscle mass. At the same time, fat is not deposited, but muscle tissue continues to increase (male figure in women). This may be the result of increased production of male sex hormones, more often testosterone. Fat accumulation in men occurs due to a lack of this hormone.

Most common reasons hormonal obesity:

1. Diseases of the thyroid gland.

2. Neoplasms in the pancreas.

3. Reception hormonal medications and antidepressants.

4. Termination of pregnancy.

5. Tumors of the adrenal glands, ovaries.

6. Infectious and chronic diseases.

7. Congenital pathologies.

8. Diseases of the hypothalamus and pituitary gland.

How to cure hormonal fullness?

Treatment of hormonal obesity consists of restorative hormonal balance therapy. The first thing you need to do is get tested to detect hormonal disorders. After confirming the presence of the problem and determining its extent, the doctor will prescribe adequate treatment.

1. Diet. For example, when male hormones increase, it limits protein food, and in case of endocrine disorders, sugar consumption is reduced.

2. Mode. Important in the treatment of hormonal obesity is adherence to daily routine, nutrition and normalization of activity. Useful in complex therapy there will be sports exercises, water procedures and walks.

3. Drugs. Doctors often prescribe medications that reduce (or increase) the production of one or another hormone. This helps to quickly restore the balance of hormones in the body and reduce excess weight.

Do not ignore the obvious signs of hormonal obesity. Remember, this type of fullness does not go away on its own and can cause irreparable harm to the body. Be healthy and take care of yourself!

Overweight in mentreatmentin Volgograd.Obesity1, 2, 3 degrees: symptoms, causes, diagnosis, prevention, diet, home treatment. Fatty liver: symptoms, consequences, treatment .

Start with yourself. My weight was 115 kilograms. As it turned out, treating obesity is very difficult. The problem is that there are many reasons that led to excess weight, but the most important is incorrect eating behavior, overeating and sedentary lifestyle. A person consumes more energy than he expends. And I am grateful to my colleague, doctor Margarita Koroleva, who helped me lose 20 kilograms of excess weight.

Why you need to lose weight! Potential Health Benefits!

Reducing weight by just 10% is:

• reduction in mortality overall by 20-25%
• decrease in blood pressure by 10 mm Hg. Art.
• reducing the risk of developing diabetes by 50%
• reduction by 30-50% of fasting blood glucose
• 10% reduction in total cholesterol
• 30% reduction in triglycerides

Where to start? What is the diagnosis of obesity?

Scope of diagnostics to identify causes overweight determined by the doctor at the appointment and depends on the suspected causes of obesity. One of the quick and inexpensive options for examination in case of excess weight is electrosomatography. Scanning of the body is carried out using the Estek device (EIS) - this is a technique for determining the condition of the body, a general screening is carried out, based on the results of which one can receive recommendations on lifestyle and nutrition. The diagnostic program covers all known risk factors and mechanisms of diseases in all body systems and is aimed, first of all, at the early identification of diseases or predispositions to them. Test results are displayed on the screen and handed out in printed form.

Bioimpedance analysis of body composition - what is it?

Bioimpedance analysis allows you to measure the electrical resistance of the body. It's no secret that different fabrics human body have different levels of electrical conductivity. Based on such data, you can find out the exact composition of the body, as well as obtain information about the content of fat tissue, the amount of muscle mass and water. Typically determined: lean mass LM, fat mass FM, muscle mass MM, total fluid TWB, intracellular water ImW, extracellular water ExtW, interstitial fluid volume IFV. Required condition To carry out the analysis, you must refrain from eating and drinking liquids an hour before the procedure. The method allows you to obtain objective data necessary for choosing the optimal weight loss program.

Body mass index. The famous BMI, which people who are concerned about losing weight know for sure, can be determined in different ways. BMI is the degree to which body weight corresponds to height. Normal weight is considered to be BMI 18,50-24,99 . Below is underweight, above is overweight. Obesity begins with a BMI of 30.

There are several types of obesity. Doctors divide them into types, depending on the reasons for their appearance:

• obesity 1, 2, 3 degrees of alimentary constitutional origin;
• exogenous obesity 1, 2, 3 degrees;
• visceral obesity 1, 2, 3 degrees;
• obesity 1, 2, 3 degrees gynoid.

