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Bioidentical hormone replacement therapy for men can help counteract the effect of andropause and low testosterone levels. Many men may develop andropause, which is a term used to describe a variety of symptoms that occur as a result of lower testosterone levels. Andropause and low testosterone are typically experienced by middle-aged men in their 40s-50s but can also develop in men in their 30s. Dr. Paukman offers testosterone replacement therapy in NYC to treat low testosterone levels and andropause.


Men may experience low testosterone levels for a variety of reasons. Andropause is a common collection of symptoms that is recognized as a result of a decline in testosterone levels. Men may also experience lower levels of testosterone due to underactive testes related to aging that are unable to produce a proper level of testosterone. Other conditions that can lead to low testosterone include inflammatory disease, Kallmann syndrome, or pituitary disorders. Additionally, patients who are overweight or on certain medications may be more likely to experience low testosterone levels.


Bioidentical hormone replacement therapy (BHRT) is a common hormone therapy that can help control various symptoms, including fatigue, low sex drive, bloating, and more age-related issues. Testosterone replacement therapy uses hormones that are designed to act exactly like the hormones that are naturally produced by your body. Compared to synthetic hormones, BHRT uses identical hormones that are easily incorporated into your body’s system. Bioidentical hormone replacement therapy for andropause is a hormone replacement therapy that can help correct age-related symptoms of low testosterone.


In men, testosterone is linked to a great deal of functions that determine your well-being and health. As men age, testosterone levels decrease, which, in some cases, can even begin as early as 30. Most laboratory tests give a healthy range of testosterone to be between approximately 250 - 1000 ng/dL. This is a wide range of acceptable testosterone levels, but the rate of testosterone decline and symptom occurrences varies from patient to patient. In fact, some patients may have testosterone levels between 300 – 500 ng/dL and still display symptoms of testosterone deficiency.

As testosterone levels drop, men often experience:
  • Decreased erection frequency & firmness
  • Low libido
  • Depression
  • Trouble losing weight
  • Trouble gaining muscle with exercise
  • Decreased exercise performance
  • Osteoporosis
  • Mood swings
  • Fatigue
  • Bone loss and fractures
  • Anemia
  • Heart Disease and high blood pressure
  • Impotence
  • Muscle loss
  • Difficulty concentrating
  • Decrease in height


Natural testosterone replacement therapy is quickly becoming very popular among aging men. At Paukman BioAge Clinic, Dr. Paukman takes a unique and highly effective approach to hormone replacement using implantable Testosterone pellets. Dr. Paukman performs Testosterone pellets in NYC for patients with low testosterone levels.

Testosterone replacement therapy in the aging male has been shown in clinical trials to:
  • Increase lean body mass
  • Decrease fat
  • Increase strength
  • Promote a healthy libido
  • Improve mood


The A.D.A.M. (Androgen Deficiency in the Aging Male) questionnaire is a basic series of questions that can be very helpful for men to understand their specific case of low testosterone and their individual symptoms.

The questions are as follows:
1.Do you have a decrease in libido or sex drive?
2.Do you have a decrease in strength and/or endurance?
3.Have you noticed a decrease in happiness?
4.Are your erections less frequent and firm?
5.Are you falling asleep after dinner?
6.Do you have a decrease in libido or sex drive?
7.Do you have a decrease in strength and/or endurance?
8.Have you noticed a decrease in happiness?
9.Are your erections less frequent and firm?
10.Are you falling asleep after dinner?


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Identify modifiable risk factors for potentially preventable diseases. Age-related diseases kill approximately 100,000 people daily.

Disease Risk Factors:
  • Obesity
  • Physical inactivity
  • Hypertension
  • Insulin resistance
  • Dyslipidemia
  • Hormonal imbalance
  • Nutritional and vitamin deficiency
  • Unchecked stress
  • Smoking

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The following step is to perform laboratory testing and analysis. We will take a sample of blood or saliva for a variety of laboratory tests.

Our goal is to detect any metabolic abnormalities and address and treat them. We help to improve insulin sensitivity and blood pressure, lower serum inflammatory markers, improve levels of vitamins, and optimize lipid profile. A baseline profile must be established so that future testing can be compared to your initial screening.

Listed below are levels that major laboratory tests use as benchmarks of health.

  • Complete blood count (with differential)
  • Metabolic levels
  • C-reactive protein (High levels = inflammation)
  • Homocysteine levels
  • Lipid panel
  • Basic metabolic panel
  • Endocrine (hormone panel)
    • Follicle-stimulating hormone and luteinizing hormone
    • Testosterone (free and total)
    • Estradiol levels
    • Sex hormone-binding globulin (SHBG)
    • Thyroid panel with thyroid-stimulating hormone
  • Tumor markers
  • Hemoglobin A1C levels
  • Insulin-like growth factor (human growth hormone)
  • Vitamins and minerals
  • Prostate-specific antigen

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Biochemistry can be assessed to establish various risk factors for disease. An image of the vascular system (blood vessels) and heart can help determine if athererosclerotic disease is present. Therefore, to further identify potential disease risk factors, a thorough cardiovascular and pulmonary assessment inclusive of carotid artery screen, echocardiogram, aortic diameter (aneurysm survey), femoral artery peripheral blood flow, and pulmonary function is done. Ultrasound technology affords us the ability to detect vascular endothelial damage and also quantify and track plaque of peripheral vascular disease (PVD). Ultrasounds can also help size an atherosclerotic aneurysm of the abdominal aorta (AAA).

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Hormonal Optimization

Bioidentical hormones are an adjunctive treatment with sometimes life-altering effects but are only prescribed to those meeting strict clinical and medical criteria. Some medical restrictions may make some patients unable to receive bioidentical hormones. In particular, growth hormones and testosterone may potentially be restored to their youthful levels. Many women are in need of bioidentical hormone replacement therapy, which can prevent osteoporosis.

Score Antioxidants Level

Dr. Paukman will perform a diagnostic scan to measure antioxidants, which will be repeated after supplemental therapy. Following this test, a weight and body composition assessment is often performed. In some cases, Dr. Paukman may suggest genetic testing.

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One of the final steps is to synthesize the collected data found through physical examination, laboratory testing, and imaging findings. Dr. Paukman will formulate a customized treatment plan that covers nutrition, weight reduction, hormone optimization, peptides, antioxidants, exercise, and stress reduction. If needed, various pharmaceuticals (mostly natural and bio-identical), may be prescribed. IV solutions are also used to supplement depleted minerals and vitamins needed for rejuvenation. Any treatment will be followed up by an evaluation with Dr. Paukman and laboratory every 1 - 3 months to determine effectiveness and adjust any details of your therapy.


Dr. Paukman and the staff at Paukman BioAge Clinic are happy to discuss bioidentical hormone replacement therapy with you. To schedule a consultation, please call our Manhattan office at 212-336-1555, our Brooklyn office at 718-376-6501, or request an appointment online. Please feel free to view our patient information and review the steps of your clinical evaluation prior to your appointment with Dr. Paukman.