Andropause: Understanding and Treating Men’s Mid-life Health Problems

January 20, 2008

For men over 40, getting older doesn’t have to mean living with declining health. Thanks to extensive research and new treatment advances, male andropause can be diagnosed and treated successfully.

What Is Andropause?

Years ago many doctors believed that male ‘menopause’ symptoms were merely an unavoidable part of the aging process; consequently, relatively little research effort was made to understand what exactly was causing the condition. Thanks to intensive research in recent years, science now has a clear understanding that andropause results from declining levels of several male hormones.

People used to equate these symptoms in men with those that occur during female menopause, and so the term ‘male menopause’ was coined, says Dr. Pansak. Extensive research in recent years has shown that the term doesn’t properly describe the male condition. While the symptoms are similar in both men and women, the causes are very different.

For women, menopause begins when the ovaries stop functioning and no longer produce hormones. In men, hormone production continues, Dr. Pansak explains, but certain bodily conditions impair a man’s hormone production to such an extent that this hormone deficiency begins to have a noticeable effect on some important body functions.

The correct term to describe this process is testosterone deficiency syndrome or androgen deficiency of the aging male, says Dr. Pansak. In simple terms, this is andropause.

Andropause and Hormone Deficiency

The impact of hormone deficiency in men  is usually gradual and often goes unnoticed at least initially. As the condition progresses it can lead to a significant impact in both physical and psychological terms on a man’s quality of life,Dr. Pansak explains. Andropause affects a man’s self-esteem and how he relates to others. Men with hormone deficiency often feel frustrated, irritable, subdued and pessimistic. Their muscles contract while body fat increases. They often experience insomnia, emotional turbulence, less-sharp thinking, a decreased sex drive and erectile dysfunction. Serious cases can eventually lead to clinical depression.

Andropause affects more than just testosterone. All hormones experience a decline, Dr. Pansak continues. One of the first to decline is melatonin, the so-called ‘hormone of the night.’ Melatonin is normally secreted after sundown and helps a person feel sleepy as bedtime approaches, allowing him to fall into deep healthy sleep around midnight. In a healthy man, the pituitary gland produces a variety of hormones during deep sleep. The first of these is the growth hormone which preserves one’s youthfulness and counters the aging process.

"The thyroid gland then produces a hormone that converts food into energy, explains Dr. Pansak. A healthy thyroid hormone function gives a man energy to enthusiastically engage in activities. The adrenal gland produces the antioxidant hormone DHEA that slows the aging process.

The male sexual hormone testosterone is the last hormone produced. This hormone helps one think decisively, reasonably and positively as a healthy man should, says Dr. Pansak. It also supports bone and muscle strength and regulates body fat and body contour. That’s why men with normal hormone levels usually don’t have a ‘beer belly.’ Their bodies are strong and their mood is good.

The Dangers of Male Hormone Deficiency

If left untreated, male hormone deficiency poses a number of potentially serious health risks, including fragile bones, weak muscles, erectile dysfunction, hypertension, heart disease and stroke.
With decreased hormone levels, body fat increases and accumulates around the waistline, notes Dr. Pansak. The ‘beer belly’ is one sign of male hormone deficiency. The criterion is a waistline in excess of 94 centimeters for westerners and 90 centimeters for easterners.

Beer Belly Dangers

While most of us are aware of the health risks that come with being overweight, the specific dangers for men with excessive fat accumulation around the waist are less well understood, but no less serious.

Think about it: When a man has a ‘spare tire’ around his waist, he’s unlikely to have the energy or the desire to stay active, Dr. Pansak explains. This lack of activity means he’s not using enough energy to burn his daily calorie intake, and that leads to even more fat buildup. This increased fat clogs blood vessels and leads to hypertension. It can also cause dyslipidemia, the condition of having too much ‘bad’ cholesterol and not enough ‘good’ cholesterol. This can significantly raise a man’s risk for stroke, a potentially deadly condition.

This unhealthy state can also affect a man’s sexual health. Clogged blood vessels affect the supply of blood to the genitals, says Dr. Pansak. This can cause erectile dysfunction. Excess fat accumulates in the genital muscles, further worsening the symptoms. This is a prime example of how the body’s many systems are interconnected.

Dr. Pansak stresses the importance of consulting a doctor at the first sign of difficulty in achieving a normal erection. Your doctor may recommend a hormone level test to check for possible deficiencies, he explains. Your doctor can recommend a treatment strategy for sexual impotency as well as other steps to address one’s overall health situation.

Treating Hormone Deficiency

Hormone Supplement Therapy

The old saying Getting old is natural, feeling old is optional certainly applies to male hormone deficiency. Today’s modern lifestyles are far different from earlier generations. People tend to spend more time working and less time sleeping, and most of us endure greater stress from everyday living. Our fast-paced world leads to eating on-the-run and sleeping just a few hours a night, while leaving less time for exercise and relaxation. These factors all contribute to premature hormone deficiency.

Dr. Pansak shares his experience: I see more and more men in their 30s who come to me because of loss of sexual desire and erectile dysfunction, hair loss or obesity. Dealing with their problems requires a holistic approach, to diagnose and treat the full range of health issues to produce a successful treatment outcome. 

Sexual impotency is an important indicator of male health problems, so we have to check blood sugar and body fat levels, hormone levels, the health of the prostate gland, and understand a patient’s lifestyle and family history to see what changes may be needed,says Dr. Pansak. Hormone supplement therapy is often recommended as part of the treatment plan. After a period of taking hormone supplements, patients usually experience noticeable improvements to their health and wellness, which are often accompanied by weight loss and improved sexual function. A patient’s mood and overall happiness usually also improves.

Lifestyle Modification

Dr. Pansak emphasizes the hormone-related differences between men and women. The female body stops producing female hormones during menopause, he explains. Replacement therapy is usually recommended to mitigate the negative effects. On the contrary, the male body never stops producing male hormones. The levels of hormones decline, but they can be restored. Doctors will advise their patients on specific lifestyle changes that can help increase hormone production. For some patients, usually older men with greater hormone deficiency doctors will also prescribe male hormone supplements to be taken on a regular basis.

There are simple guidelines that all men can follow to improve their overall health and limit the effects of hormone deficiency. Dr. Pansak recommends:
  • Going to bed early enough to ensure that you fall into deep sleep by midnight;
  • Exercising most days for 45 minutes per workout (or 300 total minutes each week) as opposed to the 30 minutes-per-  workout guideline for the general population;
  • Eating a healthier diet;
  • Adopting a positive attitude in order to avoid depression and insomnia.

According to Dr. Pansak, unhealthy living is often the biggest single factor in causing male hormone deficiency. So making healthy lifestyle changes under the supervision of a medical specialist can prove highly effective in returning to better health. Middle age really can be the beginning of a happier, healthier life. As the famous comedian George Burns said, You can’t help getting older, but you don’t have to get old.
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