Muscle mass. It's simple: it's the total muscle mass in the body. At poor nutrition, incorrect diet and lifestyle, instead of fat, a person loses muscle mass. IN healthy body muscle mass is 30-40% from the total. With normal weight and a lack of muscle tissue, we can talk about relative obesity, since the lack of muscle tissue in this case is “compensated” by fat mass, and so on. Moreover, it should be noted that individually, such hidden obesity, which occurs against the background of normal weight, is often tolerated by patients just as hard (shortness of breath, fatigue, etc.) as with an obvious increase in body weight, but with a normal muscle component.

Simple, but important indicator is lean (fat-free) body mass (LBM). This is the mass obtained by subtracting the weight of fat mass from the total weight. Lean body mass is often used to calculate the energy intake of the diet. BMT decreases as a result of fasting, disease (cachexia), and aging (sarcopenia).

Basic exchange rate. This is the number of calories the body burns at rest per day. These calories are necessary for life, and the body will “eat” them in any case, whether you are physically active or not. This number is individual for everyone; the higher it is, the faster you spend energy; The lower it is, the more likely it is to gain excess weight, even with proper nutrition. A healthy adult man has an average of 1800-2100 kcal/day, and a woman has 1300-1500 kcal/day.

Fat mass, that is, the amount of fat in the body. The very thing for which those losing weight undergo bioimpedance testing. It would seem that this is the very number of kilograms that you need to lose. But not all fat is excess. It is needed for metabolic processes, thermal insulation, and as stored energy. Optimal level fat for women - 20-29,9% , for men - 10-19,9% of the total weight. The average energy component of one kilogram of body fat is 7 thousand kcal. At the same time, a kilogram of muscle mass is energetically equal to about 1100 kcal. It follows from this that you will have to spend much more time and effort on breaking down fat masses. Studying a person's body fat mass provides useful information about others important features body. In particular, increased attention here we focus on determining the hormonal levels on which the formation of fat deposits directly depends. Fat mass located subcutaneously in the extremities and adipose tissue, located in the greater and lesser omentum (inside the abdominal cavity) differ in their biochemical effects on the body. The android type of fat deposition in both men and women is associated with metabolic syndrome. In such people, cortisol, cholesterol, blood pressure and insulin resistance increase, and are also associated with behavioral and psychosocial risk factors such as physical inactivity, alcohol intake and depression.

The amount of fluid in the body. All fluid in the body is mainly divided into extracellular and intracellular; extracellular fluid - into tissue (intercellular) fluid and blood plasma. The indicator of intercellular fluid allows you to find out whether there is edema in the body or whether fluid is retained. If the amount of intercellular fluid, that is, blood and lymph, is below normal, this indicates thickening of the blood or that you are not drinking enough, especially if you are exposed to physical activity. Normally, the amount of fluid in the body is 45-60% body weight. An increase in the volume of extracellular fluid contributes to an increase in the load on cardiovascular system. And indicators of the level of intercellular fluid make it possible to identify problems in the functioning of the renal system.

What is fatty liver? What are the symptoms and consequences of fatty liver? How to treat fatty liver?

Non-alcoholic fatty liver disease is a hepatic manifestation metabolic syndrome- conditions associated with type 2 diabetes mellitus, insulin resistance, abdominal obesity, hyperlipidemia and arterial hypertension. Fatty liver is a condition that is caused by excessive accumulation of fats in the liver in the form of triglycerides. The most important reason for the development of obesity is insulin resistance, which is associated with obesity. In addition, oxidative stress and cytokines are significant contributing factors, which together lead to steatosis and progressive liver damage. A generally accepted approach to the treatment of fatty liver, which makes it possible to change the course of the disease, is lifestyle changes and diet. Diet: It is necessary to aim for a weight loss of 5-10% and reduce calorie intake by 25% of normal nutrition (up to 2500 calories per day) in accordance with the patient's age and gender. A moderately calorie-restricted diet with a modified macronutrient composition provides best results compared to a very low calorie diet. Attention should be paid to the role of a moderately low-calorie diet and recommendations should be made on the type of foods to consume - avoiding fructose and trans fats in soft drinks and fast food, while increasing the omega-3 content of the diet. Execution physical exercise: An aerobic exercise program with moderate load three to four times a week to achieve a heart rate of 60-75% of age maximum. Drug use regimens for fatty liver disease depend on the stage of the disease, lasting 12-24 months.

