Most men, until recently, were not aware that there are medical reasons behind what many call the “mid-life crisis” or andropause. But the truth of the matter is that we are all, men and women, very hormonal creatures that are equally affected by changes in the levels of these critical substances in our bodies. If you are approaching middle age (mid 40’s and older), or are a man of any age, andropause also called male menopause symptoms may be affecting how you feel.
What is Male Menopause?
Male menopause, officially known as andropause, is a condition that in many ways is very similar to menopause in women. Its cause is attributed to drops in hormone levels that are age-related and accompanied by physical and emotional symptoms, many of which mimic female menopause. Identified in the medical community since the 1940’s, the existence of andropause, until the last several decades, has been controversial to many in mainstream medicine.
Just as with women, male menopause has both physical and emotional aspects. “Mid-life crisis” is a term that has been culturally accepted for a long time, but now it is more than just a state of mind. The middle-aged male may be restless and discontent for more than just situational reasons regarding changes in his circumstances as he ages. And there is solid evidence that drops in hormone levels has everything to do with this phenomenon.
One of the reasons it has taken so long for universal acceptance of andropause is that men don’t like to talk about what they are experiencing health-wise, at least not as freely as most women. Men visit the doctor about 50% as often as women do, and when they do go they may not open up about what’s going on with them, physically or emotionally. The good news is that this has changed to a certain degree and more men and women are aware of male menopause and its symptoms now than ever before.
What is Known About Andropause?
Research indicates there are actually two forms of andropause: Acute and gradual.
Acute andropause is the type that most closely follows the patterns associated with menopause in women. The relationship between a woman’s ovaries, estrogen, the pituitary, and the brain are almost identical between a man’s testes, testosterone, pituitary, and brain. However, unlike female menopause, acute andropause is not common. Testicular function declines slowly for most men, but certain conditions can cause it to happen rapidly. Among the most common are:
- Certain autoimmune diseases, such as systemic lupus erythematosis, which often attacks and breaks down the testes.
- Vascular conditions such as diabetes.
- Heavy smoking
- Certain surgeries such as hernia repairs, vasectomies, and surgery for testicular cancer.
- Genetic conditions that allow normal development, but lead to premature testistical failure. One example is called chromosomal mosaicism, a rare illness that involves two lines of certain cells forming from one chromosomal combination.
- Pituitary tumors
Gradual andropause is the usual type that the majority of men will experience. This occurs due to the natural declination of the male hormones testosterone (from the testis), DHEA and androstenedione (from the adrenal gland), and human growth hormone (from the pituitary). After the age of 55 or so, the levels of these hormones drop significantly in some men. With some individuals this may not happen until they are in their 60s or 70s, but on the other hand, because of the onslaught of hormone disrupting chemicals in our everyday lives, symptoms can start as early as the 30s in many men.
Another factor involves certain proteins in the blood that called sex human binding proteins or globulins. Their purpose is to bind testosterone in a biologically unavailable form. A certain amount of this is normal and necessary in order to bring balance to a man’s body. However, some conditions can cause an abnormally high amount of testosterone in the blood to become bound like this. One of the biggest causes for this is overexposure to other hormones including phytoestrogens found in plant sources such as soy, and compounds used as hormonal additives in cattle feed. Some pesticides as well as other toxic chemicals known as xenoestrogens can act like estrogen in the body. All of these factors will cause an abnormally low amount of bio-available testosterone in the body and are contributing factors in andropause.
What Are the Symptoms of Andropause?
Typical signs may sound very familiar, because many of them are also found in women who are going through menopause. Some common symptoms an andropausal man may expect to experience include:
- Lowered libido
- Erectile dysfunction (ed)
- Less intense orgasms
- Poor energy levels
- Decreased strength and endurance
- Lowered athletic ability
- Joint aches, stiffness in the hands
- Decreased productivity at work
- Loss of satisfaction in life
- Apathy towards things that formerly brought enjoyment
- Desire to isolate
- Falling asleep after dinner
- Urinary changes
- Weight gain (especially around the belly)
- Hot flashes
- Mood swings
- Insomnia and other sleep disturbances
- Premature aging
- Changes in hair growth
- Changes in skin quality
- Increased anxiety
- Loss of self-confidence
- Poor concentration
- Memory loss
With a list like that no wonder they call andropause a “mid-life crisis.” Just as menopause can rock a woman’s world, so it is with men and andropause. Men, it really helps if you know what is going on and why, so learn all you can about this inevitable consequence of aging and be prepared to meet it head on.
