You’re 40 years old and one day realized that you just went a week without thinking about sex, you are starting have some erectile dysfunction, you have little to no energy to work out and you are 20 pounds heavier than you should be based on how you eat. Your doctor wants to put you on a statin to lower your cholesterol, a blood pressure medication and told you that you need to lose weight. What I am describing is the male menopause commonly referred to as andropause. It is a myriad of symptoms as a result of primarily low testosterone, but also thyroid, DHEA and human growth hormone that accompanies aging.
1. What is your first step in being evaluated for male menopause?
Testosterone levels in men decline year over year in men starting in their early to mid twenties. I have seen men as young as 23 with testosterone levels of 150 (normal range 348-1197). However the typical male that comes into my office complaining of erectile dysfunction, low libido, fatigue, weight gain, and poor endurance is 40+. They also notice changes in mood, are less able to focus at work and they don’t have the “drive” that they used to. Their get up and go has gotten up and left as they say.
The first thing you want to do is have a complete physical and have blood work performed by a doctor who is an expert in natural hormone replacement or anti-aging medicine. They generally are more familiar with looking at hormone levels and understand the difference between normal and optimal levels. Specifically you want detailed thyroid studies (TSH, free t3, free t4, thyroid anti-bodies, reverse t3), testosterone free and total, DHEA-S, IGF-1, 8AM cortisol, Insulin. Here is a link to an article in life extension magazine on male Menopause: http://www.lifeextension.com//Magazine/2003/10/report_andropause/Page-01
2. When should you start getting treatment for male menopause?
You want to start treatment as soon as possible. The medical literature is pretty clear that men who have testosterone levels in the upper quartile of the normal range (top 25%) have a 25-30% reduction in mortality from all causes. In addition, your quality of life is going to improve dramatically fairly quickly. every day in my office I see men with testosterone levels in the 300-500 range with all the above symptoms who after weeks of being on testosterone feel amazing. Their erectile dysfunction is gone, their sex drive is way up, their work outs are outstanding, they start losing inches off their waists and their mood is amazing again. This is not an exaggeration and I can tell you from personal experience this is exactly how I felt after starting testosterone.
I just had a patient come in this morning who in 5 weeks has lost 17 pounds of fat and increased his lean body mass by 20 pounds. This guy is 51 years old and was struggling with all the symptoms of male menopause for years and is now doing amazing. In addition, his blood pressure is now normal and he is able to stop his lisinopril (blood pressure medication), his cholesterol lowering medication (he no longer has inflammation) and his doesn’t need viagra when having sex with his wife. His story is actually not unique and I see this all the time with my patients.
3. What else can you do to treat male menopause?
Correcting low testosterone is the easy part. You either give yourself a shot twice per week or use a cream daily. We also give patients DHEA, thyroid (when needed) and we use sermorelin to naturally boost growth hormone levels. In addition, we teach them how to eat (#1 rule to cut out sugar 6 days per week) and get them exercising more regularly. The combination of hormone optimization, reduction of sugar and regular exercise is the cure for erectile dysfunction, low sex drive, fatigue, weight gain and depressed mood that accompanies male menopause.
Here is a great video on the benefits of sermorelin: https://www.youtube.com/watch?v=DuouL3Svz58
The bottom line is that male menopause is a real phenomena that is affecting thousands of men right now. Low testosterone, or sub-optimal testosterone levels, is the hallmark feature metabolically which causes the majority of symptoms. Men will complain of erectile dysfunction, weight gain, fatigue, depression, lack of motivation and declining sex drive. This can be easily treated if you find the right doctor who understand the importance of hormone optimization. If you would like more information and make an appointment to get your blood levels checked, please call Dr. Breen’s office at 877-721-0047