Tue | Jan 23, 2018

Ounce of Prevention | The male menopause

Published:Tuesday | September 27, 2016 | 12:00 AM

The masculine counterpart to the female menopause is called the andropause. While it may not be as obvious or as extreme an event as menopause, men do suffer from declining hormone levels as they age. In women, their sex hormones rapidly decline in midlife, usually in their late 40s and 50s. In men, their hormone levels also fall with age, starting earlier, by their 30s, but much more gradually. As one doctor puts it, "Women fall off a cliff while men sort of roll down the hill."


The male hormone - Testosterone


Several hormones known as androgens create and support masculinity, but the most important one is testosterone, which is primarily responsible for, among other things:

- Influencing before birth the baby's later sexual preference.

- Regulating the sex drive in men (and in women).

- The development of male sexual characteristics, including dominance, emotional and physical strength, body shape, hairiness, deep voice, and even odour.

- Controlling the production and quality of sperm.

Testosterone plays a role in developing creativity, intellect, thought patterns, assertiveness and drive, as well as the ability to conceive new ideas and successfully carry them through. It also affects general health from childhood, through adolescence and during adulthood.

Testosterone is primarily produced in the testicles. After the age of 30, a man may lose up to two per cent of the function of the testicles with each succeeding year. In fact, after age 50, up to 50 per cent of healthy men have low levels of testosterone.

With falling testosterone levels, a man's ability to enjoy sex declines. In addition to a lowering of sexual desire and erectile function, men with low testosterone levels may also notice changes in mood and emotions, a decrease in body mass and strength due to loss of muscle tissue, and an increase in body fat. The following questionnaire is useful:


ADAM - The Ageing Male Questionnaire


1. Has your libido (sex drive) declined? Yes No

2. Do you have a lack of energy? Yes No

3. Has your strength and/or endurance decreased? Yes No

4. Have you lost height? Yes No

5. Have you noticed a decreased "enjoyment of life"? Yes No

6. Are you sad and/or grumpy? Yes No

7. Are your erections weaker? Yes No

8. Is there deterioration in your ability to play sports? Yes No

9. Do you often fall asleep after dinner? Yes No

10. Has your work performance declined? Yes No

If you answer 'Yes' to five or more of the questions above, you may well be having low testosterone levels.


Common signs and risks


The typical description of a man going through this process often sounds like this: 'Over the years, he has grown more irritable, more depressed, heavier, more lethargic, and much less interested in sex.'

There are also additional health risks associated with low testosterone levels. These include elevated cholesterol levels, heart disease, bone fractures, and clinical depression.


Action plan


For the man who is concerned about the andropause, have a thorough medical examination done by your doctor. Request a male hormonal panel blood test for free testosterone, plus the female hormones oestrogen and progesterone, along with another key hormone, DHEA.

Lifestyle changes: Several lifestyle changes can improve testosterone levels. They include: correcting abdominal obesity; optimal dietary protein; regular exercise, particularly resistance exercise and interval training; restful sleep; healthy stress management; and regular sunbathing.

Supplements: Several herbal supplements help to boost testosterone levels. The long list includes Ginseng, stinging nettle, saw palmetto, horny goat weed, maca, tribulus terrestris, chrysin, velvet antler, tongkat ali, ashwagandha, muira puama, rhodiola, and ginger. These are available at health-food stores.

Hormone replacement therapy: Hormone replacement therapy (HRT) is a powerful intervention in dealing with the andropause as it often produces a significant and dramatic improvement in the symptoms and a reduction in the medical risks. HRT should be undertaken in a scientific manner following some basic principles:

Use: Bio-identical hormones. Low hormone levels can be safely corrected by administering the right dosages of the specific hormone that is deficient in the body and not with a synthetic drug. This is called bio-identical hormone replacement therapy. Testosterone can be replaced by injections, skin patches, creams or gels.

Monitor: Periodically repeat the blood test, and if necessary, adjust the dosage of the hormone being given. If these guidelines are followed, then HRT is extremely safe and effective, with a powerful anti-ageing benefit.

If DHEA (another hormone the body uses to make testosterone) is also low, then DHEA can be taken to help elevate testosterone levels. If the female hormone oestrogen or progesterone is imbalanced, this should also be corrected.

Detoxify: The modern environment is badly polluted with chemicals. Many have powerful hormonal effects and act like the female hormone oestrogen. This makes testosterone deficiency worse. Avoid exposure to toxins and harmful chemicals as much as possible and consider a detoxification program. This helps to correct hormonal imbalance.

The andropause does not have to be the beginning of the end, but rather, it may be the passage to a passionate, purposeful, and rewarding time of a man's life.

You may email Dr Vendryes at tonyvendryes@gmail.com or listen to An Ounce of Prevention on POWER106FM on Fridays at 8:15 p.m. Visit www.tonyvendryes.com for details on his books and articles.