Andropause – Male Menopause

Bronner Handwerger, NMD

Dr. Bronner Handwerger, NMD

Both women AND men’s hormones decline as we age. This is one of the not-so-lovely facts of life, nature and “getting old.” For men, the impact of decreasing androgens is known as andropause, also called “male menopause” or PADAM: Partial Androgen Deficiency in the Aging Male. While this is a normal part of aging, for some men, it is accompanied by a gradual and undesired decline in their sexuality, mood and overall energy. Sometimes it can even expose men to more serious health risks.

Even gradual levels of decline in testosterone are of concern, as it serves several important functions in men. Testosterone builds protein in the male body and is crucial for normal sexual drive. Testosterone also contributes to several metabolic functions including bone formation, liver function, prostate gland growth and production of blood cells in bone marrow. Although with age, a decline in testosterone levels will occur in virtually all men, there is no way of predicting who will experience andropausal symptoms of sufficient severity to seek medical help. Neither is it predictable at what age symptoms will occur in a particular individual. Each man’s symptoms may be also different.

As with women, andropause in males begins at a time – ages 40 – 55 – when life often offers some of its greatest rewards. But unlike women, men do not have a clear-cut signpost such as the cessation of menstruation to mark this transition. Andropausal body changes occur very gradually in men and may be accompanied by changes in attitudes and moods, fatigue, a loss of energy, sex drive and physical agility. We tend to call these symptoms the “mid-life crisis,” signaled by the desire to by a Harley Davidson or Ferarri. I tease, but in truth, men are not taught how to cope with these changes in their body in the same way women are.

Very few men are aware of male menopause or andropause. They may be clued in that there are changes in their body and in their moods and sex drive, but are unclear why this is happening. In fact, Andropause has been found in medical literature since the 1940’s, so the condition is no a new phenomenon. But in and since the 1940’s, doctors lacked a method for proper diagnosis. Because the symptoms are gradual and a bit unique to each man, it’s difficult to identify and raise awareness for the condition in general. Given that, Andropause is under diagnosed and under treated.

Starting at about age 30, testosterone levels drop by about 10 percent every decade. At the same time, another factor in the body called Sex Binding Hormone Globulin, or SHBG, is increasing. SHBG traps much of the testosterone that is still circulating and makes it unavailable to exert its effects in the body’s tissues. What’s left over does the beneficial work and is known as “bioavailable” testosterone. Andropause is associated with low bioavailable testosterone levels.

Every man experiences a decline of bioavailable testosterone, but some men’s levels dip lower than others. And when this happens these men can experience andropausal symptoms. These symptoms can impact their quality of life and may expose them to other, longer-term risks of low-testosterone. It is estimated that 30 percent of men in their 50s will have testosterone levels low enough to be causing symptoms or putting them at risk.

Typical responses to low bioavailable testosterone levels include:
Low sex drive
Emotional, psychological and behavioral changes
Decreased muscle mass
Loss of muscle strength
Increased upper and central body fat
Osteoporosis or weak bones and back pain
Cardiovascular risk

In many instances, testosterone replacement in men with andropause can be highly effective and beneficial. It’s not for every man, of course. Even those who show symptoms may have other health problems at the root of it all. I’m happy to discuss this with you and see if you would be a good candidate for testosterone replacement therapy. As always, it is important to weigh the benefits with the risks and understand your general health before beginning new treatments.

For the men who are qualified to participate, what I’ve seen is that during testosterone therapy, one’s attitude improves, reinforcing self-esteem and self-confidence at work, as well as an increased energy at home and in social activities. Most men will feel more vigorous, experience improved energy levels, mood, concentration, cognition, libido, sexual performance and an overall sense of well-being. These effects are usually noted within 3 to 6 weeks. Other potential benefits include maintenance or improvement in bone density, improved body composition, muscle mass and muscle strength, as well as improvement in visual-spatial skills.

Of course, any ongoing strategy to reduce the symptoms and risks of andropause should incorporate lifestyle approaches such as optimal diet, regular exercise, stress-management and the reduction of tobacco and alcohol intake. These are all things we can discuss upon your initial visit and after we determine if this treatment is right for you. I encourage you to schedule a consultation so we can discuss further. In the meantime, you may also want to view this short video I’ve created on the topic. http://vimeo.com/1513765  – I’m eager to help you with this transition in your life and keep you in the best shape possible. Thanks so much for reading and be well, naturally!

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