Male Menopause

By Dr. Loretta Lanphier, ND, CN, HHP, CH

Most men, until recently, were not aware that there are medical reasons behind what many call the “mid-life crisis.”  But the truth of the matter is that we are all, men and women, very hormonal creatures that can be equally affected by changes in the levels of these critical substances in our bodies. If you are approaching middle age, or are a man of any age, this article may be of great interest to you and your loved ones.

What is Male Menopause?

Male menopause, officially known as andropause, is a condition that in many ways is very similar to menopause in women. It is caused by drops in hormone levels that are associated with aging, and often is accompanied by physical and emotional symptoms, many of which mimic female menopause. Andropause has been identified in the medical community since the 1940’s, but until the last several decades, its existence has been controversial to many in mainstream medicine.

One of the reasons that it has taken so long for andropause to be universally accepted, is that men being the way they are, most don’t talk about what they are experiencing, at least not as freely as most women do. 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. But this has changed to a certain degree in recent times, and more folks are aware of andropause now than ever before.

It has been determined that, just as with women, male menopause has physical aspects and emotional ones as well. “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. There is solid evidence that drops in hormone levels has everything to do with this phenomenon.

What is Known About Andropause?

Research seems to indicate that 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
  • Chemotherapy
  • 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 illnessthat 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, it starts as early as the 30s in some men.

Another factor involves certain proteins in the blood that are 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 can also cause overexposure to hormones. All of these factors will cause an abnormally low amount of bio-available testosterone in the body and can be contributing factors in andropause.

If you eat soy, make sure it is properly fermented. The vast majority of soy consumed in America is not fermented, and it is wreaking havoc with the systems of men, women, and children. Read the ingredients on almost anything you pick up in the grocery store. Chances are it has soy in it. It is very disconcerting to think about the consequences of all this hormonal exposure, especially to our children.

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 that an andropausal man may expect to experience include:

  • Lowered libido
  • Weaker erections
  • 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
  • Depression
  • Desire to isolate
  • Fatigue
  • Falling asleep after dinner
  • Urinary changes
  • Weight gain (especially around the belly)
  • Hot flashes
  • Irritability
  • 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

Wow! With a list like that no wonder they call it “mid-life crisis.”  Just as menopause can rock a woman’s world, so it is with men and andropause. It really helps if you can understand what is going on and why, men, 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 would suggest seeing a naturopath or natural medicine- friendly MD in your area and arranging for a blood or saliva test to measure hormone levels. If there is no one available in your area, there are kits available by mail that can measure hormones via a saliva sample. You simply conduct the test, and mail the package back to them for testing.

What Treatments Are Available for Andropause?

You probably have heard of Hormone Replacement Therapy (HRT). It is an oft-used treatment for female menopause, and very controversial at that. Well, HRT can also be used for men in andropause, and it too is controversial. Most of the hubbub surrounds the potential dangers of using artificial hormones, and well it should.  Despite what the drug companies claim, the risk for serious side effects from artificial hormones is very real, in both men and women.

Possible risks for men using artificial 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 artificially supplementing hormones is that it tends to get the natural source, in this case the testicles, to shut down production. Certain types of HRT, specifically injectable testosterone, are more prone to affect the testicles this way.

So, what’s the answer? Well, again, the same as it is for ladies. The best and safest option for men is the use of a natural progesterone 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 will help to accomplish 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. Be sure to have your progesterone levels checked annually. 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.

The use of USP progesterone will alleviate many of the effects of andropause, but it may not help with some of the sexual dysfunction issues if they are the result of other problems. Sometimes hormone replacement will resolve impotence, but not always. If you begin to see improvement in other symptoms but the impotence remains, I would suggest seeing a health care provider to determine if there is another problem that needs to be addressed.

In addition, the importance of an active lifestyle and a wholesome, natural diet cannot be underestimated. Exercise will help you both physically and emotionally, and is especially important for men going through andropause. If you have been involved in sports since you were younger, just because you may have lost a bit of your edge athletically does not 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.

Remember to share your struggles and victories as well guys. It will help you to communicate with others about your experiences, and it may help them as well. There is nothing so contagious as someone who has found some answers to health problems, is feeling much better about themselves, and is passionate about sharing it. Coming through andropause can open up a whole new world to you and give you back your zest for life again.

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