Guide to Andropause
by Dr. Tatiana Fleischman, MD
Although men do not experience such an abrupt and complete cessation of their reproductive function as women do, normal aging process leads to a decrease in hormonal levels. That decrease primarily involves testosterone that starts as early as in your late 20's and early 30's and then accelerate when you hit your 40's and 50's. Eventually other hormones get out of balance. For example, the levels of estrogen, a female sex hormone, can go up in your body.
These hormonal changes often lead to a clear set of symptoms that are considered male menopause or andropause. Click on the symptoms below to learn more.
Standing in front of the mirror, have you ever wondered why your biceps no longer seem as pronounced, no matter how much you flex them? Have you ever silently complained how your body seems flabbier and saggier – a far cry from how you looked twenty or even ten years ago?
It is normal for men to lose muscle strength and muscle mass as they age, and this usually indicates the onset of andropause. As early as your twenties, you may already start to experience sarcopenia (the medical term for muscle loss with aging), although it becomes more apparent after you reach 60. With advanced age comes decreased activity. As a result, your muscle cells eventually decrease and begin turning muscle fibers into fat.
What Causes Muscle Loss?
Male muscle loss is positively correlated to lower testosterone levels, which is another side effect of andropause. Testosterone is a hormone that aids in muscle creation by attaching to receptors in muscles, sending them signals to contract and grow.
Couch potatoes be warned: your muscles will naturally shrink (and eventually disappear) if you lead a largely sedentary lifestyle. From age 25 to 60, men who don’t exercise regularly will lose muscle strength and muscle mass at a rate of 0.5% each year. While it may not seem alarming at first glance, this figure doubles to around 1% every year after age 60. In another decade, muscle mass and muscle strength is expected to degrade by 2% every year. This doubling trend continues every decade until death.
Another contributor to muscle loss in men is poor nutrition. Protein, as Biology class taught us, is the building block of muscle. A diet low in protein (and high in sugar) will naturally result in muscle loss, owing to the muscles not having enough fuel for growth.
Specific Hormonal Causes or Contributors to Male Weight Gain
So how are hormones responsible for weight gain in men? Stress is primarily the culprit – specifically, the hormones our body produces in response to stress: cortisol. When cortisol levels rise in response to stress, our body goes into “survival mode.” In this mode, the body stocks up on fuel by producing a surplus of fat cells while slowing down metabolism.
Ever notice how you feel extra hungry when you are under stress? This increase in appetite is actually your body’s way of preparing itself for the energy it expects to burn when you go into "fight or flight" mode. Naturally, this will lead to weight gain.
But the effects of excess cortisol on the body do not end there. While testosterone levels normally decrease during andropause, high cortisol levels will bring these down even more. It isn’t unusual to feel fatigued or for your energy levels to go down as a result of having low testosterone levels.
Other causes of weight gain include disorders that decrease the body’s metabolic rate. These include thyroid disorders, in particular hypothyroidism, as well as having low levels of the human growth hormone (HGH).
The Solution: Male Weight Loss
Given that hormonal imbalance is one of the common culprits of weight gain in men, logically we expect that bringing balance to the body’s hormone levels will help achieve weight loss. In particular, we can bring to more optimal levels your testosterone, cortisol, estrogen, HGH and thyroid hormones, to name a few, with the aid of bioidentical hormones. Achieving this balance will set the stage for you to attain weight loss.
What Causes Fatigue in Men?
A key component of energy production is testosterone. When andropause strikes, reduced testosterone levels become one of the leading causes of insomnia or sleep apnea, two contributors to fatigue in men. Aside from this, other symptoms of andropause—night sweats, irritability, depression, weight gain, and stress, to name a few—may also lead to sleep interruption in men.
Men with fatigue find that experiencing night sweats further worsens insomnia and fatigue as the discomfort gets in the way of getting quality sleep. Fatigue often develops from experiencing extended periods of sleep deprivation. Negative feelings brought about by irritability and depression, which normally come with andropause, can also lead to tiredness and exhaustion. This feeling of sluggishness and tiredness could also be a result of gaining weight and losing muscle mass during andropause. Additionally, energy levels may be depleted by stress and high cortisol, which produce feelings of frustration and worry. And don’t forget that poor dietary choices can also lead to low energy supply.
Is it a good idea to combat fatigue with exercise? While working out will of course use up your energy stores, the endorphins released post-exercise will often lead to an energy boost. Though not everyone enjoys exercise, what’s sure is that not having enough of it can worsen male fatigue.
The Solution: Treatment for Fatigue in Men
The Chinese principle of Yin and Yang also applies to treating fatigue: Restoring hormonal balance in the body will help relieve or alleviate the more negative effects of andropause. This is most often achieved through natural bioidentical hormone replacement therapy, which balances your testosterone and cortisol levels. Stabilizing your hormone levels will bring about a positive domino effect: once the symptoms of andropause lessen or disappear, you get a boost in your energy levels as well as in your mood, which then leads to reduced or eliminated fatigue.