What is Andropause?
Testosterone is the hormone in our bodies that is responsible for defining the male gender. The reason the male body changes the way that it does during adolescence is largely due to increasing testosterone levels. That being said, it should not be hard to imagine that the reduction of this very important hormone can cause many issues for men.
Andropause refers to the reduction in testosterone that typically occurs in men around the same time that women undergo menopause. Many men begin to deal with having low energy, decreased libido and weight gain as they age. These can all be symptoms of Andropause, and it is important to properly diagnose and treat this issue because testosterone has an influence over many functions of the body including energy levels, weight management and cardiovascular health.
Andropause (AKA Male Menopause) vs Female Menopause
At around age 30 both men and women begin to experience a reduction in the hormones that define their gender. For men this means they begin to see a reduction in testosterone levels, and for women it is a reduction in estrogen and progesterone.
During menopause, usually around age 50, women experience a drastic reduction in these hormones over a period of 6-12 months. When their estrogen and progesterone levels get very low, women begin to experience symptoms such as hot flashes, weight gain, mood chances and reduced libido.
Men experience a similar transition, it just happens more slowly and over a longer period of time (several years). Men also experience symptoms associated with this type of transition, especially because testosterone is the hormone that is responsible for things like moderating your mood, building and maintaining muscle mass, improving libido, maintaining a healthy weight and fighting heart disease.
The good news is that there are now options to easily treat Andropause and its related symptoms with testosterone replacement therapy, but unfortunately many physicians do not offer them. Even worse, many physicians suggest that it could be harmful to take testosterone, when truthfully you are really missing out on several health benefits by not getting testosterone replacement if needed.
What Are the Symptoms of Andropause?
Most of the time we can tell when something is “off” in our bodies. The problem is that many men do not seek medical help or attention even when they feel something is “off.”
When it comes to low testosterone and andropause, there are several symptoms that can let you know if you will require further testing. Unfortunately, because testosterone is involved with so many different functions in the male body, the symptoms of low testosterone can sometimes be widespread and/or non-specific. Also, many symptoms associated with low testosterone are simply written off as just “getting older,” which can make it difficult for some people to get a diagnosis.
Below is a list of symptoms that are associated with low testosterone and Andropause:
- Low energy/fatigue
- Weight gain (especially in the abdomen)
- Apathy or losing your “edge”
- Decreased bone mass/density
- Decreased muscle mass
- Lower libido and/or erectile dysfunction
- Hair loss
- Insomnia, decreased sleep quality
- Irritability, depression and/or anxiety
- Changes with cholesterol or metabolic profile
Everyone is different and may present with a few, many or a range of the symptoms in the list above, but the symptoms that are most commonly associated with Andropause are lower energy, weight gain, and decreased libido. If you are experiencing these symptoms, you should get your serum testosterone levels checked. Remember that many times people think of men who are dealing with Andropause as being over the age of 50, but patients as young as 30 can experience symptoms associated with low testosterone as well. This means that age does not play as big of a part as you might think, so even if you are in your 30’s and having symptoms of Andropause you should be evaluated.
Testing for Low Testosterone
Testing for low testosterone is fairly easy, and is often even covered by insurance.
Below are the tests you would want to have done for low testosterone:
- Total testosterone – This tells you the total amount of testosterone in your blood.
- Free testosterone – Total testosterone is all the testosterone in your body, while free testosterone is what is doing the work and actually making changes in your body.
- Sex hormone binding globulin (SHBG) – It is important to look at this protein because it binds to testosterone, and high levels will influence the amount of free testosterone that is available for your body to use.
- Estradiol – Men also have estrogen, but you do not want it to be too high. There are many things, including taking testosterone that can increase estrogen levels. This can cause symptoms that could mimic low testosterone, as well as increase sex hormone binding globulin which lowers the amount free testosterone.
- Insulin – It is important to check your insulin because at high levels it has been shown to lower testosterone.
Getting the correct diagnostic tests done is just the first step. Next you need to have them properly interpreted. This can be more difficult than it sounds due to the fact that the majority of physicians don’t know how to interpret or treat hormonal imbalanced. This is why it is very important that you yourself have a basic understanding of hormone imbalances and replacement so that you can be your own advocate.
When looking at your testosterone levels, as well as other hormones, you want to evaluate them with the idea that they should be at an “opitmal” level. This means that it is not acceptable to simply be within the “normal reference rage.”
Below are some following “optimal” levels for testosterone:
- Total testosterone – It should be in the high “normal” range (in the top 25% of the reference range). For the majority of patients that somewhere within 700-1000 or greater depending on the lab being used as well as the reference rage.
- Free testosterone – You also want this to be within the top 25% of the reference rage.
- Sex hormone binding globulin – For men, this value should not be greater than 30 nmol/L.
- Estradiol – For optimal levels you want it to be less than 25-30 pg/ml.
- Insulin – You do not want your fasting insulin levels to be higher than 5 uIU/ml.
