What is male-related andropause? Is it even real?
These are the questions you may be asking yourself as you start to deal with low energy, decreased libido and weight gain as you age.
Andropause is real and it is something that all men will deal with over time.
Properly diagnosing and addressing low testosterone is important because testosterone influences several critical functions in the body: weight management, subjective sense of energy and cardiovascular health.
Learn how to diagnose and treat this condition:
Andropause refers to the reduction in male hormones (specifically, testosterone) that tends to occur around the same time that women undergo menopause.
Starting at around age 50 both male and female experience a reduction in the hormones that define their gender.
For men this is testosterone, for women, this is estrogen and progesterone.
Women experience this reduction in a dramatic fashionwhich occurs over a period of 6-12 months.
When this occurs their estrogen and progesterone levels fall to very low levels and they get the symptoms associated with that decline -> hot flashes, mood changes, weight gain and a reduction in libido.
Men experience a similar transition only they experience it over a longer period of time (the transition happens more slowly).
Around age 50, men experience a slow reduction in testosterone which occurs over several years.
Why is this important?
Testosterone is THE defining hormone in the male.
Testosterone is responsible for maintaining muscle mass, modulating your mood, improving your sex drive, maintaining your weight and fighting off heart disease and metabolic syndrome (1).
This drop in testosterone, therefore, represents a serious condition that may affect your mood, weight, and risk of mortality later in life.
The good news is that you can treat this condition (and it's not very hard), the bad news is that most physicians aren't aware of how to do this.
Even worse some physicians suggest that taking testosterone is harmful when in reality you may be missing out on several benefits by not taking it.
Most men know when something is "off" in their body.
The problem is that even when they notice something is "off" they generally don't seek medical help or attention.
Fortunately, when it comes to testosterone and andropause, there are several symptoms that may help you identify if you need further testing.
Because testosterone is so important to the male body, the symptoms of low testosterone may be very widespread and non-specific (2).
Testosterone is responsible for defining the male gender. During adolescence, the reason the male body changes the way that it does is largely due to testosterone levels.
It's not hard to imagine that the reduction of this very important hormone causing many issues as it decreases.
In addition, many of the symptoms associated with low testosterone and andropause are often pushed aside as symptoms of "getting older" which can make diagnosis difficult for some people.
These symptoms are NOT normal and should be evaluated further.
You can see a full list of symptoms that are associated with Andropause and low testosterone below:
Each person may present with a range of the symptoms listed above.
The most common symptoms associated with andropause include a reduction in energy, weight gain, low energy, and decreased libido.
These 4 symptoms are very common among people with low testosterone and if you are experiencing them you should get your serum testosterone levels checked.
When talking about andropause we are referring to patients who are generally over the age of 50, but patients as young as 30 are now experiencing the symptoms associated with low testosterone.
So regardless of your age, if you are a male and experiencing these symptoms you should be evaluated.
Testing for low testosterone and Andropause is actually quite easy and is generally covered by insurance.
To get evaluated you will want to ask for the following tests:
These tests are easy to get ordered and your current physician should have no problem checking them.
But this is only the beginning:
Now you need to properly interpret your lab results.
When it comes to hormones most physicians don't know how to interpret or treat imbalances.
Because of this, it is very important that you have a basic understanding so you can be an advocate for yourself.
When evaluating your testosterone and other hormones you want to evaluate them with an "optimal" level in mind.
Meaning that levels within the "normal reference range" are not acceptable.
Look for the following "optimal" levels:
Examples of lab values below:
Don't accept that your testosterone levels are "normal" if they are not "optimal".
Consider that the lab values and reference ranges include a wide range of males (including males who are 70+ years old).
You don't want to compare your testosterone levels to some random person.
Because each of you is used to a different serum testosterone level, this is not a "one size fits all" hormone.
So even if your serum testosterone level is 400 (which is considered normal), that doesn't mean it is "normal" for your body.