How Do I Know if I am Experiencing Andropause?
Any of the symptoms above is a definite clue, but there is a more definitive way to determine exactly where you are at. There are tests available that can measure your testosterone levels, to give you a gauge as to where you fit in the normal ranges. This is not a foolproof technique, and even if you are in the midst of andropause, most men will not show testosterone levels that are below the normal range. This is especially true for men in gradual andropause. With acute menopause, below normal testosterone levels are much more common. If you are having symptoms and suspect andropause, I suggest seeing a naturopath or natural medicine-friendly MD, DO or DC (chiropractor) in your area and arranging for a saliva test to measure hormone levels. If there is no one available in your area, there are saliva test kits available by mail that can measure hormones via a saliva sample. You simply conduct the test in the privacy of your own home, and mail the package back to the lab for testing.
What Treatments Are Available for Andropause?
You probably have heard of Synthetic Hormone Replacement Therapy (SHRT). It is an often used treatment for female menopause, and very controversial because of side effects that are concerning. SHRT can also be used for men in andropause, and it too is controversial. Most of the concern surrounds the potential health dangers of using synthetic hormones, as well it should. Despite what the drug companies claim, the risk for serious side effects from synthetic hormones is very real, in both men and women.
Possible risks for men using synthetic hormone replacement therapy include:
- Increased risk for prostate cancer
- Increased risk for heart disease
- Breast enlargement
- Liver disease, including liver cancer and cholestatic hepatitis.
One that deserves special mention is suppression of testicular function. One of the dangers of synthetic hormones is that they tend to get the natural source, in this case the testicles, to shut down production. Certain types of SHRT, specifically injectable testosterone, are more prone to affect the testicles in this manner.
Natural Solutions for Andropause Symptoms
Well, again, mostly the same as it is for women. One of the best and safest option for many men is the use of natural progesterone USP cream that is also recommended as an excellent alternative to synthetic hormones for women. It may take a bit of taming for the male ego to use the same product as your spouse does, but it is perfectly safe and can help to achieve balanced hormone levels that can quickly help to relieve many of the symptoms of andropause. Make sure you choose a product with natural, pharmaceutical grade USP progesterone. It is highly recommended to have your sex hormones saliva tested before using any type of natural hormone replacement therapy. A saliva test will not only measure your hormone levels but it will also be a baseline from which you can measure the success of your treatment. You want to have the correct balance of hormones, and not let the pendulum swing too far the other way and create an imbalance of another type.
RELATED: Men Need Progesterone, Too
The use of USP progesterone can alleviate many of the effects of andropause, but it may not help with some of the sexual dysfunction issues, such as erectile dysfunction (ed), if they are the result of other issues. Sometimes hormone replacement will resolve impotence, but not always. If you begin to see improvement in other symptoms but the impotence remains, it is best to see a knowledgeable health care practitioner to determine if there is another concern that needs to be addressed.
Lifestyle Suggestions for Andropause
Healthy Diet And Healthy Fats Are Foundational
A healthy diet is foundational, in other words required, in reversing hormone imbalance. So let’s park here for just a moment.
Below is how your body makes testosterone:
Cholesterol –> pregnenolone –> androstenedione –> testosterone
Testosterone, and all sex hormones, begin with cholesterol. This is one reason why low cholesterol levels can do more harm than good. Healthy fats and cholesterol don’t make you fat. They provide your body with the building blocks to create balanced levels of testosterone and other sex hormones. In return this makes you lose weight and build muscle, especially when current testosterone levels are too low.
So the addition of healthy fats in your diet is very important. Men who present with low testosterone often consume way too many carbohydrates. It’s much healthier to remove those empty calories and load up on healthy fat. You will feel more satisfied and your insulin levels will stay steady instead of rapidly going up and down. The Journal of Steroid Biochemistry published a study about serum sex hormones and the effects of diet in healthy men. The results indicated that when men decreased their healthy fat intake, serum concentrations of androstenedione, testosterone and free testosterone also decreased. These results tell us that low-fat diets may play a part in low testosterone.