Here is an example of some lab results:
Most physicians will tell you that your levels are “normal,” even if they are not “optimal,” as long as they are within the reference range. You should not simply accept this because lab values and reference ranges include a very large range of males (even those over 70 years old), and you do not want to be comparing your testosterone levels to those of a random person. Testosterone is not a one-size-fits-all hormone, and each person is used to having a different serum testosterone level. This means that even if you have a testosterone level of 400, which is considered to be “normal,” it does not mean that it is “normal” for your body. Also, when you were younger and felt better, which is what most people are trying to get back to, you probably had a testosterone level closer to 1000. It is safe and can be very beneficial to use replacement to return your testosterone levels to what they are naturally when we are younger, but if you start receiving doses that are higher than what the body produces naturally it can begin to cause negative side effects.
5 Causes of Low Testosterone and Andropause
We have already established that age can be one of the main reasons for low testosterone, but there are other things that can effect your testosterone levels. Andropause usually happens closer to age 50 for most men, but there are still many others who experience low testosterone symptoms as young as in their 20’s and 30’s.
If you can find the cause of low testosterone, then it allows you to possibly be able to increase your testosterone naturally. This is especially helpful if you are not able to find a physician willing to prescribe testosterone replacement. Also, addressing any issues that could be leading to lower testosterone levels can help to balance the other hormone systems in your body which may be out of whack.
Read on to learn more about the 5 main causes of low testosterone and Andropause.
#1. Age (getting older)
No matter how healthy you are, your testosterone will eventually begin to decrease as you age. This is especially frustrating for men who focus on being healthy, eating the right things and getting regular exercise. However, unhealthy lifestyle choices and behaviors can cause this decline to happen earlier and faster than normal. This means that making healthy lifestyle choices can prolong the time that it takes for you to start having symptoms from low testosterone, but will not prevent it completely. Most men will start seeing a decline in their levels beginning in their 30’s, with symptoms developing in their 40’s and 50’s.
#2. Lack of exercise, especially resistance training
Strength training helps to increase your testosterone levels by increasing your muscle mass, and heavy resistance training has been shown to naturally increase free and total testosterone levels, as well as IGF-1. The younger you are the more dramatic the rise in testosterone is after you exercise, but it is still very helpful for men who are in their 40’s and 50’s to incorporate regular strength training into their regimen. This also means that lack of exercise will lead to less muscle mass and lower levels of testosterone and IGF-1.
#3. Insulin Resistance
Another common cause of low testosterone in both males and females, as well as early Andropause, is insulin resistance.
Insulin resistance causes lower testosterone levels, which in turn causes increased body fat, weight gain and leptin resistance.
You may be wondering how you get insulin resistance in the first place. Consuming high amounts of carbohydrate foods, such as refined carbohydrates, refined sugars, etc. One of the worst things you can consume are sugary drinks like juice, soda, juice, etc. These types of foods cause blood sugar levels to spike, which then leads to a rise in insulin levels. A repeated rise in insulin levels causes insulin resistance, low testosterone and weight gain.
Insulin resistance can easily be treated with a combination of dietary changes and targeted supplements, so it is important test for it. Getting testosterone replacement for low testosterone levels can help to reverse insulin resistance as well, and can even be a part of treatment for type II diabetes.
#4. Stress and/or lack of sleep
When you consistently have high levels of chronic stress it can lower your testosterone levels prematurely. The same thing can be said for a chronic lack of sleep.
In some studies having one week of reduced sleep (from 8 to 5hrs/night) caused testosterone levels to be reduced by 10-15%, while at the same time cortisol levels spiked higher. High cortisol can cause existing insulin resistance to worsen, and over time persistently elevated cortisol can affect blood sugar homeostasis.
Approximately 20% of working men report that they get an average of 5 hours of sleep per night. This can lead us to assume that these 20% have 10-15% lower than normal testosterone levels. With this information we can almost safely assume that up to 20% of males have at least 10-15% lower than normal testosterone levels. This does not account for the impact that cortisol has on insulin resistance.
Stress alone can lower testosterone in both men and women. This includes stress that you experience on a daily basis, such as issues with your children, spouse, co-workers, road rage, etc. Anything that contributes to your stress levels, no matter how small it is, adds to the cumulative amount of stress that you are under. Once this chronic stress reaches a certain point, you will begin to have more symptoms than just low testosterone.
#5. Weight Gain
Weight gain and low testosterone can become a viscous cycle. When you gain weight it causes your testosterone to lower, which in turn causes even more weight gain, and so on. When you have a lot of weight to lose it is even more difficult to lose weight because your testosterone levels are more suppressed.
Studies have shown that when your testosterone levels are higher, it is easier to lose weight and to lose more of it.
This means that it can be more beneficial for men to take testosterone to assist them with losing weight, rather than have them try to lose weight naturally in order to increase their testosterone levels. If men have more than 30lbs to lose, it can be a good idea to use testosterone to assist with that weight loss.
Testosterone Replacement Therapy
Luckily, testosterone replacement therapy that is used to replace the testosterone your body is deficient in is quite easy, safe and effective. The purpose of the treatment is to help restore your testosterone levels to what they were when they were at their peak in your teens and twenties.
You may be wondering why you would want to do that. This is when most people feel the best throughout their lives as far as energy, libido and muscle mass. Also, you already know that you tolerated this level of testosterone in the past, so returning to it will not be too much or cause any issues.
