Andropause is the male equivalent of what women experience during menopause. Women experience hormonal changes during menopause and men go through similar changes with their hormone levels, especially testosterone. The decline in testosterone can be gradual or sudden, the typical decline is about 1% a year or more and this can start as early as 35 years old. A blood test is required to check for hormonal imbalances and to determine if testosterone replacement is an option.
Common symptoms of Andropause:
– Erectile dysfunction / Weak erection
– Lack of motivation
– Atherosclerosis / Heart disease
– Mood swings
– Poor memory / Lack of concentration
– Depression and anxiety
– Decreased libido
– Decreased sense of well-being
– Muscle weakness / Decreased strength
– Decreased energy / Fatigue
Common treatment for Andropause:
The most common treatment for Andropause is bio-identical testosterone. It comes in a variety of forms but the two easiest methods of using it are in the form of an injection or a transdermal cream or gel. The injection form is usually done once or twice a week. The cream is usually administered on a daily basis, morning and night. Deciding which form is right for you can be addressed with the help of your doctor.
Only bio-identical testosterone is safe and effective in treating Andropause symptoms in men. Synthetic versions are not safe for the liver.
We talk a lot about how testosterone helps a man maintain energy, mood, bone strength, sex drive, sexual function, muscle mass and strength but there is more.
A new study (presented at The Endocrine Society’s 91st Annual Meeting) shows that testosterone lowers a male’s risk for developing cardiovascular diseases. This in turn means that a testosterone deficiency, common as men begin to age, is not only linked to decreased libido, but also a number of medical problems including increased chances of developing heart disease, having a stroke and or being diagnosed with diabetes.
Another medical problems is metabolic syndrome, a cluster of metabolic risk factors that increase the chances of developing heart disease, stroke and type 2 diabetes. Nonalcoholic fatty liver disease, also called a fatty liver, commonly co-occurs with the metabolic syndrome and may aggravate the metabolic problems. To receive a diagnosis of the metabolic syndrome, patients must have three of the following five risk factors: abdominal obesity (a large waist line), low HDL (“good”) cholesterol, high triglycerides (fats in the blood), high blood pressure and high blood sugar.
Some physicians are reluctant to prescribe testosterone for conditions not related to sexual function but more studies are showing that testosterone has a much wider therapeutic role than just for improving sexual desire and erectile function.
The study included 122 testosterone-deficient men, ages 36 to 69 years (mean age: 59.5). Results showed that restoring testosterone to normal levels led to major and progressive improvements in many features of the metabolic syndrome over the 2 years of treatment. Specifically, the men’s weight, waist line and body mass index (a measure of body fat) continued to decline over the full study period. The other metabolic risk factors also significantly improved during the first year of testosterone treatment. Of the 47 men who met the criteria for a diagnosis of the metabolic syndrome at the beginning of the study, 36 (77 percent) no longer had the diagnosis after 2 years of treatment, the authors reported.
Furthermore, liver function significantly improved during the first 12 to 18 months of therapy and stabilized for the remainder of the study period. Treatment also greatly decreased blood levels of C-reactive protein, a measure of inflammation that is linked to increased risk of cardiovascular disease.
The authors concluded that testosterone therapy in men with testosterone deficiency can largely improve or even remedy the metabolic syndrome, which will most likely decrease their risk of diabetes and cardiovascular disease.
Testosterone in Women:
Continuing on with our discussion we must not forget about women. Women too have 3 major circulating sex hormones in their blood: estrogen, testosterone and progesterone. Each of these is produced by the ovaries. Estrogen is also made throughout the body but particularly in body fat. Testosterone can be made by the adrenal glands and in other parts of the body from hormones (DHEA and DHEAS) that are produced by the adrenal glands.
At the time of natural menopause or surgical removal of the ovaries, estrogen and progesterone levels fall precipitously.
Testosterone and DHEAS levels however, fall more gradually with increasing age such that a woman in her forties has on average only half of the testosterone and DHEAS circulating in her bloodstream as does a woman in her twenties. After a woman has her ovaries removed by surgery testosterone levels can fall by up to 50 per cent. However testosterone does not change across menopause, although this varies somewhat between women.
Testosterone and other related hormones (DHEA and DHEAS) in the body (also known as androgens) have known physiological roles in women. Firstly, estrogen is actually made from testosterone and DHEA, and without the ability of women’s bodies to make testosterone they cannot make estrogen. Testosterone and DHEA appear to have direct independent effects in different parts of the body, and some women may experience a variety of physical symptoms when their blood levels fall. Such symptoms may include:
– Impaired sexual interest (loss of libido or sexual desire)
– Lessened sexual responsiveness
– Lessened well-being, mood swings
– Loss of energy
– Lack of motivation
– Lack of strength or endurance
Testosterone therapy may be beneficial for some women who have had their ovaries surgically removed or in some who have significant symptoms in the form of loss of libido, fatigue, strength and diminished well-being. In most cases for a woman treatment consists of daily applications of a hormone cream or gel. Results will vary but most women see the benefits fairly quickly.
The benefits of hormone replacement are remarkable and over time. I believe more and more studies will highlight the positive aspect of this therapy for both men and women. Most therapies aim to restore low hormone levels to their previous optimal state. This keeps the body functioning properly and gives it the ability to maintain healthy hormone levels.
Testosterone replacement therapy is contraindicated in patients with certain medical conditions. You and your doctor will determine if hormone replacement is right for you.