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Andropause or Male Menopause...


... relates to the reduction of the male hormone testosterone in middle-aged man. Starting at age twenty, Testosterone declines 10% every decade while sex hormone-binding globulin (SHBG) increases. This results in an age related decline in bioavailable testosterone. It is assumed that premature andropause can occur due to exposure to endocrine disruptors, like xenobiotics (chemicals, plastics and pesticides) that have an estrogen like effect.

What is the function of Testosterone?

Testosterone is important for maintaining muscle bulk, adequate levels of red blood cells, bone growth, sense of well-being and sexual function.

What are symptoms of low Testosterone?

As a man's testosterone level declines slowly, the following signs and symptoms of deficiency develop often gradually.

·         Loss of muscle mass and muscle strength

·         Increase in body fat

·         Low sex drive

·         Erectile dysfunction

·         Fatigue and low concentration

·         Decreases sense of well being

·         Depression and mood swings

·         Brittle bones (osteoporosis)

·         Decrease in hemoglobin and possibly mild anemia

·         Decrease in body hair

·         Changes in cholesterol levels

How is Andropause diagnosed?

The only accurate way is to get a blood test for testosterone. You should be evaluated for total testosterone and free or bioavailable testosterone and DHEA which is a precursor to testosterone.

How Is Testosterone Deficiency Treated?

·         By intramuscular injections, generally every two weeks

·         Testosterone patch

·         Compounded testosterone cream or gel

Are there risks involved?

In general, testosterone replacement therapy is safe, but every medial therapy needs to be evaluated in regards to potential risks and benefits. All men should undergo a prostate cancer screening prior to starting this therapy. Men who have prostate cancer or breast cancer should not take testosterone replacement therapy.


As hormones are tightly regulated, Testosterone replacement therapy will lead to a reduced production of one’s own testosterone. This feedback mechanism will also reduce sperm production. Younger men, who still plan to have a family, must take this into account.


Some of the possible side effects of Testosterone replacement include:


·         Acne or oily skin.

·         Mild fluid retention.

·         Increased urination or decreased stream or frequency.

·         Breast tenderness or enlargement.

·         Worsening of sleep apnea

·         Decreased testicular size.


Which Laboratory abnormalities can occur?


·         Increase in red blood cell count.

·         Decrease in sperm count (especially in younger men).

·         Increase in PSA, Estradiol or Dihydrotestosterone (DHT).


An individualized approach leads to the best results.


Integrating hormone replacement into a comprehensive nutritional and lifestyle program is essential. Besides addressing hormones I often recommend a dietary program, exercise plan, stress management and supplementation. Regular follow up appointments are important.