How to treat obesity?

First of all, you need to understand: obesity is a chronic disease and its treatment should also be “chronic”. Excess fat has accumulated in the body for many years. To change the situation, you will have to change too. You won’t be able to “go on a diet” and then get off it - you need to change your eating habits forever and motor activity. And do it in such a way that your new lifestyle gives you pleasure. Don’t try to lose 15 kg in one month by eating kefir or cucumbers alone. You still won’t eat kefir all your life, and the kilograms you quickly lost will also quickly return to you, and even in excess. Set a realistic goal to lose 3 kg in 1-2 months. Understand what you want to achieve and why you need it, and start moving towards this goal, changing your life once and for all. You should start worrying already if your body mass index exceeds 25 kg/m2. It is believed that in case of excess body weight (BMI no more than 29.9) and the absence of diseases associated with obesity, treatment should begin with modification of lifestyle and diet, and this is quite possible.

Non-drug weight loss interventions include:

• moderate hypocaloric diet,
• teaching patients a healthy lifestyle with changing eating habits,
• keeping a food diary,
• physical exercise.

Why is drug therapy for obesity important? What drugs reduce body weight?

Drug therapy for obesity is used only in a comprehensive weight loss program to increase the effectiveness of dietary measures, if necessary, more rapid decline weight and is of an auxiliary nature. One of the main tasks in the fight against obesity is to reduce the feeling of hunger in patients in order to reduce the amount of food consumed. This direction of pharmacotherapy is implemented using drugs that suppress appetite (anorexigenic drugs). Another way is to intensify metabolism and energy consumption in the body using, for example, thermogenic agents. The third way is to influence the digestive processes, in particular limiting the absorption of individual food components. In addition, new and promising directions The use of analogues and antagonists of hormones that regulate food absorption and the feeling of satiety is considered. Fourth way - low level testosterone (hypogonadism) is a stimulating factor for the growth of fat cells. Therefore, if it is not possible to reduce body weight while following the doctor’s recommendations, it is necessary to determine the level of testosterone and, in case of a decrease, prescribe therapy with testosterone drugs until the waist circumference normalizes.

Drugs central action(anorexigenic drugs that reduce food intake): Preparation Goldline (sibutramine) intended for the treatment of obesity with central action. It helps to increase the feeling of fullness and reduce the need for food, as well as increase thermal production. A decrease in body weight is accompanied by an increase in the concentration of HDL in the blood serum and a decrease in the amount of triglycerides, total cholesterol, LDL and uric acid. Goldline prescribed orally 1 time/day. The dose is set individually, depending on tolerability and clinical effectiveness. You can take the drug only after consulting a doctor.

Peripheral acting drugs. Listat tablets(orlistat) - inhibitors of gastrointestinal lipases. Prevents the absorption of fats into small intestine. Hence the side effect of this Listat is loose, oily stools when consuming too much fatty food. But this drug has no systemic side effects. Overweight or obese patients with type 2 diabetes mellitus who take Listata for 6-12 months experience greater weight loss compared to patients receiving dietary therapy alone.

How can you change your eating habits?

This is by no means a diet that can be canceled later. This is how every person who wants to be healthy and feel good should eat. You need to eat well, plentifully, tasty, not starve, but at the same time eat the right foods. If you are overweight, choose a “certain diet” for yourself. But special attention We pay attention to the complete exclusion of mayonnaise and sausages, frankfurters, sausages - we replace them with whole meat. As Svetlana Yuryevna Kalinchenko says: “a man’s food should be like a hunter’s food - a lot of meat or fish, cooked without fat and a light vegetable (and ideally vegetable) side dish.

The concept of “rational nutrition” includes not only the consumption of “healthy” and the exclusion of “harmful” foods, a rational diet, the right combination of foods, methods of preparing food without fat, but also certain behavior during each meal.

Under no circumstances should you allow yourself to go hungry. This is not an acceptable way to treat obesity. During fasting, human tissue cells do not receive glucose, the main source of energy, and switch to alternative source nutrition - fats. As a result of the breakdown of one's own fat depots, free fat accumulates. fatty acids, and their excess breaks down to form ketone bodies.

