By Bonnie Jenkins, Advanced Natural Wellness
Do you feel hot under the collar these days, but seldom under the sheets? Is your midsection getting softer by the day? Are your mood swings and night sweats enough to drive your partner to the couch?
I know what you’re thinking: It must be menopause.
But wait a minute, you’re a man! Could you also be in for a “change of life?”
Hormones Gone Haywire
Although male menopause has been under the radar for decades, recent studies are giving the condition credibility. Here’s what you need to know:
Scientists have long known that a man’s testosterone level begins a slow downhill slide as early as age 30, dropping about one percent a year after the age of 50. Add that to the fact that other sex hormones and brain chemicals also begin to fluctuate, and middle-aged men can quite possibly look forward to an array of “change of life” symptoms, including loss of muscle mass, fatigue, depression, erectile dysfunction and even hot flashes. But because the condition is exceedingly hard to test for – and historically difficult to discuss – it’s been largely ignored by doctors and patients alike.
As studies begin to link low testosterone with heart disease, cognitive decline and bone loss, a growing number of researchers are calling for more studies on the phenomenon of waning testosterone. The burning questions: When and how should “menopause” be treated? And is treatment safe? Meanwhile, thousands of men are flocking to anti-aging clinics for everything from testosterone shots to acupuncture to herbal supplements.
What’s In a Name?
Despite more than three-dozen clinical trials on the subject and scores more in the works, the notion of male menopause is far from universally accepted. A widely heralded report commissioned in 2004 by the US National Institute of Aging and the National Cancer Institute concluded, “there is scant evidence that male menopause exists,” and points out that “the likelihood a man will ever experience a major shut-down of hormone production similar to a woman’s menopause, is remote.” On the other hand, the report left the door open, calling for more research.
Semantics are at the root of the controversy because menopause, by definition, means the end of menses. So calling the male experience by the same name often ruffles feathers. To get around the problem, some doctors call it hypogonadism, which means low hormone production. Others call it andropause – a more acceptable term.
Although menopause comes on fairly rapidly for all woman, halting production of progestin and estrogen and spelling the end of fertility, the male process comes on subtly and varies in severity, depending on the man’s lifestyle. And while the female “change of life” can lead to fairly specific health issues like rapid bone loss and hot flashes, linking testosterone-loss to conditions like weight gain, ED and depression – all of which can have numerous other causes – can be tricky. Because men, even in their 30s and 40s, often turn to potentially-risky testosterone treatments to quell those changes, the subject remains controversial.
So just how can you know for sure if low testosterone is the problem? Another tricky question. Testosterone levels normally fluctuate throughout the day (higher in the morning), from season to season (highest in the fall; lowest in the spring), and can vary according to stress levels and diet. So it can be difficult distinguishing whether testosterone levels have truly dipped or if you took the test at an inopportune time.
Assuming that you truly have age-related testosterone loss, another question then arises: How low is too low? A “normal” healthy adult male’s total testosterone concentrations can range anywhere from 300 ng/dL to 1,000 ng/dL. Those with levels of 200 ng/dL to 319 ng/dL are good candidates for therapy.
By those measures, one in 10 men between the ages of 40 and 60 has abnormally low testosterone levels, and after 75, the ratio rises to 3 in 10. But because some men naturally produce more testosterone in their youth, those benchmarks can be misleading. For instance, a man 20s who has a testosterone level of 1,000 discovers that it has dropped by 50 percent by the time he hits 50. He has lost half of his testosterone and is likely to have symptoms. On the other hand, a man who is at 400 in his 20s and drops to 250 may not have any symptoms at all.
The only way to tell if you have low testosterone levels is to undergo an array of blood tests. In addition, your doctor should gather information about your lifestyle and spend some time talking with you before making a diagnosis.
If you are suffering from male menopause, take a page from the women in your life. Instead of trying to replace your male hormones, go natural with supplements that can ease symptoms. The B vitamins can help with stress and boost energy. Vitamin C can stabilize the production of stress hormones. And herbs like ashwagandha and ginseng can counteract the damage created by long-term stress.
Other popular supplements used for male menopausal symptoms include fish oil supplements, which can improve cognitive function, boost energy, and prevent heart attacks, and L-arginine, an amino acid that helps dilate constricted blood vessels associated with erectile dysfunction.
While these DIY strategies are a good place to start, you may want to talk to your doctor about dehydroepiandrosterone (DHEA), a building block for sex hormones that declines rapidly with age. Studies suggest that it can improve skin, sex drive, mood, and strength in aging men. But remember that DHEA is a hormone, and overuse of hormones can result in serious side effects. So before adding DHEA to your daily supplement regimen, have your blood DHEA levels tested and then have them retested periodically once you start taking it.
One Last Thing …
There is another way you can boost testosterone levels – and it doesn’t require drugs or supplements. Since there is a direct relationship between muscle mass and testosterone, you can raise your testosterone levels by getting into a weight-lifting program. Studies show that as few as two sessions of strength training per week can increase muscle strength by more than 30 percent while also boosting bone density (another victim of declining testosterone), speeding up metabolism and pushing up production of testosterone and other sex hormones. Exercises that target several large muscle groups (like squats or bench presses) boost testosterone levels more than those that train isolated muscles (like curls). But don’t stop there. Add in aerobic exercise to increase the production of feel-good endorphins, which can also get thrown out of balance as men age. Just don’t overdo it, especially if you are on a weight loss diet. Over-training and under-eating can also wreak havoc on testosterone production.
In one study, volunteer male soldiers undergoing an intense, eight-week training course also ate a restricted-calorie diet (about 1,200 calories less than what they needed). Their free testosterone levels dipped to “castrate levels” while bound testosterone went through the roof. Once they started getting enough calories again, their levels returned to normal.
Another study of 39 middle-aged men found that switching to a strict, low-fat diet for eight weeks reduced circulating male hormone levels by 12 percent on average. Generally experts recommend that men get roughly 30 percent of their calories from healthy fat. And don’t obsess on getting your cholesterol at rock bottom levels since cholesterol is a building block of many hormones, including testosterone.
This Just In …
Since we’re on the subject of menopause, one recent study reports that black cohosh – an herb widely used by peri-menopausal women to manage hot flashes – may reduce the risk of breast cancer. The population-base, case-controlled study investigated possible links between this traditional alternative to HRT and breast cancer risk in 949 breast cancer patients and about 1,500 controls.
Researchers calculated that the use of the herb reduces the risk by an impressive 61 percent. So if you find that frequent hot flashes are interfering with your life, give this very cool remedy a try. Typical dose is 20 to 40 mg. twice a day and it may take a month or two before you notice a reduction in the number and severity of hot flashes. Black cohosh can be taken for up to six months, and then it should be discontinued.
Genazzani AR, Inglese S, Lombardi I, et al. “Long-term low-dose dehydroepiandrosterone replacement therapy in aging males with partial androgen deficiency.” Aging Male. 2004;7:133-143.
Rebbeck TR, Troxel AB, Norman S, et al. “A retrospective case-control study of the use of hormone-related supplements and association with breast cancer.” International Journal of Cancer. 2007;120: 1523-1528.
Wang C, Catlin DH, Starcevic B, et al. “Low-fat high-fiber diet decreased serum and urine androgens in men.” Journal of Clinical Endocrinology and Metabolism. 2005;90:3550-3559