Andropause… male menopause
Andropause, the male equivalent of menopause, is real although more subtle than menopause. While estrogen levels decline abruptly after menopause in women, there is a gradual decline in male hormones (androgens) that usually begins in the 40’s. Testosterone (T)–the main male hormone–declines slowly. However, the sex-binding-hormone globulin (SBHG) increases with age, resulting in less free bio-available testosterone.Along with the age-related decline in human growth hormone, the loss of testosterone contributes to the familiar “pot belly” and declining muscle tone in middle age men. The symptoms of andropause include a waning interest in sex, difficulty in having and maintaining an erection, as well as fatigue, depression, irritability, aches, pains, and stiffness.
As men age, there is an overall decline in bio-available T, while Estrogen (E) levels tend to rise or stay the same. The increase in SBHG, which binds both T and E, leads to an imbalance that directly causes many of the debilitating health and performance problems associated with aging. As testosterone levels are lowered, there is a change in body composition that results in higher body fat levels. The fat cells possess an aromatase enzyme that further encourages the production of estrogen from testosterone in men. This relative increase in estrogen may explain the enlarged prostate so common in aging men!
Practitioners of Age Management Medicine (AMM) can order simple blood tests to determine levels of male hormones. The normal reference range for T ranges from 250 to 1100. This is a huge range. Men at the lower end of the spectrum can be symptomatic while men at the higher range are fit, active, mentally clear, and have active sex lives! The goal of AMM practitioners is to boost production of T or supplement it to higher normal levels, to restore optimal health and quality of life.
There has been a long-held dogma in modern medicine that testosterone was implicated in higher rates of prostate cancer and heart disease. The reality is that the lowest levels of testosterone in men are associated with higher rates of heart disease and prostate cancer. This has been confirmed by countless medical studies (refs below). Additionally, there have been two studies in the last two years that have associated higher mortality rates in men with the lowest testosterone levels.
It is now becoming clear that T is a total body hormone. T-receptors are located in the brain, where sexual stimulation and erection begin. Here, neuronal T-receptor sites are prompted to ignite a whole cascade of biochemical events that involve T-receptors in the nerves, blood vessels and muscles. Free T promotes sexual desire and facilitates both sensation and performance. T must be optimized and E suppressed to maintain a normal youthful balance.
An increasing number of studies have shown an association of low T levels and cardiovascular disease rates in men. T additionally has beneficial effects of maintaining heart muscle, promoting coronary artery dilation (good circulation), some modest help in cholesterol and lipid levels, as well as lowering systolic blood pressure.
T is also involved in facilitated glucose transport into the cells and can be helpful in improving insulin resistance-a major factor in adult onset diabetes.
T optimization increases muscle mass, decreases fat mass, helps maintain bone density, and can increase muscular strength, with no change in diet or exercise.
T supplementation can improve depression that is related to low levels of T. Many adults have been able to reduce or stop anti-depressants onceT is optimized. Many of the modern anti-depressants have common complications of a decrease in libido which can be helped by T.
DHT (dihydrotestosterone) is made in the body from T. DHT contributes to benign prostatic hyperplasia, a non-cancerous enlargement of the prostate gland, but annoying as it can cause difficulty passing urine and increased frequency, especially at night. DHT levels have to be monitored as increases in T can lead to increases in DHT.
Some men can boost their T levels by using human chorionic gonadotropin (HCG). T can also be supplemented by either transdermal creams or injectable T to maintain youthful levels.
Studies have shown supplemental T can result in lower levels of cholesterol, glucose, and triglycerides, reductions in blood pressure and decreased abdominal fat mass, increased sense of well-being, increased libido, increased energy, better focus and concentration and increase in muscle mass and strength.
Practitioners of AMM commonly see the following scenario: A 50 year old male presents with a pot belly and flabby musculature. He has little if any desire to exercise. If he does exercise, he is totally wiped out for several days. His sexual performance and desire is waning. His mood, energy, and quality of life are less than optimal. Restoring testosterone to youthful levels can resolve many or all of these symptoms. We do not have to rely on medications that treat the symptoms such as Viagra or anti-depressants. Treat the cause: decreased bio-available testosterone! Andropause is real and treatment programs are available. Women, do not let your husband or significant other suffer in silence.
Men do not have to age as they normally would without hormone replacement, and lose quality of life. There are viable options.
1. The Sinatra Solution. Stephen T. Sinatra, MD, FACC. Basic Health Publications, Inc.
2. Life Extension Revolution. Phillip Lee Miller MD and the Life Extension Foundation. Bantam Dell Publishing Group, 2005.
For more info, contact Age Management Institute at 775-787-8300 or firstname.lastname@example.org