Men's Health Specialist

Robert Milanes, MD -  - Aesthetics

Luminary MD

Robert Milanes, MD

Aesthetics & Family Medicine located in Orange County, Irvine, CA

Men's Health Q & A


As men age, there is a natural decline of testosterone that leads to their own type of menopause called Andropause also known as Male Menopause. Until the age of 30, testosterone levels remain constant in men but after these level decrease. This decrease is gradual and the symptom onset is less noticeable. The decline of testosterone leads to the decline in male health leading to increased body fat, weight gain, depression and a decrease of lean muscle mass, strength, bone mass and sexual function. It has been shown that testosterone helps combat these changes while also lowering insulin resistance and decreasing LDL and total cholesterol.

In contrast to the female counterpart, Andropause occurs gradually and is less obvious. Some of the first signs of andropause include:

  • Downward shift in strength and energy
  • Loss of Sex Drive
  • Loss of enthusiasm for work and competition

Not only is testosterone lowered naturally, it also gets impacted by excessive stress, weight gain and lack of exercise.

In addition to a decrease of testosterone, as men age, estrogen (estradiol) levels start to balance of sometimes increase relative to testosterone with estrogen eventually becoming the more dominant hormone. Luteinizing Hormone, a pituitary hormone which stimulates testosterone production is also decreased by estrogen.

What is Testosterone?

Testosterone is an essential sex hormone that plays an important role in both men and women. Testosterone is essential for regulating the immune system, creating energy, mental sharpness, increasing strength and regulating sex drive. Testosterone gives men deeper voices, large muscles & increased hair. Testosterone aids in sperm production, libido control and normal erections.

Signs and Symptoms of Low Testosterone (less than 600 ng/dl)

  • Low libido
  • Weight Gain
  • Irritability
  • Erectile dysfunction
  • Depression
  • Weight Gain
  • Decreased Strength
  • Loss of Muscle
  • Metabolic Syndrome
  • Sleep disturbances
  • Osteoporosis
  • Adverse changes of cholesterol

The symptoms of androgen deficiency and low testosterone levels are used to establish the diagnosis of hypogonadism.

Why Treat Low Testosterone (Andropause)

Testosterone replacement therapy has been shown to drastically improve quality of life. The goal is to treat the signs of symptoms associated with low testosterone and place the body in physiologic balance. Studies have shown that testosterone optimization therapy improves libido, mood, cognition, muscle mass, & bone density.

Luminary MD Hormone Optimization Program

Dr. Milanes provides several options for Male Hormone Optimization. The first part of the process is to fill our a symptom questionnaire and obtaining your hormone values from your blood. This can be done prior to your visit at home, with our Luminary MD blood spot kit, or you can go to a commercial lab after your visit.

Once Dr. Milanes receives your results, an individualized treatment plan will be developed for not only testosterone optimization but also complete hormone optimization. Together you will discuss the best treatment strategy for you so you can live a happier and healthier life. Not only are hormones discussed, but lifestyle factors are addressed.

Treatment options include:

  • Testosterone via transdermal creams, gels, injections
  • HCG Injections
  • Clomid
Luminary MD