You may have had a serum testosterone level of 1000 when you were younger - and this is the level we are trying to get you back to.
Replacing testosterone to normal and physiologic levels is safe and very helpful (5).
You only get into trouble if you start using supraphysiologic doses (meaning doses higher than what your body is used to producing naturally).
We know that age absolutely causes low testosterone, but there are other factors that can influence testosterone as well.
While many males suffer from low testosterone secondary to andropause around age 50, many other males are experiencing the symptoms of low testosterone as in their 20's and 30's.
Understanding what causes low testosterone can help for several reasons:
Finding the cause of your low testosterone allows you to potentially increase your testosterone levels naturally.
This is extremely helpful if you can't find a physician willing to work with you or prescribe testosterone.
Addressing these other issues may dramatically improve your quality of life by balancing other hormone systems in your body (they will help you lose weight and feel better).
With that in mind let's talk about the 5 most common causes of Andropause and Low testosterone:
Regardless of how healthy you are your testosterone will eventually decrease over time.
This can be frustrating for men who spend a lot of time eating healthy and exercising regularly.
We know from statistical studies that testosterone will eventually decline over time (6).
We also know that unhealthy behaviors and lifestyle choices can impact this decline and make it occur earlier than normal and more rapidly.
On the flip side, that means that making healthy choices may prolong the time it takes until you start to develop the symptoms of low testosterone.
Most men will experience some decline in testosterone starting in their 40's which will continue through their 50's.
You probably know that testosterone influences muscle mass production by influencing protein synthesis in skeletal muscle (7).
What you may not have realized is that strength training can actually increase your testosterone levels by increasing your muscle mass.
Studies have shown that heavy resistance training(8) can help to naturally increase free and total testosterone as well as IGF-1.
This effect is more pronounced the younger you are (younger men experience a more dramatic rise in testosterone after a work out), but it is still helpful for men in their 40's and 50's.
Maintaining muscle mass will help to maintain serum testosterone levels.
This also means that not exercising will lead to lower levels of muscle mass and lower levels of testosterone and IGF-1 in your body.
Make sure you are exercising and utilizing resistance training in your exercise program.
Insulin resistance is another common cause of low testosterone and early andropause in both males and females.
Insulin resistance is involved in the weight gain/low testosterone cascade:
Insulin resistance leads to low testosterone which causes increased fat mass, leptin resistance, and weight gain.
But how do you get insulin resistance?
Insulin resistance is developed when you consume high carbohydrate (refined carbohydrates, refined sugars, etc.) foods.
One of the worst offenders is sugary drinks (soda, juice, etc.).
These high carbohydrate meals cause a spike in blood sugar which leads to a rise in insulin levels.
Over time, repeated rise leads to insulin resistance, weight gain, and low testosterone.
It's important to test for insulin resistance because it can easily be treated using a combination of dietary changes and the addition of targeted supplements.
Refer to the lab reference ranges above for more information on how to test for insulin resistance.
As an aside - this condition can lead to low testosterone in young men as well, and if you have a personal diagnosis of type II diabetes you likely have very low testosterone.
Replacing this low testosterone actually helps to reverse insulin resistance (9) and can be part of your treatment for type II diabetes.
Next on the list is stress.
High levels of consistent and chronic stress can prematurely lower testosterone.
In the same vein, chronic and persistent lack of sleep can also prematurely lower testosterone.
So the question becomes:
How big of an impact do these two things play?
Studies have shown that a 1-week reduction in sleep (10) (to an average of 5 hours per night) lowered testosterone level by 10-15%.
During this same time period, cortisol levels also spiked.
This is important because high cortisol can worsen existing insulin resistance and persistently elevated cortisol (secondary to stress) can alter blood sugar homeostasis.
What's more concerning is that around 20% of working men state they get 5 hours of sleep per night on average.
With this information, we can almost safely assume that up to 20% of males have at least 10-15% lower than normal testosterone levels (not accounting for the impact of cortisol on insulin resistance).
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