A healthy, hormone-free and plant-based diet cannot be underestimated. Veggies like broccoli, cauliflower, radishes, turnips, cabbage and Brussel sprouts are rich in Diindolylmethane which can help balance your estrogen and testosterone levels as well as increase the amount of free circulating T in your body.
Throw refined sugar to the curb. It’s suggested that the average American consumes 12 teaspoons of sugar a day which equals almost two tons of sugar in a lifetime! Sugar has also been linked to depleting testosterone levels in several ways. The American Diabetes Association (ADA) reports that type II diabetics are twice as likely to develop low testosterone levels. Once your body develops diabetes, it isn’t able to produce the correct levels of testosterone as it should. The ADA also recommends that diabetics should get their testosterone levels checked by a knowledgeable doctor.
If you eat soy, make sure it is properly fermented and organic. The vast majority of soy consumed in America is not fermented, is genetically modified (GMO), and can wreak havoc with men’s, women’s and even children’s hormones. Read the ingredients on every prepackaged item you pick up in the grocery store. Chances are it contains soy. It is very disconcerting to think about the consequences of all this hormonal exposure, especially to young children.
If you smoke, now is an excellent time to stop. There is some controversy as to whether or not smoking lowers testosterone levels or can actually raise testosterone. To err on the side of safety is often more important than throwing caution to the wind because some study found that smoking can raise testosterone. When it comes to future health issues, smoking is not your friend.
If you are overweight, now is a good time to concentrate on losing those extra pounds. Exercise can definitely help you both physically and emotionally, and is especially important for men going through andropause. Just because you may have lost a bit of your athletic edge doesn’t mean you should slack off physically. You may want to drop the intensity level somewhat, or even switch to a less intensive activity. An example might be exchanging jogging for cycling.
“Weight loss has a predictable and linear relationship with increased testosterone naturally.”
Dr. Gary Wittert – Head of the School of Medicine at the University of Adelaide, Australia
BHRT (Bioidentical Hormone Replacement)
Men who restore testosterone to natural levels through the use of testosterone replacement therapy have been shown to lessen their risk of heart attack and stroke. Balanced testosterone levels have a definite link to higher energy levels and healthy weight control. One study found that men treated with testosterone therapy experienced a reduction in fat mass and increases in muscle mass and strength. Other benefits of hormone therapy for men include enhanced sexual desire and performance, better bone density with aging and improved spatial performance in those with Alzheimer’s disease.
Men who have used bioidentical hormone replace therapy indicate the following benefits:
- More energy
- Reduced body fat
- Improved mood
- Reduced anxiety
- Increased muscular strength
- Boosted sexual performance
- Maintenance of lean body mass
Using bioidentical hormone replacement therapy is an effective and natural option for restoring healthy hormone levels in men. Conventional methods used to restore male hormone levels, such as synthetic hormones produced by pharmaceutical companies do not provide the tailored treatment necessary for achieving and maintaining optimal health. It is worth your while to talk with a practitioner who is knowledgeable about bioidentical hormone replacement therapy before considering any type of hormone replacement therapy.
Personal Care Products
The personal care industry for men is huge. Men now use almost as many personal care products as women. Most deodorants, lotions, shampoos, conditioners, shaving creams, and other personal care products contain endocrine disrupting chemicals. It’s important to be an ingredient reader and avoid the following:
- Phthalate. Phthalates mimic estrogen and accumulate in fat cells.
- Parabens. This includes methylparaben, ethylparaben, propylparaben, and butylparaben. All four of these chemicals mimic estrogen in the body and are common preservatives in many personal care products.
It’s especially important to use a good natural ingredient deodorant since the pores in your armpits absorb chemicals easily. Skip the antiperspirant deodorants. When you stop yourself from sweating, you’re blocking one of your natural detoxifcation routes which is sweating. Most antiperspirants use aluminum to stop you from sweating. Aluminum has probable links to dementia, especially Alzheimer’s.
Supplements and Herbs
Talk to a knowledgeable health care practitioner about natural supplements, herbs and vitamins that can help with the symptoms of andropause. Supplements that are helpful include intraMAX, DHEA, Zinc Orotate, deAromatase, Vitality C, Calcium Orotate, Suntrex D3 and Max B-ND. Herbs to research include maca, holy basil, nettle root, suma root, tribulus terrestris, tongkat ali, muira puama, ginseng and saw palmetto. Unfortunately, in my experience with clients, while herbal remedies may provide some symptom relief, they do not usually provide clinical balance and may not get to the root of the issue.
