Hormone Balancing Strategies for Male Menopause (Male Menopause - Part II)

"You're never too old to become younger."
-- Mae West

In December's column I described andropause, or "male menopause," a condition similar to female menopause in that it is precipitated by a change in hormones. Although andropause was first described in medical literature in the 1940's, the medical community's ability to diagnose and treat it properly are recent developments. Sensitive tests for bio-available testosterone were not available until the past decade, so andropause went through a long period where belief in its existence was questioned.

Because symptoms of andropause can be vague and can vary from one person to another, some men find it difficult to admit that there's even a problem and physicians do not always think of low-testosterone levels as a possible culprit for the symptoms their male patients are having. Historically, physicians thought that the ill-defined collection of symptoms attributable to andropause in middle-aged or elderly men -- fatigue, depression, irritability, reduced sex drive and impotence -- were related to medical conditions other than testosterone deficiency and they counseled their patients to accept the fact that they were no longer "spring chickens."

This has changed. The new testing procedures have led to an increased interest in the field of men's aging among medical researchers. So much attention is being focused on andropause that major efforts are underway to quickly share emerging scientific information with the international medical community.

About Testosterone

Testosterone is a hormone that has a unique effect on a man's total body. It is produced in the testes and in the adrenal glands and it is to males what estrogen is to females. Testosterone is essential for normal sexual function. It also affects many metabolic activities such as production of blood cells in the bone marrow, bone formation, blood fat metabolism, carbohydrate metabolism, liver function and prostate gland growth.

Testosterone regulates the structure of all body proteins and insures the development and integrity of the male reproductive organs. The adult testicles normally produce about 7-10 mg of testosterone daily. A deficiency causes only modest changes initially such as an increase in weight (beer belly), progressive aging of the face, muscular weakening and weakening of bone tissue. In addition to decreased sexual drive, lowered testosterone secretion causes low functioning of other body organs and leads to memory impairment, general fatigue and higher estrogen levels. The development of clogged arteries, varicose veins, hemorrhoids, the atrophy of the skin, high blood pressure and increased cholesterol are also among the aging-associated changes in males that may be reversible with testosterone supplementation.

The Benefits of Testosterone Replacement Therapy

Numerous clinical studies have reported that there is a significant number of men who can benefit from testosterone treatment. The documented responses to testosterone therapy include:

With testosterone therapy, one's attitude improves, reinforcing self-esteem and self-confidence at work, as well as an increased energy at home and in social activities. Most men on testosterone therapy feel more vigorous, experience improved energy levels, mood, concentration, cognition, libido, sexual performance and an overall sense of well-being. These effects are usually noted within 3 to 6 weeks after beginning of therapy.

Other potential benefits include maintenance or improvement in bone density, improved body composition, as well as improvement in visual-spatial skills.

There are various ways approaches to testosterone therapy. These include injections, creams, pelleted implants, oral preparations and most recently developed, patches to put on the skin. From a historical perspective, oral testosterone preparations are somewhat controversial. An orally administered preparation which was once used in the United States, methyl testosterone, is associated with liver damage, and has been banned in Europe. However, modern oral preparations of testosterone esters are quite safe and have no effect on the liver. An ester is a chemical compound that can be easily metabolized by the body for easier absorption.

One of the more recent developments in the field of replacement therapy for men has been the development of testosterone patches, which may be worn on the scrotum or the on the skin of the back, arm, abdomen or chest. Patches do an excellent job of keeping other hormonal levels, like estradiol, within normal ranges when compared to other forms of testosterone supplementation.

Testosterone Therapy Safety

Most of the available evidence suggests that testosterone replacement is potentially beneficial to aging men and relatively risk-free. However, the magnitude and longevity of the beneficial effects are not known.

The short-term treatment risks of adverse effects appear to be predictable and easy to monitor and manage. Frequent follow-up blood tests (PSAs) and physical examinations are an essential part of the monitoring process.

The most important factor to consider is whether or not testosterone replacement therapy is appropriate for you. This can only be determined in consultation with your physician. In most cases, testosterone replacement in men with andropause can be highly effective and beneficial. However, in men who have an existing cancer of the prostate testosterone is contraindicated because it can promote tumor growth. Some men with age-related enlarged prostates (BPH) can qualify for testosterone therapy. Only a physician can make the decision of whether or not you qualify.

Natural Alternatives to Testosterone Therapy

Again, it is vitally important to work with a knowledgeable health professional when considering any therapeutic supplementation protocol. Some of the supplements which have been used to reduce the symptoms of andropause include DHEA, L-Arginine, DL phenylalanine, Avena Sativa and a variety of herbal hormone precursors. Correct dosage is especially essential when using any supplements that affect your hormonal systems.

Of course, any ongoing strategy to reduce the symptoms and risks of andropause should incorporate approaches such as optimal diet, regular exercise, stress-management, and a tobacco-free, low-alcohol lifestyle.