To compile balanced diet you need to calculate the number of calories that can be consumed per day, taking into account individual energy consumption. And from the calculation daily norm calories, you can create a menu for the whole day. In this case, you can eat foods taking into account your usual preferences, but change the ratio of “harmful” and “healthy” foods according to existing recommendations.

What physical activity should you do if you are overweight?

Increasing physical activity is very important and should be considered an important part of a weight loss program. Increasing physical activity has been shown to not only promote greater weight loss, but also help you maintain your gains.

Before you start exercising and choose the type of physical exercise, you should consult your doctor. Physical activity and exercises should be enjoyable and well tolerated by the patient. If, for health reasons, a doctor prohibits a patient from doing aerobics and shaping, this does not mean that physical activity cannot be increased. The simplest, but sufficient effective way increase physical activity - this is walking. Moreover, it is not the pace of walking that is important, but the distance traveled. For example, one hour of walking burns 400 kcal, and jogging for 20-30 minutes only 250 - 375 kcal. Physical activity may include playing, walking, gardening, or playing sports such as swimming. Try to move as much as possible. Even if you live on the 20th floor, walk up several flights of stairs. Very useful! Make a commitment to yourself to walk at least three kilometers every day. The main rule is that these exercises should bring you pleasure, be regular and fairly frequent (3-4 times a week). If you are not used to physical activity, then you need to increase its duration and intensity gradually. If you already have chronic diseases, this does not cancel physical activity, but you will need to agree on its type and duration with your doctor. If you have diseases of the heart and blood vessels, or if you are not used to exercise, it is recommended to start with light exercise, focusing on your heart rate, i.e. on the pulse.

1. Change your lifestyle, starting with the store. Buy low-calorie foods.
2. If you buy not sausages or cheese, but fresh vegetables and greens, then your family will benefit. Buy products from lowest content fat When choosing meat and fish products, try not to buy semi-finished products.
3. Many people say that they “cannot afford” to eat properly. Don’t lie: by limiting your consumption of meat and sausages, you can afford seafood and greens. Cheeses and sausages are no cheaper than fresh or frozen vegetables. Don't buy food for future use.
4. Follow some rules when preparing dishes. Try to use cooking methods without adding fat: not frying, but stewing or baking in the oven. Try to use less salt. Excessive salting of food not only increases appetite, but also increases the risk of developing arterial hypertension.
5. Use small plates and serve small portions. Have a small bowl or plate. This will make it much easier to limit the serving size and eat it slowly and with pleasure.
6. Don't eat unless you're hungry or have nothing better to do.
7. If you come to visit, it is better not to advertise your dietary restrictions. Choose the dishes that you allow yourself to eat.
8. Don't go hungry, eat little and often. Complete fasting is not a solution. Try to avoid feeling too hungry. Eat often (4-5 times a day) and little by little. Try not to eat at night; let your dinner end no later than 2-3 hours before bedtime. If you feel hungry between meals or before bed, eat something low in calories - a vegetable salad, or an apple, low fat yogurt.
9. Don't eat in front of the TV or while reading a book. You may get so carried away that you won't notice whether you're full or not and will continue to eat. Beware of chips and nuts, popcorn.
10. Limit your alcohol intake. Alcoholic drinks are high in calories and increase appetite.
11. Try to prepare beautiful dishes and eat them slowly and with pleasure.
12. For snacks, use low-calorie foods. It is better to eat an orange or an apple, a vegetable salad or low-fat yogurt than a chocolate bar or a cheese sandwich.
13. Don't despair if a breakdown occurs. For example, you ate fried potatoes at night. This is not a reason to give up, but a reason to give yourself additional physical activity. And of course, try to avoid such breakdowns.

The material was prepared by urologist-andrologist, therapist Oleg Viktorovich Akimov.

Not so long ago, there was an opinion that excess weight is an annoying and unaesthetic inconvenience, that excess fat deposited in the body is not necessarily associated with hormonal imbalances in the functioning of the body, but is only an unattractive evidence of diet errors. In fact, excess weight, leading to obesity, is very dangerous, since in most cases it causes many serious diseases. There is no reason to believe that overeating will only affect your appearance. U healthy people who do not have major problems with body weight, chronic diseases are much less common.

