Andropause, “Male Menopause”
For many decades until now we are discussing and almost everybody knows about menopause among women.
However, most people don’t know anything about Andropause.
We all know that menopause is a condition that each woman will sooner or later experience. A rapidly evolving process, characterized by multiple hormonal and biological changes in women, who see their lives changing so much, with monthly menstruation being disrupted, and start feeling aging on their bodies.
However, men have exactly the same hormones as women.
The fact that a cyclical or monthly event is not present in men, though, similar to the menstrual cycle in women, has turned away for many years both men and the Medical community from focusing on what happens with male hormonal system.
What is Andropause, “Male Menopause”?
What is now defined as “Andropause” or “Male Menopause” is a slowly evolving process of increasing hormonal reduction among men, which due to the absence of “male menstruation” that could facilitate men in understanding the hormonal changes taking place in their bodies, it finally leads them to search for a solution for what is happening to their bodies at a much later stage as compared to women. Testosterone is a steroid hormone, which belongs in the group of androgens. As all other hormones, testosterone exists in women too, but in smaller quantities.
The levels of testosterone in each adult male start reducing progressively from the age of 30 onwards, as indicated by the World Health Organization (W.H.O.). The reduction of normal levels of testosterone in men is approximately 1% to 2% per year, from the age of 25 onwards. The gradual reduction of testosterone and the progress of relevant symptoms may often go unnoticed. Nevertheless, during a tie period, at some point in the future, the significant depletion of testosterone may also manifest clinically. The condition in which this critical reduction of testosterone has occurred in men is known as Hypogonadism.
During the gradual reduction of testosterone levels, in the age of mid-40s and till the age of 50, at least 35% of men worldwide will have low testosterone levels; this causes certain symptoms and puts them at risk.
The main symptoms during Andropause may be:
Loss of libido (sexual desire),
Sexual function disorders,
Anxiety, nervousness and irascibility,
insomnia, while feeling the need to sleep more,
Fatigue and muscle weakness,
Melancholy and Depression,
Cyclical Emotion and moroseness,
Psychological instability and sense of insecurity
Difficulty in concentration,
Loss of muscle tone and muscle strength,
Increase in body fat and changes in body weight,
Hair loss and wrinkles,
Skin dryness and sagging.
Andropause and Causes
In men, hormonal reduction, especially the reduction of normal testosterone levels as well as DHEA (Dehydroepiandrosterone), is linked to increasing age. As men get older, certain metabolic and cellular changes take place, which affect our body and hormonal processes.
These changes, taking place at the molecular level, during andropause, may manifest in the body of men, similarly to the symptoms of female menopause.
As men move towards Andropause, their ability to normally produce testosterone is reduced, and this affects their ability to enjoy life. But it is not only testosterone and DHEA that are lost, but also other hormones, such as estrogens, thyroid hormone, cortisol, and growth hormone (HGH), among others.
Furthermore, aging increases the risk of Chronic and Metabolic Diseases, such as Diabetes Mellitus, high Cholesterol, Hypertension, Insulin resistance, Metabolic Syndrome X, as well as an overall increased level of Inflammation, which ultimately leads to Chronic Inflammatory Diseases.
This particular metabolic transformation that occurs in men during Andropause and is responsible for the increased transformation of testosterone to estrogens is termed Aromatization.
The enzyme aromatase, which is found in abundance in our adipose tissue, is an important factor during aromatization of testosterone to estradiol.
This is why overweight men (excess weight) experience Andropause in a more intense way.
Because they have more increased levels of aromatase in their adipose tissue as compared to thinner men. The high concentration of aromatase leads to testosterone level reduction, converting it to estradiol (estrogen). This increase of estradiol levels further exacerbate symptoms during Andropause.
Treatment management of Andropause (Hypogonadism)
Following specific exams for Andropause, including the Bio 4h hormonal profile, hormonal status is detected, and special needs of each individual are identified.
The cost of the exams is affordable and the results are ready with two to three days.
Treatment of Andropause is achieved through the restoration of testosterone levels with Biomimetic testosterone, usually in the form of cream.
Biomimetic testosterone administered during Andropause is extracted from natural ingredients, which are then converted to the natural hormone of a young man.
