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Male menopause…fact or fiction?

Kim Piper N.D.

Nature has a way of pulling the rug from underneath us as we progress through life. Just when we want the vitality, vigour and good health of a pain-free body to fully enjoy our later years, something happens to our hormone levels that are beyond our control. During this time of life, both men and women experience a natural decline in their production of hormones. The question is…how can we enjoy our lives fully as we age without these high levels of hormones?

For some men, this can be a confusing time. Men in their later years often experience symptoms of the black dog called ‘depression’ which take hold creating general lethargy and disinterest in life. But not all ageing men experience life the same, even if most men experience a similar lowering of testosterone that once kept them vital, strong and dynamic. Could some of these later year changes in behaviour and zest for life be more to do with the natural decline of testosterone or is it more linked with ongoing stresses of life, a negative outlook of the future, financial worries and poor health?

To answer this, let’s first consider if in fact male menopause does exist. The male menopause, usually referred to as andropause, is an unhelpful term sometimes used in the media. This label is misleading because it suggests the symptoms are the result of a sudden drop in testosterone in middle age, similar to what occurs in the female menopause. For men, this is not true. Although testosterone levels fall as men age (this is natural), the decline is steady at less than 2% a year from around the age of 30-40. This steady decline is unlikely to cause any significant. By the time a man reaches 70 years of age his testosterone is about one third of what it was then he was 20 years old. The natural and progressive lowering of testosterone as men age can sometimes be responsible for some andropause symptoms but in many cases the symptoms have little to do with hormones and more to do with personal or lifestyle issues. There are plenty of men with little to no testosterone but still have a very healthy libido, remembering that the brain is actually the biggest and most important sex organ in the body!

The symptoms of andropause are varied but can include loss of libido and erectile dysfunction, loss of drive and strength, low energy and low enthusiasm for life and love. An all-enveloping mental and physical tiredness can descend on men. They change from being positive, outgoing people who are good to be around to negative, pessimistic, depressed bears with sore heads who are increasingly difficult to live or work with. Combine this with increased body fat, memory dysfunction and decreased hair growth and it is no wonder depression takes a hold.

To unravel this further, erectile dysfunction, loss of libido and mood swings can also be the result of stress, depression or anxiety. There are also physical causes of erectile dysfunction such as changes in the blood vessels which may happen alongside any psychological cause. Psychological problems are typically brought on by work or relationship issues, divorce, money problems or worrying about ageing parents. A ‘midlife crisis’ can also be responsible for some of the symptoms when men think they have reached life’s halfway stage. Anxieties over what they have accomplished so far, either in their job or personal life, can lead to a period of depression or just feeling flat.

Other possible causes of andropause for men include lack of sleep, a poor diet, low level of exercise, excess alcohol, gut and auto immune issues, smoking and low self-esteem. In some cases, andropause can simply be due to a very low output of testosterone as the testes fail to produce few or no hormones. When performing routine saliva/urine/blood tests in clinic, I am seeing this low production of hormone more routinely even in young men under 30 years of age. Combine this low testosterone production with a rising estrogen (female hormone) level in men and we have some of the reasons behind men developing breast tissue, midriff fat and increasing infertility. The many chemicals now present in our food and water mimic estrogen in men and women so these elevations of female hormones are now becoming common (but not normal) for both men and women. Stress will also disorder these hormones as the adrenals are also adjunctively involved in hormone production.

A diagnosis for testosterone deficiency is easy and simple. Either see a Naturopath specialising in hormonal management where a simple saliva test is performed at home then sent off to the labs in Melbourne or you can have all androgens checked via a blood test with a doctor. These tests are especially recommended where a man is healthy but is experiencing a diminished sex drive with erectile issues. It is essential men check for PSA prostate levels via blood and undergo an ultrasound or MRI to give further knowledge as to the health of the prostate gland. I do treat many men with BPH usually with good success in reducing the size of the swollen prostate. A detailed history is essential to gain a clear and accurate picture which will lead to the right treatment plan.

Men can also have life stresses alongside a very low testosterone level and if this is the case they will tend to suffer the most. Healthy ageing requires a totally holistic approach in caring for ourselves so the healthier men are as they advance in age the less they may feel the effects of a diminished testosterone level. Balance is the key.

If you think your man is suffering from male menopause, give him some support. And if you are a man who recognises some of these symptoms, don’t be afraid to ask for help. There is much to be enjoyed at this time of life with the freedom that good health and hormonal balance can bring to everyone’s life.