The vast majority of doctors believe that obesity can lead to diabetes mellitus, worsen cardiac activity and vascular function, and also provide the patient with hypertension and joint problems. Of course, excess weight is a cause of decreased quality of life, and this problem requires medical intervention, because adipose tissue is not only a subcutaneous layer, but also a “cushion” that grows on internal organs and makes it difficult for them to work properly.

New methods of losing weight and returning patients to a full life are now more relevant than ever. Excess weight problems are widespread throughout to the globe. This is not only a concern for the fair half of humanity, which has always been preoccupied with its figure. Now the percentage of the male population suffering from obesity has increased, and we can already talk about the scale of the epidemic. Research shows that the average life expectancy of men is reduced by 8-12 years compared to women. At the same time overweight men's bodies are much more difficult to treat than women's. The development of obesity progresses, primarily leading to inhibition of the heart and blood vessels. Traditional methods getting rid of excess weight is quite difficult, new research and methods should come to the rescue.

How can male obesity be diagnosed?

Men's health directly depends on the level of the hormone testosterone in his body. Hormonal imbalances lead to excess weight. How do you know if you are obese? The easiest way is to determine your waist circumference. We can talk about obesity if this number is 94 cm. With large waist circumference values, the diagnosis of testosterone deficiency is no longer excluded. Testosterone is the most important male sex hormone, because it is responsible not only for physical strength and endurance, but also for the quality of sexual life and social self-determination.

Obesity is always a consequence of a deficiency of male hormones. And this deficiency can negatively affect the overall picture of obesity treatment. Muscle mass is replaced by fat, which leads to loss of strength, poor mood and well-being.

Modern research has shown that testosterone levels decrease in obese men. For example, in Norway, specialists examined overweight men. Conducted simple test determining waist circumference, then using a blood test to determine the level of male hormone. In all one and a half thousand patients with a waist circumference of about a meter, the testosterone content in the body was noticeably reduced.

Consequences of excess weight in men

• Cardiovascular disorders

Long-term disruptions in the functioning of the heart and blood vessels can lead to increased blood pressure - the so-called. arterial hypertension . The inability of the heart to consistently pump blood through the circulation leads to heart failure. If there is a disturbance in the blood supply to the brain in acute cases, a stroke cannot be ruled out. And whenmyocardial infarction the heart muscle partially dies, thrombosis and varicose veins of the extremities are also possible, which leads to damage to the veins.

• Musculoskeletal

Obesity can lead to osteochondrosis and scoliosis of the spine, as well as provoke inflammatory processes and joint pain - that is, arthritis.

• Exchange

Non-insulin dependent diabetes(or diabetes mellitus type 2) is also associated with obesity, as a result of which the metabolism of carbohydrates in the body is disrupted. Impaired fat metabolism leads to atherosclerosis and hyperlipidemia. The deposition of salts in the kidneys and joints leads to gout.

• Respiratory

  Night snoring is another consequence of excess weight. When combined with shortness of breath and slow or stopping breathing at night (apnea), it can also be dangerous.

• Gastrointestinal

Stones formed in gallbladder, lead to cholelithiasis.

• Oncological

Obese people are more likely to develop colorectal and prostate cancer.

The consequences of the main problems of excess weight listed above speak for themselves, but obese men are also at risk of developing sexual dysfunction - this includes decreased libido (sexual desire) and erectile dysfunction.

With an increase in body mass index, the quality and quantity decrease significantly male sperm. The characteristics of the seminal fluid deteriorate, which can lead to partial or even complete infertility, the so-called “sterility”. The sperm of obese men are less viable and may have significant defects, which in turn leads to the inability to fertilize the egg and the risk of developing genetic mutations. The more pronounced the obesity, the greater the likelihood of genetic defects.

In teenagers, being overweight is also very dangerous. Rise extra pounds leads to a deficiency in the production of male hormones that trigger the mechanisms of puberty. In boys, this can cause delayed puberty.

How can obesity in men be treated?

This interests every patient concerned overweight, and there may be several recommendations here. First of all, of course, it is highly advisable to follow a diet. This is the main and most stringent recommendation. But it is quite difficult to comply with it. However, it is quite possible to lose some excess weight and achieve improved mood and well-being.

