Male Andropause
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Hormone Health: Male Andropause

by Karan Y. Baucom, MD, FACOG, FAAAM
December 2, 2008

What Is Male Andropause?

When it comes to hormone decline, equal rights mean men suffer the same fate as their female counterparts. In fact, by the time men reach ages 45-55 they can experience the same phenomenon similar to female menopause called andropause. Unlike menopause, which generally occurs in women during the mid-forties to mid-fifties and is marked by the cessation of menstruation; men’s transition is more gradual and can expand over several decades.

As men age they begin to experience changes in attitudes and moods, mild depression, fatigue, lower sex drive, reduced erections, abdominal weight gain, loss of energy and reduction in physical agility.

Both menopause and andropause are distinguished by a drop in hormone levels. Estrogen for women and testosterone for men. Andropause was first cited in medical literature in the 40’s, so it is not new. However, for a very long period of time it was under-diagnosed and under-treated. A recent World Health Organization report states that male androgens progressively decline with age. The impact of decreasing androgens is known has andropause or PADAM Partial Androgen Deficiency in the Aging Male.

Symptoms of Andropause

Andropause is often under-diagnosed because symptoms can be vague and vary between men. Some men find it difficult to admit they have a problem. Common symptoms associated with Andropause include:

  • decreased libido
  • abdominal weight gain
  • irritability
  • depression
  • decreased quality of erection
  • decrease in strength and endurance
  • lower energy
  • poor concentration
  • joint pain and stiffness

Two other important symptoms are:

  • Osteoporosis:
    Low testosterone associated with andropause is thought to reduce the ability to regenerate bone tissue necessary to help prevent osteoporosis.
  • Cardiovascular Risk:
    It is accepted that women’s risk of atherosclerosis (hardening of the arteries) increases after menopause. Estrogen replacement therapy seems to reverse this trend. New evidence suggests that a similar phenomenon occurs with men as testosterone diminishes with age. A cause and effect relationship has not been established in large clinical trials and more research is needed.

Symptoms of andropause occur gradually over time. In addition, there is great variability of testosterone levels among healthy men, so all men do not experience the same symptoms to the same degree.

Diagnosing Andropause

Physicians didn’t always think of low testosterone levels as the cause behind andropause symptoms. So often doctors would conclude that they were caused by other medical conditions (i.e. depression) or were simply related to “growing old” and encouraged their patients to accept the reality of aging.

Today, this situation has changed and there is increased interestin male aging among medical researchers. In addition new blood and saliva testing methods have been developed that enable a trained and experienced physician to accurately diagnose andropause and prescribe a treatment plan to significantly reduce the symptoms of andropause.

Diagnosing andropause involves extensive blood testing and interpretation.

Importance of Testosterone

Testosterone is an important hormone produced in the testes and adrenal glad that affects the whole body. Testosterone is essential to normal sexual behavior to include erectile quality, as it is the hormone of sexual drive.

When it is low, so is sexual desire. Testosterone affects many metabolic activities such as: production of blood cells in the bone marrow, bone formation, lipid metabolism, carbohydrate metabolism and liver function. Testosterone helps build protein. Maintaining normal levels of bio-available testosterone is an important part of age management medicine.

Treatment Options

Treatment for andropause involves bioavailable hormone replacement therapy. Not all patients are eligible for treatment as there are conditions where testosterone replacement therapy should not be used such as: prostrate and breast cancer. Other conditions may include: heart or blood vessel disease, enlarged prostate, liver disease, kidney disease and diabetes mellitus.

The metabolism of testosterone to dihydrotestosterone (DHT) and estradiol is important in the safety and efficacy of testosterone restoration therapy. In inexperienced hands these metabolites can interfere with achieving the health benefits of testosterone replacement therapy and contribute to side effects.

There are four treatment options available: oral, transdermal, intramuscular and pellet implant.

Once weekly testosterone injections for men is a reliable, safe, easy and least expensive option. It can be done in-office or by the patient himself with minimum discomfort.

Medical Monitoring

Testosterone Replacement Therapy (TRT) begins with precision diagnoses to include baseline lab results. Once diagnosed and treated, TRT then requires periodic follow-up lab test to monitor results and assure proper dosage. At the Baucom Institute safety is our number one goal.

There is no scientific evidence that TRT causes prostate cancer or heart disease. In fact, there is overwhelming evidence that testosterone helps protect against: heart disease, diabetes, obesity, osteoporosis and dementia.

Medical monitoring is an essential part of age management medicine. TRT should only be conducted under the medical supervision of a qualified physician experienced in age management and hormone replacement therapy.

Expected Results

In addition to disease prevention, there are many positive health improvements that can be expected to include:

  • Fat loss and leaner body
  • Improved energy
  • Increased libido and sexual function
  • Higher concentration
  • Improved sleep and,
  • Enhanced strength

Medical managed TRT should not be confused with reported abuse of anabolic steroids by athletes resulting in aggressiveness and hyper sexuality, as this stems from unlawful testosterone use by men with normal levels using dosages way beyond TRT supplementation for the treatment of andropause.

Do You have Andropause?

The passage to middle age is a complicated phase of life. Not all men going through this phase of life will experience it the same way, as everyone is different. There are many changes and challenges during this phase of life to include: personal , family, work, economic , social etc. It can be difficult therefore to differentiate the symptoms of andropause with symptoms of changes in your life that are unrelated to andropause. The following quiz may help. Answer each question with a YES or NO. No need to cheat yourself, so be very honest with your answers.

  1. Do you have a lack of energy?
  2. Do you have a decrease in your sex drive (libido)?
  3. Are your erections less strong?
  4. Do you have a decrease in strength and/or endurance?
  5. Do you find it harder to concentrate?
  6. Do you fall asleep after dinner?
  7. Are you sadder or grumpier than usual?
  8. Have you lost height?
  9. Have you noticed a decrease in work performance?
  10. Have you noticed a decreased enjoyment in life?

If you answered YES to three or more questions to include question number 2 or 3, you may be a candidate for the treatment of andropause. If so, The Baucom Institute may be your best alternative for diagnoses and treatment. Otherwise, discuss your symptoms with your physician and feel free to share this information with them.

For more information visit the website of
Karan Y. Baucom, MD, FACOG, FAAAM
Fellow American College of OB-Gyn
Fellow American Academy of Anti-Aging Medicine

 

 

other articles by Dr. Baucom:

The Thyroid Paradox
Adrenal Glands and Cortisol: the Stress Hormone

 

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