A word about D3 levels. Most people, in general, have no idea what their vitamin D3 levels are. If you have low vitamin D levels, it will absolutely suppress your testosterone levels. In fact, one of the most crucial nutrients that can help raise testosterone levels is vitamin D3. The journal Hormone and Metabolic Research announced in 2011 that vitamin D supplementation boosts testosterone naturally in overweight men by up to 30 percent. This research is exciting because it we know that vitamin D3 is also linked to helping to prevent and treat cancer.
Keep Your Liver Supported
Your testosterone output is affected greatly when your liver does not function properly. The main reason for this is because your liver contains an enzyme that conjugates the 17beta-hydroxyl group of testosterone. The Journal of Gastroenterology and Hepatology published a study revealing that “serum testosterone is reduced in up to 90 percent of men with cirrhosis, with levels falling as liver disease advances.” This alone indicates just how important liver health is to your testosterone levels. Many studies verify the effects of liver function on testosterone.
Keeping your liver clean and supported with a liver support product such as Livatrex is very important in keeping hormones in balance.
Don’t Skimp On Restful Sleep
Did you know that your testosterone levels rise when you sleep?
Testosterone rises while you sleep, particularly during the REM phases. Today, men are often skimping on their shut-eye, which in turn is zapping their testosterone levels.
An article from the journal Current Opinion of Endocrinology, Diabetes and Obesity, reports that getting enough sleep and at the right times are two of the most effective natural ways to raise testosterone. Most people require around 7 hours of sleep every night, and it’s critical to take advantage of the 10 p.m. – 2 a.m. window which is when the body does the most healing and repair work. And your body’s circadian rhythm resets itself every night and releases chemicals, such as cortisol, which contribute to the overall hormone balance that can halt low T-levels. It’s been said that one hour of sleep between 10 p.m. and 2 a.m. has the same healing effects on your body as two hours of sleep before or after this particular time period.
The best case scenario for optimal hormone balance is going to bed around 10 p.m. (dark and cool room with all devices off) and waking up around 6 a.m.
Chemical and Heavy Metal Cleansing
The age in which we live has not been and is not kind to our hormones. Serum testosterone levels, in American men, have declined by about 1% each year for the past 30 years. Hormone-disrupting chemicals abound more than ever before, physical activity has declined and many doctors continue to insist that a low-fat, low-cholesterol diet is the healthiest way to eat.
In this article, I have talked about powerful ways to help increase your testosterone, both medically and naturally. Many of these suggestions also ring true for women. Men may have more testosterone, but balanced testosterone levels are also important for women.
It’s important to know your testosterone levels in all seasons of life in order to have a baseline and to make sure your levels are healthy. Talk to a knowledgeable practitioner in men’s hormones.
It is also helpful to share both your struggles and victories as well with your spouse, trusted friends and/or a knowledgeable practitioner. There is nothing so contagious as someone who has found some effective answers to their health concerns, is feeling better about themselves, and is passionate about sharing it. While going through andropause is often difficult, the good news is that it doesn’t last for ever and coming thru it can open up a whole new world to you and provide an entirely new zest for life.
Gauthaman K, Ganesan AP, Prasad RN. Sexual effects of puncturevine (Tribulus terrestris) extract (protodioscin): an evaluation using a rat model. The Journal of Alternative and Complementary Medicine. 2003 April;9(2):257-65.
McKay D. Nutrients and botanicals for erectile dysfunction: examining the evidence. Alternative Medicine Review. 2004 March;9(1):4-16.
Tambi MI, Imran MK, Henkel RR. Standardised water-soluble extract of Eurycoma longifolia, Tongkat ali, as testosterone booster for managing men with late-onset hypogonadism. Andrologia. 2012 May;44 Suppl 1:226-30. doi: 10.1111/j.1439-0272.2011.01168.x.
Oshima M, Gu Y. Pfaffia paniculata-induced changes in plasma estradiol-17beta, progesterone and testosterone levels in mice. J Reprod Dev. 2003 Apr;49(2):175-80.