But if you were temporarily on a strict diet with a large number restrictions, the body will one way or another require to replenish lost reserves, and, having “left” the diet, there is a risk of gaining lost kilograms, and sometimes, on the contrary, increasing the initial body weight. Even without overeating, you risk losing the battle with a deceived body. Therefore, all kinds of diets are extremely undesirable - it is a lot of stress for the body. The best solution will radically change your eating habits.

In addition to changing your diet, you must not forget about physical activity. Physical education and sports are optimal. This way, along with reducing your calorie intake, you can increase your energy expenditure for exercise. Walking is very useful; such exercises do not require any special training. Half an hour or a little more of intense walking a day, combined with a healthy diet, will help you lose weight. Additional physical activity will not be superfluous.

If you change your diet, exercise until you get tired, and the results still leave much to be desired, testosterone deficiency in the body is possible. And testosterone is an anabolic hormone that is also responsible for burning fat.

About the lack of testosterone in male body can be judged by some indirect signs: - sexual dysfunction (decreased libido, premature ejaculation, infertility and erectile dysfunction); - somatic disorders (problems with urination, such as frequent and nighttime urges, engorgement of the mammary glands (gynecomastia), joint pain and lumbar region, general fatigue and increase in adipose tissue); - psycho-emotional problems (depression, drowsiness, fatigue, irritability and nervousness, which can lead to problems falling asleep, insomnia, memory impairment and low reactions to stimuli).

Laboratory diagnosis of testosterone deficiency is the final stage in making a diagnosis. Find out the level total testosterone You can take a blood test for hormones. The doctor will make a diagnosis of “hypogonadism” or testosterone deficiency if the symptoms described above are present and the level of total testosterone in the blood does not exceed 12 nmol/l.

Therapy and prevention of testosterone deficiency in men using evidence-based medicine

Most effective therapy It is believed, as shown above, to combine a change in diet with physical activity, which will reduce calories consumed both by switching to proper nutrition and through physical exercise, which will help expend energy more intensively. This technique will help to simultaneously replenish testosterone deficiency in the body and cure obesity, since testosterone is the main hormone responsible for fat burning.

Many experts believe that it is enough to reduce excess weight to start the processes of increasing testosterone production, since main symptom– fat cells – will no longer provoke a deficiency of the male hormone, negatively affecting the effectiveness of diets. These questions still cause a lot of medical debate, as they contradict the opinion of some doctors who insist on maintenance correction of testosterone in the treatment of obesity. Achieve the desired results only with the help rational nutrition and physical activity without adjusting male hormones still seems extremely difficult.

There is still no consensus in medical circles and general methodology on testosterone maintenance therapy in the prevention and treatment of obesity. Only healthy people could answer the question of whether it is necessary to artificially replenish testosterone deficiency when combined with excess weight. medical research. Evidence-based research would help in developing similar methods and recommendations for treating physicians.

From the point of view evidence-based medicine The most influential studies now are double, placebo-controlled studies with large numbers of patients - one group of patients receiving real male hormone therapy, and the other receiving a dummy drug. In the case of double-blind testing, neither the doctor nor the patient will know whether the control group received testosterone or placebo. The difficulty of conducting such experiments is that not every patient will agree to “blind” therapy with an unknown drug. Clinicians also face challenges in such studies because ongoing testing must be closely monitored.

Compose international recommendations It will become possible for treating physicians only after many similar studies have been conducted, but for now, in the treatment of obesity, one can rely on the results of already conducted double-blind placebo-controlled tests. For the first time in our country, such a study was conducted from 2005 to 2009, supervised by doctors S.Yu. Kalinchenko and Yu.A. Tishov, the result was the writing of a PhD thesis on the role of correcting testosterone deficiency in the treatment of male metabolic syndrome.

The study aimed to show that bringing testosterone to normal levels in men's bodies helped reduce weight. All 170 patients participating in the experiment were diagnosed with testosterone deficiency and obesity. Initially, they all received orders from doctors to normalize their diet and increase physical activity. Moreover, during therapy, most of the patients received injections of testosterone undecanoate (testosterone preparation), and the rest received a placebo, that is intramuscular injections, do not contain male hormone.

