Andropause

What is Andropause?

The word andropause is formed by combining two Greek words – andro meaning male and pause meaning stop. Using the original meanings, we can define andropause as a condition that comes about when masculinity declines and has some superficial similarities to menopause in women. Today we recognize this condition as a decline in circulating levels of Testosterone. This can happen because of age related decreased production rates, poor nutrition, increased stress, chronic illness, use of some medications and/or exposure to heavy metals and other toxic compounds.

Testosterone History:

Research on the action of testosterone received a brief boost in 1889, when the Harvard professor Charles-Édouard Brown-Séquard (1817–1894), then in Paris, self-injected subcutaneously a “rejuvenating elixir” consisting of an extract of dog and guinea pig testicle. He reported in The Lancet that his vigor and feeling of well-being were markedly restored but, predictably, the effects were transient (and likely based on a placebo effect), and Brown-Séquard’s hopes for the compound were dashed. Suffering the ridicule of his colleagues, his work on the mechanisms and effects of androgens in human beings was abandoned by Brown-Séquard and succeeding generations of biochemists for nearly 40 years.

Isolation of the hormone from animal tissues in amounts permitting serious study in humans was not feasible until three European pharmaceutical giants—Schering (Berlin, Germany), Organon (Oss, Netherlands) and Ciba (Basel, Switzerland)—began full-scale steroid research and development programs in the 1930s.

Andropause (male climacteric, viropause, low-testosterone syndrome, low T) is characterized by a slow decline in the testosterone level of men during middle age. Menopause is a well-known natural condition that occurs in women much more rapidly than does andropause in men. The key difference is menopause causes the complete cessation of reproductive ability in women, but men remain reproductive even with the complete onset of andropause; however, bouts of impotence are not uncommon. Until recently, andropause had not received the same level of attention as menopause; although, andropause affects more than 25 million men between 40 and 55 years of age in the United States and approximately 408 million men worldwide. One study reported that 52% of men between 40 and 70 years of age were impotent. Other studies have observed andropause in association with Alzheimer’s disease and increased risk of osteoporosis in men.

Over the past four decades, our diet has changed significantly. Fast foods and processed foods now dominate our diets. Plus, most people do not eat adequate amounts of vegetables and fruits. Unhealthy eating is the norm today. And so what is the big deal? Well, obesity has now replaced smoking as public enemy number one, not only in the USA but also across the globe. Close to 20% of children are now obese and many of them even have type 2 diabetes. However, what is also of importance is that our digestive tract has also changed in terms of its microbial flora. Today, more people than ever have digestive complaints. There are millions of people with irritable bowel syndrome, lactose intolerance, food allergies, celiac disease, Whipple disease, constipation, recurrent yeast infections and food poisoning.

International Journal of Pharmaceutical Compounding 461 Vol. 6 No. 6 November/December 2002 ANDROPAUSE: A Review of Treatment Options Bamrom H. Jonathan, PharmD (Candidate) University of Houston Pharmacy Intern Professional Compounding Centers of America, Houston, Texas

Fuller SJ, Tan RS, and Martins RN (2007). “ Androgens in the etiology of Alzheimer’s disease in aging men and possible therapeutic interventions.” J. Alzheimers Dis. 12 (2): 129-42. PMID 17917157.

Symptoms:

Erectile Dysfunction
Insomnia
Sleep Apnea
Night Sweats in Men
Muscle Loss
Weakness
Low Libido or Sex Drive
Depression
Lethargy
Weight Gain
Urinary Problems
Hot Flashes in Men
Gynecomastia (male breasts)
Hair Loss
Fatigue
Mood and cognitive disorders
Decreased motivation
Previous leisure activities are not enjoyable any more
Irritability

Evaluation:

After a thorough History and Physical exam your provider will consider a series of lab tests to evaluate hormone levels and consider certain risk factors for the use of testosterone replacement therapy. Frequently, this will include checking testosterone levels; as well as, other hormone level, such as thyroid, cortisol, insulin, etc. It is important to consider that hormones do not exist and work in our bodies in a vacuum. All hormones respond to their own levels and effect change in targeted cells, as well as interacting with each other. This interaction potentially effects changes in production and levels of other hormones and may change the intensity of influence over the target cells of these other hormones… In other words, an abnormal level of a hormone (like testosterone) could change the effect of another hormone on the body (like insulin or cortisol).

Wellness Health Group may also check on your prostate, heart, bone strength and sugar metabolism. At our clinic we believe that we should not just treat an abnormal lab result, but take into consideration other biological markers and symptoms to have a more accurate picture of the patient’s health needs.

Our primary goal is to improve patient symptoms in the short time, but long term (years or decades) we would like to change a patient prognosis for chronic conditions and hopefully improve their longevity; as well as, their quality of life.

Management:

For many patients, an increase in testosterone levels is necessary for their symptomatic improvement. Increased testosterone levels can be achieved through direct supplementation (creams, drops, etc.), or using supplements/medications that would result in similar increased levels. We always recommend the use of Bioidentical Hormone Replacement if indicated, avoiding similar but artificial medications and compounds that have either confirmed or suspected unwanted ( and sometimes dangerous) side effects.

Increasing levels of testosterone is just a small part of the recuperation process for a patient with a clinical presentation compatible with Low Testosterone.

When appropriate a patient would undergo nutritional supplementation which may include:

Use of a high quality, highly bioavailable Multivitamin.
Use of supplements to improve stress management, digestion, sleep, Adrenal support or supplements to optimize your body production of Growth Hormone.
Use of Protein supplements free of artificial sweeteners or flavouring to expedite muscle and lean body mass growth.

Up to this point in our management the patient is expected to simply follow the prescribed regimen. Even though it may involve a daily schedule for the use of above Rx/supplements; there is no further work involved for the patient until there is improvement of his stamina, concentration, desire, etc… From here on the patient will want to increase his physical activity and we strongly recommend starting an exercise program with an emphasis on weight lifting (under supervision). In addition, we recommend modifying meals to include a high protein diet and a more health oriented sleep regime.

Other Recommendations will include stress management with new learned techniques if necessary; as well as, an emphasis on spending time with family and friends so to improve quality of life.

Women, if you are wondering how to support your guy during this time, just do all you can to stay communicative and supportive. Think of how you would like him to treat you during menopause and use that as your starting point. Don’t be afraid to take the reins if he is dismissive of his symptoms. He might not be familiar with the existence of andropause. If he has all or some of the above symptoms, suggest he get a medical checkup, including the checking of hormone levels. Men often neglect health issues, and yet as we age, nothing is more important than staying vigilant and making positive lifestyle choices that can result in improved quality of life.