Restoration using Biomimetic hormones is also based on the restoration of all male hormones levels, DHEA in particular.
Patients should not change their everyday life. To the contrary, they see their health improving gradually, together with their overall physical condition.
Dr. Nikoleta Koini, M.D.
Doctor of Functional, Preventive, Anti-ageing and Restorative Medicine.
Diplomate and Board Certified in Anti-aging, Preventive, Functional and Regenerative Medicine from A4M (American Academy in Antiaging Medicine).
1. Basaria S, Dobs AS. Risks versus benefits of testosterone therapy in elderly men. Drugs Aging 1999; 15 (2): 131-42
2. British National Formulary No. 39. London: The Pharmaceutical Press, 2000 Mar: 342-3
3. McClellan KJ, Goa KL. Transdermal testosterone. Drugs 1998 Feb; 55 (2): 253-8
4. Albright F, Reifenstein EC. Metabolic bone disease: osteoporosis. In: Williams, editor. The parathyroid glands and metabolic bone disease. Baltimore (MD): Williams and Wilkins, 1948: 145
5. Oppenheim D, Klibanski A. Osteopenia in men with acquired hypogonadism: improvement with testosterone replacement [abstract no. 585]. Programs and Abstracts of the 71st Meeting of The Endocrine Society; 1989 Jun: 289
6. Katznelson L, Finkelstein JS, Schoenfeld DA, et al. Increase in bone density and lean body mass during testosterone administration in men with acquired hypogonadism. J Clin Endocrinol Metab 1996; 81: 4358-65
7. Behre HM, Kliesch S, Leifke E, et al. Long-term effect of testosterone therapy on bone mineral density in hypogonadal men. J Clin Endocrinol Metab 1997; 82: 2386-90
8. Salmimies P, Kockott G, Pirke KM. Effects of testosterone replacement on sexual behaviour in hypogonadal men. Arch Sex Behav 1982; 11 (4): 345-53
9. Arver S, Dobs AS, Meikle AW, et al. Improvement of sexual function in testosterone deficient men treated for one year with a permeation enhanced testosterone transdermal system. J Urol 1996; 155: 1604-8
10. Morales A, Johnston B, Heaton JPW, et al. Testosterone supplementation for hypogonadal impotence: assessment of biochemical measures and therapeutic outcomes. J Urol 1997; 157: 849-54
11. Wang C, Eyre DR, Clark R, et al. Sublingual testosterone replacement improves muscle mass and strength, decreases bone resorption, and increases bone formation markers in hypogonadal men: a clinical research center study. J Clin Endocrinol Metab 1996; 81: 3654-62
12. Sih R, Morley JE, Kaiser FE, et al. Testosterone replacement in older hypogonadal men: a 12-month randomised controlled trial. J Clin Endocrinol Metab 1997; 82: 1661-7
13. Brodsky IG, Balagopal P, Nair KS. Effects of testosterone replacement on muscle mass and muscle protein synthesis in hypogonadal men: a clinical research study. J Clin Endocrinol Metab 1996; 81: 3469-75
14. Schiavi RC, White D, Mandeli J, et al. Effect of testosterone administration on sexual behaviour and mood in men with erectile dysfunction. Arch Sex Behav 1997; 26 (3): 231-41
15. Arver S, Dobs AS, Meikle AW, et al. Long-term efficacy and safety of a permeation-enhanced testosterone transdermal system in hypogonadal men. Clin Endocrinol 1997; 47: 727-37
16. Zgliczynski S, Ossowski M, Slowinska-Srzednicka J, et al. Effect of testosterone replacement therapy on lipids and lipoproteins in hypogonadal and elderly men. Arteriosclerosis 1996; 121 (1): 35-43
17. Hajjar RR, Kaiser FE, Morley JE. Outcomes of long-term testosterone replacement in older hypogonadal males: a retrospective analysis. J Clin Endocrinol Metab 1997; 82: 3793-6
18. Bhasin S, Bagatell CJ, Bremner WJ, et al. Issues in testosterone replacement in older men. J Clin Endocrinol Metab 1998; 83: 3435-48