“When I experienced the hot flashes at 48 years of age and would wake with my night shirt soaking wet, no one suggested to me to measure my hormones. They said male menopause was an illusion!”(Gynecologist Edward M. Lichten, M.D.)
Our experts say that 20% of baby boomers today are experiencing decreased levels of testosterone, more commonly known as andropause. We suspect this number to be even greater.
All men should inform themselves about the phenomenon of andropause. Although sexual desire and sexual activity are barometers of a man’s general health, any notable changes in sexual function can forecast Andropausal issues at midlife.
What are the symptoms of andropause?
Although this controversial phenomenon is often denied by the 'unlearned' segment of the medical profession, men can experience a condition similar to female menopause between the ages of 35 and 55 give or take a few years. Physical changes accompanied by changes in attitude and mood often occur at this time.
The first, and possibly the most noticeable, symptom of male menopause is fatigue. Typically, there are restless, interrupted sleep patterns at night with rare night sweats and a pronounced feeling of exhaustion upon rising in the morning.
At midlife men can also experience a decreased sexual drive, a slight or pronounced difficulty in developing or maintaining erections. Having said this though, we typically counter these ill thought of occurrences with over-attention to sexual activities. This often causes our mate or even our selves at times to consider a “lack” of sexual drive as non-existential. One or two occurrences in this arena are enough to consider it “a change”.
One might also experience increased urinary frequency especially at night. An annual prostate exam is a must for any man over the age of 35.
Perhaps you have encountered periods of impaired memory,
a change in body shape (less muscle, more fat),
a decrease in strength or endurance.
All this will probably be accompanied by a decreased ability to handle stress, Mood swings, Irritability, Depression,
And a slump in your overall sense of well being.
What is testosterone’s role?
Andropause is a medical condition that is considered to be a counterpart to menopause in women. A decline in the levels of sex hormones in both women and men occurs during midlife.
Men also experience a more complicated set of physical changes. The main male sex hormones are collectively known as androgens, meaning male producing. Testosterone is the main androgen, 95% of which is produced by and secreted from the testicles. Testosterone is responsible for a man’s ability to perform sexually and for secondary sex characteristics such as: body hair, muscle bulk, body shape, and a deepening of the voice.
Testosterone is much more than a sex hormone. There are testosterone receptor sites in cells throughout the body, most notably in the brain and heart. Testosterone has a role to play in nearly every aspect of a man’s physical function.
Total testosterone levels are highest in the early twenties and decline steadily from a man’s 30th year on, at the rate of approximately one percent per year. This drop in total testosterone often seems so gradual that it may be overlooked as the symptoms of andropause.
What appears to be more relevant is the drop in free testosterone. This is the active form of testosterone that is not bound in the blood by sex hormone binding globulin (SHBG). This protein limits the amount of free (active) testosterone by hooking up to it, making it unavailable to tissue. As men get older, the mechanisms for freeing testosterone begin to shut down; one sign is an increased level of SHBG in the blood.
This increased binding of free testosterone helps to explain why men who are on testosterone-replacement therapy do not report long-term aphrodisiac effects. However, the herbs stinging nettle (urtica urens) and pygeum (prunus africana) are known to block the testosterone-binding effects of SHBG. Preparations made from the nettle root have a unique mechanism for increasing levels of free testosterone by displacing it from the SHBG binding site. Nettle root and pygeum extracts also benefit the prostate gland as a preventive treatment for benign prostatic hyperplasia (BPH).
Estrogen’s role?
Estrogen also contributes to an increase of SHBG in a man’s blood. A small supply of estrogen is a normal aspect of a man’s hormonal makeup.The balance of estrogen and testosterone is critical in both men and women. The two hormones are chemically quite similar. The male body can and does convert a certain portion of testosterone into estrogen using an enzyme found in the adrenal glands and fat cells called aromatase.
