Hormonal Signs & Symptoms for Men


Depression is a complex syndrome that affects both mind and body. In the case of andropause, the loss of energy, interest, and libido that occur because of changes in hormone levels represent a significant loss for men. These changes are usually slow and sometimes subtle, but with time the progressive melancholy depletes the neurotransmitters (serotonin and norephinephrine) like any chronic illness. Some have also raised the cause and effect issue. Could it be that depression comes first, and depressed men produce less testosterone? We know that as cortisol rises, testosterone levels tend to drop. Thus, there seems to be a constant tug-of-war between stress and testosterone. A vicious circle is also likely: lower testosterone leads to depressed mood; depressed mood leads to less exercise and social activity, which further lowers testosterone production, which in turn leads to more depression.

Decreased libido and erectile dysfunction
Testosterone is clearly the hormone that has the most prominent effect on the sex drive in men. The rise of levels during puberty marks the beginning of the desire for procreation. This is all mediated in the brain which is the most important sex organ. Testosterone stimulates the nerves of the hypothalamus causing the brain to release nitric oxide. The release of Nitric oxide causes dilation of the blood vessels in the penis which allows for an erection. Since performance and desire are closely related, erectile dysfunction leads to decreased libido and low libido leads to erectile dysfunction. Even though medications like Viagra and Cialis improve blood flow in the penis, without some interest their effects are minimal.

Fatigue can be due to many reasons. Many medical illnesses and physcological disturbances present with lack of energy. In andropause, compromised performance is probably the result of depression and even loss of muscle mass than occurs with falling testosterone levels. This is manifested by the general loss of interest and stamina. Many older men consequently find it difficult to stay up after sunset.

Poor concentration and memory
Many chronic illnesses, medications, and stresses can affect memory. Cognitive function also declines with age but there seems to be some evidence that testosterone deficient males of similar ages have more difficulty storing and recalling new information. Replacement of hormone is not thought to be a cure-all but physical activity, proper nutrition, and stress management, along with normalization of hormones make good sense. It all begins with having the energy to get up and go.

Sweating and Hot flashes
Men and women alike can experience hot flashes and sweating. The dilation of blood vessels which is designed to cool the body is the mechanism and it is triggered by the thermo regulatory center of the brain. Low testosterone and/or elevated estradiol levels in men seem to trigger this area of the hypothalamus, resulting in the sudden hot flashes.

Decreased muscle mass
Andropause is the opposite of puberty. Muscle development is triggered when testosterone levels are increased. This is why some athletes have inappropriately used testosterone supplementation to enhance performance. Conversely older men have difficulty building muscle when exercising because of low testosterone levels. The goal of replacement therapy is to normalize levels. Exceeding those levels is not felt to be healthy for men.

Increased Abdominal Fat
The increase in abdominal fat that occurs commonly with age is based on a couple of factors. Some fat stores are purely related to energy balance when intake of calories exceeds the expenditure of calories, and the excess is stored as fat. One reason the expenditure may be less is because of inactivity and the other is the loss of muscle, which is a feature of andropause.

Breast enlargement (gynecomastia):
Men produce a small amount of estrogen from body fat, but the effects are negligible because of the dominance of testosterone. When body fat increases and testosterone levels fall, the hormone environment becomes estrogen dominant. The estrogen’s effects may manifest by an increase in breast tissue.

Sleep disturbance
Whether low testosterone interferes with sleep quality, or whether poor sleep causes low testosterone is not clear. What is clear, however, is the association.  In addition, it is clear is that improvement in energy, exercise, fat mass, and muscle mass help with sleep quality. There are a few studies that show a correlation between low testosterone levels and patients with sleep apnea. The bottom line is that improvements in overall health are associated with improved sleep patterns.

Bone Loss
Testosterone is a stimulating hormone for the bone. When factored for age differences, men in general have a greater bone mass than women of equivalent age, and this is due to their higher levels of male hormone. Testosterone replacement has been shown to have a positive effect on bone mass by preventing the natural loss of bone that occurs with age.

Aches and Pains
There are many studies that show a strong correlation of testosterone levels and chronic pains. There are also studies that show improvement in pain thresholds with replacement of testosterone. Narcotic pain medications lower the production of testosterone and replacement of testosterone seems to reduce the need for the chronic medications.