MALE MENopause

Volumes have been written about menopause; books and articles abound, detailing everything from dietary regimens to deeper, spiritual aspects of this life-changing transition. But what happens when guys get “the change”?

If you’re a guy—or you have a guy—it’s a phenomenon worth knowing about. The idea of a male menopause was noted as early as 1944, when two researchers compared the symptoms of what they called “male climacteric” with those of menopause, and did a controlled study showing the effectiveness of testosterone replacement. Since then, researchers have studied the phenomenon with contradictory findings; many studies have suggested that the effects of testosterone supplementation in men have mixed effectiveness, and some question the existence of “male menopause” altogether.

Also known as Androgen Deficiency of Aging Men (ADAM), andropause is characterized by a decrease in androgen—a group of male sex hormones, including testosterone—as well as other hormones. Starting in their 40s, men experience a gradual decline in the amount of testosterone their bodies produce. Unlike menopause, during which a woman’s hormones decline suddenly and precipitously, the drop is testosterone is much slower and more subtle; as a result, most men may not even notice the change. But since the decline in testosterone may be magnified by other age-related health changes, some men experience considerable discomfort.

Though the questions continue, many studies do acknowledge that a drop in testosterone can create often-significant changes that affect the quality of life and the function of multiple organs and systems. The more immediately noticeable effects include loss of libido, erectile dysfunction, weight gain, reduced muscle bulk, diminished mental acuity, impaired memory, mood changes, and fatigue. Some studies also suggest a link between andropause and osteoporosis, heart disease, insulin resistance, and Alzheimer’s disease.

Additionally, a decline in testosterone can lead to a vicious cycle of events. For example, as testosterone levels naturally decrease with age, the ratio of testosterone to estrogen (which occurs in men as well as in women) drops. Excess weight can also contribute to the imbalance of testosterone to estrogen; an enzyme called aromatase, found primarily in fat cells, can convert testosterone to estrogen. As testosterone is converted to estrogen, and estrogen levels rise, so does a protein called serum hormone binding globulin (SHBG), which binds to testosterone and makes it unavailable for use. Then, as testosterone levels continue to decline, more muscle is converted to fat—which means more testosterone is converted to estrogen.

It’s a cycle that’s hard to break, but taking a few steps can slow the decline of testosterone and prevent its conversion to estrogen:

1. Watch your weight, to decrease fat stores and help balance testosterone-estrogen ratios.
2. Exercise. Besides boosting weight loss, it can improve sense of well-being and self-worth, and help alleviate depression.
3. Reduce stress. Excess stress increases the production of cortisol, which dampens testosterone production and also encourages weight gain.
4. Eliminate xenoestrogens—chemicals that mimic the actions of estrogen—to avoid further disrupting the balance of testosterone to estrogen. They’re found mostly in plastic food containers and wraps, pesticides, conventional meat and dairy, and many personal care products. Stick to natural and organic food and personal care items.

A variety of natural herbs and supplements may also help increase testosterone and other hormones, and combat the effects of andropause. Studies are mixed, but many of the remedies have been traditionally used for thousands of years. Even so, some have side effects, so always check with your health care provider before using. Some to try:

Tongkat ali, also called long jack, is a traditional herb used to treat sexual function and improve libido. Studies suggest it can increase testosterone levels and improve sexual performance.

DHEA (Dehydroepiandrosterone) is an adrenal hormone that acts as a precursor for other hormones, including testosterone. Some suggest that DHEA may boost testosterone. Other studies point to its ability to reduce visceral fat, increase muscle mass, lower insulin, and decrease inflammation.

Zinc. A deficiency in this important mineral is linked to lower testosterone levels as well as volume of seminal fluid, and studies suggest that zinc supplementation can lead to a significant increase in testosterone levels. Other studies have suggested that zinc supplementation enhances sexual performance.

Tribulus terrestris, a common herb for treating erectile dysfunction (ED) and infertility, may help increase testosterone, though studies are mixed. Other studies have found that taking tribulus during athletic training increases strength and reduces fat.

Horny goat weed, also called epimedium, has been used for thousands of years to treat male sexual problems, especially ED. It’s thought to work by dilating the blood vessels that supply the sex organs, and may also raise testosterone levels. Horny goat weed also dilates blood vessels that supply the brain, which can boost cognitive abilities. Because daily use can lead to adverse effects, some natural practitioners recommend taking it for one or two weeks, then skipping one or two weeks, before repeating the cycle.

Yohimbe is a traditional treatment for ED; the active constituent, yohimbine, increases blood flow to the penis, and it’s also thought to help boost testosterone levels and increase nitrous oxide (NO), important for producing and maintaining an erection. Because yohimbe can have severe side effects, it should be used only in formulas or under the care of a skilled herbalist; never take it if you have high blood pressure.

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