What is Andropause?

Though aging can’t be halted, some of its effects are actually treatable. Recent research has identified a number of common physical and emotional symptoms experienced by aging men. Termed “andropause” or “male menopause”, these symptoms are related to decreasing levels of testosterone. The effects over time are numerous and include: decreased libido, impotence, decreased muscle mass and strength, osteoporosis, heart disease, stamina, sleep disorders, mood changes, depression and anxiety.

For andropausal men, treatment is necessary to restore strength, vitality and quality of life. This usually involves re-balancing the system with supplemental testosterone. But not all men are the same and based on blood testing and age, the amount of testosterone necessary to address the symptoms of andropause are different. The value of hormone replacement therapy through compounding is the ability to customize a therapy to fit your individualized needs. One of the more common and effective ways of dosing testosterone is topically via creams, gels or lotions applied directly to the skin.

While growing older is inevitable, the effects of andropause can be addressed. Ask today how customized hormone replacement therapy can help you return to a fuller, healthier lifestyle.

To learn more about the treatment for andropause read the excerpts to the right from Dr. Rouzier’s book, “How to Achieve Healthy Aging”

Excerpts From How to Acheive Healthy Aging by Dr. Neal Rouzier, MD.
While this section deals with men and hormones, every woman should read and educate themselves about how to maintain health, happiness, and well being in their spouse or significant other. This chapter starts with a story as I believe stories paint pictures, and pictures speak a thousand words…

Once there was a man who had spent his life jumping hurdles and cunningly climbing social and political ladders. His ambition had built an economical empire and his decisions trickled down into many aspects of other people's lives; when he moved it seemed people held their breath so as not to disturb him. He held all the strings, and with one tug could send a person's world toppling down. This sounds appealing to many men, this powerful resonance that engulfs a man's surroundings. But do you know that this man also succumbed to a mid-life crisis? As with most men suffering andropause, he was ignorant of the symptoms of his age-related hormone deficiency. He had never heard either within or outside of his social circles that men suffered, like women, a sort of menopause.

Like many men, this hormone alteration presented itself in the disguise of fatigue and disinterest in life. Instead of being vibrant and motivated, he lost his ambition and drive. The awesome director was losing his ability to lead and encourage as he once did. He now became tired and withdrawn, with no energy or desire to exercise or travel. His wife noticed that his libido and performance had declined. The romantic lover he used to be was only a memory.

You may be saying to yourself, "C'mon, is this guy for real?" The story may sound stereotypical, but stereotypes come into being for a reason. With the decline of hormones every aspect of a person's health and well-being is affected. We work hard to finally feel comfortable in our own bodies and after 50 years, we're assaulted with a whole new setting. A decrease in testosterone accounts for the loss of a man’s sense of well-being. Testosterone replacement will allow a successful transition into the rest of his adulthood. By the time a man reaches 50, we see a significant drop in his testosterone levels. Unfortunately for many men, this slow but sure decline has not been an issue of discussion. As with the example of the man above, ignorance does not always bring bliss.

I've seen testosterone work wonders for a man's ego. It has helped marriages waning under sexual dysfunction and depression. Many men and women are uneducated about andropause, or male menopause. The whole idea of men going through menopause and needing hormone replacement therapy can be emasculating. Virility is second nature to a man. Starting when hormonal changes occur around age 40, men see a marked decline in abilities they once perceived to be as easy as breathing. Men find that erections are not as frequent, sex is not as exciting, ejaculation is not as powerful, and the stamina and endurance they once experienced has diminished. It seems that after 45, men often have a hard time rising for any occasion. This is what is referred to as andropause, male menopause or viropause. So why do most men not know anything about andropause? Andropause has recently received attention and recognition, but why the holdup? There are many reasons behind the stifling of its discovery along with many frames of mind that are still hindering its cure.

Total vs. Free Testosterone—There is a Difference
In the previous section, I mentioned the difference between total testosterone and free testosterone. The total testosterone level is much greater than the free testosterone, as most of testosterone exists in the blood as a protein-bound complex. It serves as the carrier or transport molecule that stores and sends testosterone throughout the body. This transport protein tightly binds testosterone, making it difficult for testosterone to float freely in the blood. Liken this total testosterone to money in the bank—it’s yours but you don’t have access to it as it is stored in the bank. The free testosterone, on the other hand, floats freely in the blood and is available to be used and attach to testosterone receptor sites. Liken this to money in your pocket—it can be used right now.

As men age, they lose their free testosterone, which is the most important testosterone. Even though the total testosterone remains normal, free testosterone levels fall with age. This is due to increased amounts of the protein that binds testosterone. SHBG increases because of many factors. The cause most noted in the medical literature is elevation of estrogen. Although estrogen might have a small influence, it is minimal. This fact is often misunderstood when there is not a clear understanding of the physiology of estrogen. In women, oral estrogen passes through the liver and results in increased SHBG. However, transdermal estrogen does not increase SHBG. Since men do not take oral estrogen, the serum level of estrogen in men does not account for much elevation of SHBG. Typically SHBG increases secondary to age, alcohol use, obesity, lack of exercise and medications.

The elevation of SHBG and resultant decrease in free testosterone can be remedied either by lowering SHBG levels or by administering testosterone. Raising the free testosterone levels into a more optimal range may result in a concomitant high, super-physiologic level of total testosterone. Total testosterone levels can increase by two to three times the normal levels. When patients and their physicians encounter extremely high levels, they may fear that these high levels are harmful. They are not at all harmful, and in fact are most beneficial. Remember, our goal is to raise hormone levels to the optimal range of a young adult for free testosterone. We do not treat the total testosterone level. This level is meaningless with a Natural Hormone Replacement Program. If the physician and patient are not experienced and knowledgeable in the science behind optimal hormone replacement, this level will be meaningless and misdiagnosed.

Another important point is the difference between optimal and normal. Normal for one’s age is not optimal for one’s age. The medical literature supports replacement levels to that of a younger age, typically 20 to 30 years old. At these levels, optimal health is attained, as well as the feel-good effects. The problem is how one defines normal and optimal. Normal for a 70-year-old is not normal for a 20-year-old. If a 20- year-old man has the testosterone level of a 70-year-old man, he will not feel well. If a 70-year-old man has the level of a 70-year-old man, this is considered normal. No man should have the testosterone level of a 70-year-old as supported in our medical literature. In reality we are not trying to be 30; however our goal is to optimize levels to those we would see in a 20 to 30 year-old. A free testosterone lab value of 25 may be interpreted as optimal when in fact this level is quite low. A lab value of 40 would be interpreted as being too high when in reality it is a perfect level and our goal for a younger person. All the medical studies utilize hormone dosages resulting in levels on the upper end of the physiologic range. These are levels found in young adults.

In past years, various labs would list the testosterone ranges for all ages next to the lab results. Today, the labs publish only the normal levels based on a person’s age. This does not provide the appropriate indication of optimal levels as it is age specific. For example, normal free testosterone levels for a 60-year-old man range from 5 to 25. Optimal is therefore expected to be 25. A traditional medical doctor would interpret 25 as optimal. But remember, our goal is to replace free testosterone levels to that of a younger male. These free testosterone levels would be 30 to 40. A lab value of 40 would be interpreted by the lab as being too high, when in reality the level of 40 is perfect and is always our goal.