What is Andropause?
Andropause is a medical condition characterized by low testosterone levels in men. Low testosterone levels have been reported in men as early as age 35. By age 40, all men experience a normal decrease in their levels. By the age of 50, at least 95% of men experience symptoms of testosterone deficiency. Andropause in men is similar to menopause in women, except the symptoms and the intensity can vary greatly. In men it is gradual. Andropause has received little medical attention until recently, as doctors attributed their complaints to old age or depression. SEE SIGNS AND SYMPTOMS
Male Hormone Solutions Do Exist
The reality of these changes does not make this season of “slump” acceptable. The baby boomers have a keen interest in health and performance, and to that end there are several lifestyle changes (SEE LIFESTYLE SOLUTIONS) that can have a noticeable impact on the effects of the progression of andropause. Regular exercise, healthy eating and alcohol in moderation not only boost natural testosterone levels, but also keep serotonin and norepinephrine levels optimal. There is medication that can enhance the natural production of testosterone. Beyond this, the replacement of testosterone certainly has its place in the battle against aging. These male hormone solutions are similar to those used in women during menopause.
EVALUATION of testosterone deficiency is similar to any medical consultation. A thorough personal and family history identifies factors that would need to be considered as causes. Men with prostate cancer, or even more rarely, breast cancer are not candidates for testosterone replacement. Current medical conditions, past surgery and medical illnesses, medications and social habits/challenges are importantly noted by the physician. Patients with liver disease, blood clotting disorders and diabetes require special considerations. A physical examination including a prostate exam is mandatory for a complete evaluation for testosterone deficiency.
LABORATORY measurements of testosterone and estrogen levels are crucial, along with other blood tests to evaluate blood count, thyroid and kidney function. Males do produce some estrogen from body fat, and some testosterone is converted to estrogen by an enzyme known as aromatase. Small amounts of estrogen are normal. Knowing the tendency for a man to “convert” estrogen is important in the decision to treat, as well as how to monitor during hormone replacement therapy. FOR MORE INFORMATION ABOUT TESTING
DISCUSSION of replacement strategies is important in any thorough evaluation. Especially challenging with sex hormone (testosterone and estrogen) replacement is the fact that oral medications (pills that you swallow) fail to achieve significant levels because the gut and liver break most of the molecule down before it can reach the target areas. The normal gonad (testes) releases the hormone directly into the blood stream at a fairly steady rate. “Bypassing the liver” is thought to be the most natural delivery system. See more discussion under the specific option section.