Male Menopause / Andropause

The truth is that, as they age, both men and women will experience hormonal fluctuations. For women, this shift is clinically referred to as "menopause" and is marked by an onset of unpleasant symptoms such as hot flashes, night sweats, weight gain, increased mood swings as well as irregular menstrual bleeding. From a clinical perspective, physicians will say that a woman is officially "menopausal" when she has not had a period for at least twelve months. The signs and symptoms of menopause are overt, e.g. expected at middle age and easy to diagnose.

In contrast, when men begin to experience hormonal fluctuations at mid-life, the effect may be more gradual and more subtle. The clinical name for male menopause is "andropause." Unfortunately, while many of the best researchers in medical science recognize andropause as a very real phenomenon, most of the general public and many of their physicians still do not realize that "male menopause" is a reality of aging.

The medical truth is that symptoms such as low vitality, sexual dysfunction, memory loss, weight gain and depression can signal that the male body is suffering from a decline in male hormone production of androgens, specifically testosterone and DHEA. The decrease typically begins in the late thirties, and by the seventies, a man's blood levels may have dropped by one-third to one-half. If at the same time, levels of the female hormone estrogen are too high, more serious health concerns may emerge such as increased risk of cardiovascular disease, bone density loss, a rise in cholesterol and urinary and prostrate disease. In my book From Hormone Hell To Hormone Well I provide a comprehensive clinical explanation of Andropause.

The androgens increase energy and decrease fatigue; they help in maintaining erectile function and normal sex drive and in their anabolic (building) capacity they are instrumental in increasing the strength of all structural tissues- the skin, bones, muscles and heart. Men make more testosterone than do women, accounting for their generally greater muscle and bone mass. A proper balance of the androgen hormones also helps prevent depression and mental fatigue. These are the hormones that help provide the virility, stamina and drive most often associated with the male species. As Dr. David Zava, an internationally recognized expert in the field of hormone balance, frequently tells his medical colleagues: "Androgens are critical to the health and well-being of the middle aged man. They continue to put the 'M' in 'MACHO'."

According to a 2001 Harvard Medical School Newsletter on male menopause, the National Institutes of Health (NIH) have funded human-trials that, when the results are published, should confirm and extend the medical community's understanding about the role of the androgens and the opportunities for supplementation in healthy aging men. The first step towards restoring male hormone balance is to diagnose deficiencies and excesses. This can be done through saliva or blood spot testing. The findings will provide a hormonal profile that will allow for individualization of hormone replacement therapy. Clinical studies have shown that gradually replacing deficient testosterone and DHEA levels with human-identical/bio-identical hormone replacement can actually reverse many of the age-related complaints. Furthermore, if a man evidences excess estrogen levels, then treatment should include adding human-identical/bio-identical progesterone in physiologic doses. The added progesterone serves to eliminate the condition of estrogen dominance, thereby decreasing the risk for urinary and prostate problems.

As a physician who has treated literally tens of thousands of men and women with hormone imbalances, I want to underscore that it is critical that any hormone replacement regimen be composed of human-identical/bio-identical hormones compounded in a compounding pharmacy vs. synthetic hormones produced by pharmaceutical companies. While the topic of human-identical/bio-identical hormones vs. synthetic hormones is a substantive topic for medical debate in and of itself, the essence of why it is important to prescribe only human-identical/bio-identical hormones is actually very simple.

Human-identical/bio-identical hormones have exactly the same molecular structure as the hormones produced in the human body; they are recognized by the body as "natural" and are the "keys" that fit perfectly into the body's hormone receptor "locks". In contrast, synthetic hormones have a slightly different molecular structure which allows pharmaceutical companies to patent their formulation. The problem with synthetic hormones is that these molecular "keys" do not exactly fit into the body's hormone receptor locks. Because the human body does not recognize these hormones, synthetic hormones will misfit and ultimately trigger very significant- and sometimes lethal- side effects.

With any supplementation, it is important to be aware of any potential complications. Studies suggest that although testosterone is not a cause of new prostate cancer, it can contribute to the growth of existing prostate cancer. Any physician considering prescribing human-identical/bio-identical testosterone for a male patient should also routinely test prostate specific androgen (PSA) levels. High PSA levels are a warning sign of prostate health risks. Normal PSA evaluation is a prerequisite to initiating any testosterone therapy.

Current data on cardiovascular risk suggest that it is better for men to have a high rather than a low testosterone level. In general, higher serum testosterone levels correlate with lower metabolic cardiovascular risk factors, including higher high-density lipoprotein (HDL) cholesterol levels, lower blood pressure, and lower levels of plasma fibrinogen, fasting insulin and lipoprotein.

It is time for the medical community-at-large, as well as the general public of health care consumers, to recognize the link between a decline in male hormone production and common age-related concerns in healthy men. No longer should symptoms such as decreases in muscle tissue and bone density, increased abdominal fat, a rise in cholesterol, deteriorating heart function, increased lethargy and fatigue and decreased sex drive be considered inevitable. We can now translate to our male patients the positive experience we have had treating hormonal imbalances in women. The medical truth about male menopause/andropause is this: It does exist but, with appropriate supplementation of testosterone and DHEA, many of the problems regarded as an inevitable consequence of aging can be helped to lessen or disappear.

Suggested OTC Supplements:

Dr. Randolph's Natural Balance Cream for Men

Co-Q10

Mega II

Steel Libido

DHEA

"From Hormone Hell to Hormone Well" book

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Dr. Randolph's book, "From Hormone Hell to Hormone Well"

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