Andropause: The Male Menopause
April 5th, 2009
Most men hate to admit it but the truth is that men do experience the change in life as hormonal changes take place in the body. This may manifest in physical and mental symptoms since the hormone testosterone has receptors found all over the body. Signs and symptoms associated with declining hormones may be subtle or pronounced depending on the speed of the decline. For instance, a slow decline may just manifest as subtle personality changes while a rapid decline may show up as hot flashes and night sweats similar to that experienced by women during menopause. When should a man’s testosterone be replaced? My answer to that is again, treatment should always be individualized. A man who is symptomatic but has normal levels, should be treated in my opinion. Why wait till numbers are abnormal before getting treatment? By that time, symptoms may be catastrophic such as a heart attack. Testosterone, by the way, is also important for cardiovascular health.
There’s an adage which says “if it walks and talks like a duck, then it must be a duck”. If a person has signs and symptoms of andropause, then by all means, treat it (usually they’re low normal).
Some of the things I learned from my mentors are that 1. Medicine is an art and not just a science, 2. Treat the person, not the paper (look at person clinically and not just their lab reports) and 3. Use your intuition.
In my practice and those of other antiaging practitioners, we look at optimal ranges and not just normal ranges. I also recommend different forms of testosterone such as the sublingual, transdermal and injectables. I don’t recommend the oral form due to liver problems that it could create. I recommend aromatase inhibitors and DHT blockers as well when I place someone on testosterone. I start out with natural supplements that accomplish that before I recommend medications. Testosterone replacement has finally been endorsed by Harvard scientists (see Life Extension Foundation article from December 2008 at www.lef.org). Regarding hormone supplementation in general, they work like a symphony. If one hormone is off, it affects the others.