After 30 weeks of the experiment, it turned out that in patients receiving testosterone intramuscularly, their waist circumference decreased by an average of 6 cm compared to those receiving a “dummy”. They also returned to normal sexual function, levels of triglycerides, atherogenic lipids and cholesterol decreased. Gone depressive symptoms, improved general condition, “inflammatory markers”, which usually lead to problems with the heart and blood vessels, and are produced by adipose tissue, have decreased.

Those who received the placebo also saw their waist circumference decrease slightly, mainly due to increased exercise and decreased calorie intake. Their cholesterol and triglyceride levels remained at the same level, as did manifestations of depression and sexual dysfunction.

Thus, it can be concluded that in men diagnosed with obesity, testosterone levels should be measured, and in the case of hypogonadism, testosterone therapy should be carried out in conjunction with exercise and a balanced diet.

In our medical centers This is the approach used to treat excess weight in men. At the same time, all problems associated with obesity are corrected. An endocrinologist and urologist (and for women, also a gynecologist) can recommend and develop an individual complex of not only physical exercises and changes in eating habits, but also a course hormonal correction body, that is, replenishing the missing testosterone in men.

The hormone testosterone is found in the body in both men and women. The only difference is in the quantity and functions it performs. Only two percent of this hormone is in a free state, the rest is bound. Testosterone deficiency is insufficient quantity of this hormone in human body. This pathology is the cause of violations of certain functions in people of both sexes.

Testosterone is the main male hormone. Without the required amount, the body of both men and women cannot function normally. In representatives of the stronger half, it is produced by the adrenal glands and testes. A man needs testosterone:

• During the development of the genital organs and secondary signs gender;
• To regulate sexual behavior and spermatogenesis;
• The exchange of phosphorus and nitrogen is affected.

He's playing vital role in the production of sperm, the development of bones and muscles, and the mood of a man. Thanks to this hormone, the boy becomes virilized or develops characteristics characteristic of a man. Under its influence, a man's physique, hair growth, voice and other characteristics are formed, and the shoulder girdle expands.

In women, this hormone is produced by the adrenal cortex and ovaries. Under its influence:

• In the maturing follicle it is converted into estrogens;
• The mammary glands develop (its level increases during pregnancy).

Testosterone is activated during embryonic development.

Causes of testosterone deficiency

Why is the level of the most masculine of all hormones decreasing? Unfavorable circumstances and illnesses, developmental abnormalities can lead to testosterone levels being lower than necessary normal values. The cause of testosterone deficiency in men can be:

1. Disturbed;
2. Improper functioning of the hypothalamic-pituitary system;
3. Changes associated with age;
4. Increased body weight;
5. Taking certain medications;
6. Bad habits;
7. Frequent stress;
8. Wrong lifestyle;
9. Genetic disorders such as Down, Klinefelter, Kallman syndromes.

The complex pathogenesis of testosterone deficiency, especially associated with age-related changes, comes down to the fact that a man’s testicles stop synthesizing this hormone with age.

Testosterone deficiency in men can develop due to improper functioning of the testicles. This can result from traumatic injuries, surgical interventions, developmental anomalies and diseases. If a representative of the stronger half has his testicles removed, this leads to a sharp decrease in the amount of testosterone.

The hypothalamus and pituitary gland synthesize hormones that stimulate the production of testosterone in the testicles. If there is little production of these stimulating hormones, this will disrupt the functioning of the testicles and lead to a lack of testosterone.

Often, a decrease in the male hormone is associated with age-related changes. Currently, the so-called male menopause has become significantly younger. This is due to many reasons: unfavorable environmental conditions, bad habits, stress, unhealthy lifestyle.

Testosterone deficiency and obesity are directly related. In men who are overweight, estrogen increases, which suppresses testosterone production. A sedentary lifestyle also does not contribute men's health, but excessive physical activity also leads to a decrease in testosterone production.

Hereditary and genetic pathologies - Down, Kleienfelter, Kallman syndromes - among other symptoms, are also characterized by a reduced level of testosterone in the blood serum. It would seem that a woman does not need the male hormone. But this is far from true. Shortage also does not bode well, although it is necessary for normal operation female body quite a bit. What are the reasons for the reduced amount of testosterone in the female half? Among the main circumstances causing this condition are the following:

• Age-related changes (menopause);
• Kidney failure;
• Down syndrome;
• Taking certain medications;
• Removal of ovaries.

