Health Watch:Andropause: The ‘MAN’opause
When men enter their early 30s, they begin losing testosterone at a rate of one to two percent a year. According to the U.S. Census Bureau, approximately 4 to 5 million men have symptoms of low testosterone, and only 5 percent to 10 percent seek treatment.
A recent World Health Organization report analyzed male hormones and found testosterone levels in most 70-year-old men were 10 percent that of 25-year-old men. Generally, men between the ages of 40 and 55 begin experiencing symptoms of andropause.
Importance of Testosterone:
Testosterone assists the male body in building protein and is crucial for normal sexual drive, stamina and erections. Testosterone also contributes to several metabolic functions, including bone formation, liver function, prostate gland growth, sperm formation and production of blood cells in bone marrow. The sex hormone-binding globulin (SHBG) inhibits a substantial portion of remaining testosterone from working; the remaining, working testosterone is referred to as bioavailable testosterone. Bioavailable testosterone declines over time, causing gradual male menopause symptoms.
Although levels of testosterone tend to decrease with age, the degree of decline can vary greatly among men. As the levels decline, it changes the ratio between hormones and estradiol. It is critical to maintain a healthy balance between testosterone and estradiol both for prostate health and for overall health. In fact, if the balance goes in favor of estradiol, a condition called estrogen dominance can occur. Estrogen dominance is associated with an increased risk of prostate cancer.
The normal range of testosterone is 350 to 1,200 ng/dL (nanograms per deciliter). Although there is no definitive figure that identifies testosterone deficiency, 300 ng/dL is generally viewed and the low-end of normal.
Signs of Testosterone Deficiency
Symptoms appear over the course of a decade or more, and it becomes a very slow, insidious process often attributed to old age. Symptoms include:
- Loss of sex drive
- Erectile dysfunction
- Fatigue and decreased sense of well-being
- Thinning of bones (Osteoporosis)
- Trouble concentrating
- Weight gain
- Sleep apnea
- Memory loss
- Diminished libido
- Loss of body hair
- Hot flashes
- Decrease in muscle mass
- Night sweats
- Enlargement of breasts
- Changes in lipid and cholesterol levels
- Heightened irritation levels
Factors that Decrease Testosterone
Several factors may inhibit or cause a decline in testosterone levels:
Age: Blood levels of testosterone decrease with age. This decline usually begins between the ages of 35 and 45.
Use of medication: Corticosteroids and medications used to treat prostate cancer can reduce testosterone levels.
Injury to testicles: Testosterone production could decrease if both testicles are injured.
Infection of testicles: A mumps infection affecting testicles during adolescence or early adulthood can impact testosterone production.
Prostate cancer therapy: Chemotherapy and radiation therapy could temporarily reduce testosterone production, but in some men this loss is permanent.
Diseases: Chronic illness, such as cirrhosis, sarcoidosis and chronic kidney diseases can affect testosterone levels.
Alcohol: Excessive use of alcohol causes a decline in testosterone.
Obesity: Increased weight leads to elevated estrogen levels, which in turn lowers testosterone levels.
Prolonged endurance exercises: Testosterone levels decrease with prolonged activity, especially frequent endurance training. Testosterone is needed to support muscle, but if extended exercise occurs too frequently, then there is not enough time for tissue repair and recovery of testosterone levels.
Natural Ways to Increase Testosterone
- Testosterone supplements have been shown to increase testosterone levels, libido and sexual health. However, benefits and risks of testosterone replacement need to be evaluated by a qualified hormone therapy expert.
- Excess weight leads to elevated estrogen levels, which lowers testosterone levels. Therefore, losing weight can increase testosterone.
- Individualized nutrition, supplement and fitness programs and avoiding a high-protein diet could improve testosterone levels.
- Engage in frequent sexual activity.
- Exercise regularly. Exercise stimulates the pituitary gland, and testosterone levels increase with short intense bursts of exercise.
- Relaxation exercises.
- Oats, Carnitine, Fenugreek (hulba), Pomegranate (Rumman), Tribulus terrestris (a wild shrub found around Aden) can boost testosterone production and can free bio available testosterone.
Andropause is often under-diagnosed and under-treated. Luckily, proper monitoring of testosterone can help diagnose andropause. The condition is now much better understood, as is treatment. The best news for men is that hormone losses and imbalances are easily correctible. And through proper treatment, older men can be healthier, younger and more vital.