This conversion process is necessary for the healthy functioning of estrogen-sensitive tissues in a man’s body. Estrogen is extremely beneficial to the male brain. However, as a man grows older, he produces larger quantities of aromatase, which convert excessive amounts of testosterone to estrogen. If estrogen levels get out of hand, the estrogen-to-testosterone ratio shifts and estrogen will compete with the masculine effects of testosterone.
Estrogen seriously reduces the effect of testosterone, causes an increase in the risk of heart attack or stroke, and promotes cell growth in the prostate gland, increasing the occurrence of benign prostatic hyperplasia or BPH. Estrogen also increases the body’s production of SHBG, which lowers the amount of the active free testosterone.
One reason that we are impacted today by midlife “crisis” issues more than previous generations is that Estrogenic Chemicals, known as xenoestrogens, are found in commercial foods and the environment. They also have a powerful estrogen-like effect on the human body and add to the estrogen overload.
In contrast, organic, non-genetically modified soy proteins and flaxseeds can reduce the effects of excess estrogen. Both are high in isoflavones, a type of natural phytoestrogen that competes with estrogen for receptor sites and blocks its action. The herb saw palmetto also seems to have a similar phytoestrogenic blocking effect.
The connection between obesity, estrogen and andropause?
In many cases, obesity, especially in the abdominal area, is attributed to male hormonal imbalances. Fat cells contain large amounts of the aromatase enzyme, and estrogen is stored and manufactured in fat. Fat cells synthesize the aromatase enzyme, causing male hormones to be converted to estrogen. Therefore, an increase in fat will cause estrogen levels to go up.
Eating high-fat foods may reduce the levels of free (active) testosterone. A fat-containing meal can reduce free testosterone levels for about four hours. Men suffer from testosterone deficiency caused by both the production of excess aromatase enzyme in fat cells and also from the fat they consume in their diet. So in effect, although a man might exercise frequently and even diet and not appear to have gained a “pot belly” he can still be exhibiting all the effects of Andropause.
Eugene Shippen, M.D., author of The Testosterone Syndrome sates that alcohol, grapefruit, and drugs such as NSAIDS, antibiotics, analgesics, anti-fungal agents, anti-lipid agents (statins), SSRI type anti-depressants, beta-blockers, calcium channel blockers, marijuana, cocaine, and amphetamines inhibit the liver’s primary processing enzyme system, known as P450. This results in a slower metabolism or breakdown of estrogen and increased estrogen levels in the body.
Foods and substances that increase the P450 enzyme system and decrease estrogen levels include vitamin C in high-doses (1-3 grams), niacin (all the B vitamins are valuable during andropause), soy protein, cruciferous vegetables (broccoli, cauliflower), oysters, and grapeseed extract.
Alcohol also decreases zinc levels. Zinc is known to play a beneficial role in the male body as an inhibitor of excessively high levels of aromatase. Many men can help restore a proper balance of testosterone and estrogen by using zinc supplements (citrate or chelate) at a suggested dose of 30 to 90 mg/day for a period of six months.
For men over forty, maintaining a youthful level of free testosterone has numerous health benefits and often requires dedicated effort. However, studies show that men are often reluctant to admit, even to themselves, when they need help dealing with sexual health problems. Hopefully, this blog will provide some of the information needed to support those who recognize themselves, or their loved ones, experiencing male menopause.
References
1. Shippen, E. The Testosterone Syndrome, NY: Evans & Co., 1998.
2. Sheehy, G. Understanding Men’s Passage, NY: Random House, 1998.
3. Rose, M. A Woman’s Guide to Male Menopause, LA: Keats Publ. 2000.
4. Saul, D. Sex For Life, BC: Apple Publ. 1999.
5. Martin,P. “Testosterone & regional fat distribution,” Obes Res 1995 Nov;3.
6. Gooren, L. “Endocrine aspects of aging in the male,” Mol Cell Endcr. 1998 Oct 25;145(1-2):153-9.
7. RoseMarie Pierce, www.vistamagonline.com