Surgery to remove the ovaries - oophorectomy - leads to decreased hormone production. In this condition, women experience artificial menopause due to the lack of production of sex hormones. Under such circumstances, the risk of developing cardiovascular pathology and osteoporosis. Removal of the adrenal glands - adrenalectomy - leads to testosterone deficiency, since these organs are responsible for the production of the most masculine of hormones. Some medicinal substances(corticosteroids, ketoconazole, opioids) also reduce the level of this hormone.

Often, hormonal imbalance occurs with a fanatical desire to lose weight. This especially affects young girls who want to live up to imposed ideals. Sometimes after watching an interview with a celebrity, which is an advertising campaign for some questionable drug, and taking it as a guide to action, they cause great harm to their health.

Symptoms

The lack of male hormone in men has more pronounced manifestations than in women. Vegetative-vascular abnormalities may be observed, which are manifested by tachycardia, hot flashes, and cardialgia. Often increases blood pressure, which can cause a stroke. Hemoglobin decreases, and excessive sweating may occur.

Often with a lack of hormones and endocrine disorders are manifested by obesity, gynecomastia, reduced amount of facial hair, armpits, pubis Musculoskeletal abnormalities are manifested by the following symptoms: decreased muscle mass and density bone tissue, osteoporosis, bone and joint pain, physical weakness.

Psycho-emotional disorders are manifested by frequent mood swings, depressive states, high fatigue, tiredness, bad memory, sleep disturbances, inability to concentrate on one thing. Lack of testosterone can cause trophic disorders. With a lack of the hormone, the skin becomes dry and early wrinkles appear.

Deviations from the genitourinary system are expressed by a decrease in sexual desire, dulling of orgasmic sensations. A man suffers either from a weak erection or from accelerated ejaculation. Frequent urination may be bothersome. Testosterone deficiency may be a cause small size testicles, and the lack of the hormone in women is not so pronounced, but it causes certain disturbances in the body:

1. Anorgasmia and genital insensitivity appear;
2. Irregularity of menstruation;
3. Heavy sweating;
4. Dry skin, hair (become brittle), wrinkles;
5. Fatigue, decreased ability to work;
6. Memory loss.

Insufficient testosterone levels as a result of past illnesses and congenital pathologies in boys during this period become the cause of incomplete virilization.

Under such circumstances, male hair growth is reduced, the figure is formed according to the female type, muscle mass does not develop enough, and the timbre of the voice becomes high. Sexual desire will be reduced, the functioning of the autonomic, vascular and endocrine system, unstable psyche, depressive states.

Hormone deficiency in women not only causes low libido, but can also lead to infertility. In girls, this pathology leads to reduced estrogen synthesis and reduces bone strength. A woman’s mood is also dependent on this hormone: if it is not produced enough, then the woman is prone to depression. With a lack of testosterone, fatigue and lethargy will occur.

Diagnostics

Testosterone deficiency is diagnosed only in laboratories. For this purpose, venous blood is collected on an empty stomach. On the eve of the procedure, it is necessary to avoid taking medications, alcohol, and smoking. Normally, men should have at least 2.6-11 ng/ml in their blood serum, and women – from 0.7 to 3 nmol/l of testosterone.

Treatment

What to do if testosterone deficiency occurs? Testosterone deficiency in men is treated with hormone replacement therapy. Testosterone-containing drugs are prescribed. Endocrinologists recommend not monotherapy, but complex treatment, which helps restore many functions in the body.

With properly prescribed treatment, men restore erectile function, increase muscle mass, reduce the amount of subcutaneous fat, strengthen bones, and increase male-pattern hair growth.

With proper treatment, women will also experience signs of testosterone deficiency. She will immediately feel better, lose excess weight, and increase sexual desire and satisfaction from sex. But treatment should only be prescribed by a specialist. If there is both testosterone deficiency and obesity, you also need to adjust your diet and reconsider your lifestyle. The treatment is quite lengthy and is carried out by the attending physician under the control of testosterone levels in the blood.