We all know that women undergo hormonal changes that results in the process known as menopause. Men also undergo hormonal changes as they age resulting in the gradual appearance of a number of symptoms signaling a decline in function and that process is known as “andropause.” Not only do men experience various symptoms of andropause, but the condition has health risks associated with it as well.
The term andropause is derived from the Greek words andro (male) and pausis (stop). It wasn’t a term that was accepted in medicine until the 1940s and many doctors of today continue to be non-accepting regardless of the wealth of scientific evidence that proves its existence. The main hormone, that determines when a male reaches andropause, is testosterone and that, in turn, depends on what is being produced by his body. It is natural and genetically determined for a man to gradually produce less and less of all hormones, including testosterone. The symptoms of andropause appear less suddenly in men than in women undergoing menopause. Men gradually produce less testosterone and other hormones year by year and it surprises most to learn that this gradual decline begins in the mid twenties. In most men, the andropausal process is so gradual that many don’t recognize the symptoms and just begin to feel that they are getting “old.” The situation is made worse because their doctor may be telling them the same thing, “you’re just getting old.” Of course, they are getting older, that’s an inescapable fact, but the news is: something can be done about it. Regardless of the genetic cards one is dealt, more and more men are realizing that something can be done to offset the negative effects of andropause, but the process of education for the public and the medical profession has been rather slow and inefficient. One of the main factors resulting in such an obsolete approach to this problem has been that most doctors are not aware of the facts about the aging process and the importance of maintaining proper hormonal balance.
There are a number of symptoms consistent with andropause, but most men focus on their declining libido (sex drive). There are a number of other signs, but this is the one that concerns most men as it strikes at their masculinity and is perceived in a very personal manner. Of course that is understandable, but there are other important factors associated with andropause that most men and many doctors don’t recognize. For example, many of my female patients speak to me about their spouses or boyfriends and whether or not they should be evaluated because of low energy, depression, loss of sex drive, lack of stamina, weight gain, loss of muscle mass, loss of strength and moodiness. All the above are symptoms of andropause, but the most important factor is the one that is never mentioned and unknown to most doctors. Testosterone has a cardiovascular protective effect! In other words, higher levels of testosterone have a protective effect on the heart and brain as the result of preventing atherosclerotic vascular disease (hardening of the arteries). Testosterone is also important in maintaining healthy bones. Proper levels (optimal) help maintain proper mineralization and add to the strength of bones. When bones are stronger, they are much less likely to fracture with minimal trauma.
What is Andropause?
When most men become aware of the cardiovascular and skeletal protective effect of testosterone, they strive to never let their blood levels fall to previously accepted “normal” levels. That brings up the point of what doctors consider normal. As an example, if we were to study 1,000 men, age 60, their levels would prove to be much lower than a sample of 1,000 men at 25 years of age. When a doctor tells a male patient, over the age of 45, that his levels are normal, what he/she is really saying is that compared to everyone else in that age group, their levels are about the same. Apparently it never occurs to most doctors that if everyone in a particular age group is low, then a low level will be considered “normal” as well. Normal does not mean that it’s healthy, it’s just a mathematical number computed from averages in a particular age group. This illustrates something very important and something lost in doctors’ training programs. Normal values do not necessarily mean “optimal.”
If it is determined that testosterone levels are not optimal, there are a variety of ways to increase those levels in order to reach the optimal range. Many feel that their problem is solved once they begin taking testosterone, but that is not typically the case. The blood levels must be checked periodically to make certain the patient is staying in the optimal range. I also monitor levels of estradiol (estrogen) and SHBG. If either of those increase beyond certain levels, the patient will experience problems and it usually will not be solved by altering the dose of testosterone. Instead, medications are available to reduce levels of either substance.
In summary, andropause is a normal process that will occur in every male, but the negative effects of andropause can be countered with proper treatment by a knowledgeable physician. The choice is yours! You can choose to allow nature to reduce your quality of life when you should be enjoying it the most or you can choose to be proactive and slow the process allowing you to remain productive by providing the quality of life you deserve.