The most common ways to replace Testosterone are with injections or by using transdermal testosterone gels. You do not want to take oral testosterone because you want to bypass the first pass metabolism of the lover and absorb it directly into your issues.
Some people may want to consider using an estrogen blocker and HCG along with testosterone. An aromatase inhibitor, or estrogen blocker, helps to stop excess testosterone from converting into estrogen. HCG helps with maintaining testicular size, while also providing a natural boost to testosterone levels.
It can take some trial and error to find your “optimal” dose of testosterone, and for the best results, you should speak to your physician about other natural therapies you can consider.
Natural Treatments for Low Testosterone
The treatments listed below are all considered “natural,” but for best results they should be combined with testosterone replacement therapy.
#1. Eat a clean, healthy diet
Changing your diet probably won’t dramatically increase your testosterone levels like injections or gels will, but it is still helpful. It changes how you feel, your weight and your energy levels. Making healthy changes to your diet can help with other hormones besides just testosterone..
Below are some healthy changes you can make to clean up your diet:
- Eliminate or drastically reduce your intake of added or refined sugars (sugary drinks, ice cream, candy, pastries, etc.
- Limit caffeine (cut back on coffee, soda or energy drinks)
- Reduce your alcohol consumption, or eliminate it all together
- Eat less breads, pastas, rice and other carbohydrate dense foods
- Increase healthy fats. Cook with extra virgin olive oil, coconut oil and butter from grass fed cows
- Eat at least 1 full plate of vegetables every day. You can have one large salad at lunch or side servings of vegetables at lunch and dinner
- Limit the amount you eat out to once or twice per week max
These changes will help you to feel better, as well as lower your insulin and blood sugar and improve your cholesterol profile.
#2. Use supplements
Over the counter testosterone boosters do not dramatically increase your testosterone, but they do serve an important purpose. They can help increase sex drive and improve mood and energy levels. They can also treat symptoms that are not caused by low testosterone.
Below are some supplements which clinical studies have shown at lease at some degree to increase testosterone:
- Maca root – It’s not clear exactly why, but maca definitely increases sexual desire, libido and sperm count in men. These benefits have not been linked with serum testosterone levels, but they may be related increased cell signaling related to testosterone. You will want to use 3,000mg per day blended in a smoothie to get these benefits.
- D-Aspartic Acid – D-aspartic acid has been shown to help increase both free and total testosterone, but some studies have shown that this benefit seems to taper off after a few months. To see these benefits, even if they are not long-term, you should take 6 grams, or about 1tbsp of this supplement daily.
- Fenugreek – Fenugreek is another supplement that can give you temporary increase in testosterone, specifically free testosterone. Studies have shown that taking fenugreek in combination with resistance training results in improved muscle mass and decreased fat mass. This change in body composition could be what results in the increase in free testosterone. For these benefits you should take at least 500mg per day.
- Zinc – Serum testosterone levels and cellular zinc levels are closely related. If you are deficient in zinc and supplement with it, it will increase your serum testosterone levels. It turns out that zinc deficiency in the young and elderly, even in the US, is quite common. Repleting this deficiency will take 3-6 months at 50-60mg per day.
#3. Improve sleep and reduce stress
You should be getting 8 hours of sleep each night, but if you aren’t you can try these recommendations:
- Supplements like melatonin, 5 HTP or Hydroxy GABA can help to increase the quality of your sleep
- If you work on a computer all day, make sure you use blue light blocking glasses to block out blue light in the evening
- Get up at the same time each morning and go to bed at the same time each evening. Find a schedule and stick to it!
- Avoid drinking alcohol in the evening
- Be active each day with things like exercise, walking, swimming, etc.
One of the best options for reducing stress is to try to make your body more resilient to the stress you inevitably come into contact with. It is difficult to eliminate all sources of stress in your life, so a better approach can be to help your body be able to better handle it.
This can be done by doing some of these recommendations:
- Take an adaptogen supplement to help reduce the impact that stress has on your body
- Practice yoga, meditation or prayer daily
- Look for hobbies that you enjoy
- Make sure that you reserve time to “play”
- Make a point to regularly be intimate with your spouse or significant other because sex increases endorphins and improves your adaptive response
#4. Resistance training
You should be exercising regularly, and specifically you should incorporate weight training in your regimen 1-2 times/week.
There are several reasons weight training is helpful:
- It helps build muscle mass, which improves metabolism and increases testosterone and growth hormone
- It improves your mood through neurotransmitter signaling
- It improves glucose homeostasis and insulin resistance
- It helps reduce the decline in muscle mass due to aging
Don’t think that you need to become a body builder, you can see many of these benefits with just lifting for 20-30 min a few times per week. Especially in the beginning you will want to focus on major muscle groups like pectoral muscles, glutes/hamstrings/quads, back and deltiods/arms.
The following exercises target these muscles:
- Lateral pull down – Lats
- Shoulder press – Deltoids
- Chest press – pectoral muscles
- Squats/weight lunges – Gluts, quads and stabilizer muscles
- Horizontal pull – Rhomboids, paraspinal muscles, scapular muscles, traps