Male Menopause: Is It For Real? Low Testosterone 101

Doctors acknowledge that women go through menopause — the fluctuation and reduction in female hormones that culminate in the end of menstruation – typically in their late forties or early fifties. But what about men?

You may hear the term “male menopause,” or “andropause,” and wonder if it’s a real situation. Here’s the bottom line.

Around the age of 50, and sometimes even earlier, many men start to experience a drop in their male hormone, testosterone, and it can cause a range of symptoms. The medical term is hypogonadism — which means, a deficiency in the male hormone testosterone.

How is Low Testosterone Defined?

While it’s normal for testosterone to decline somewhat as you age, for good health, most men should have levels that fall within the reference range of about 300 ng/dL to 1000 ng/dL. Typically, low testosterone is considered to be a level below approximately 300 ng/dL. A blood test can measure testosterone levels.

What are the Symptoms of Low Testosterone?

• Fatigue
• Less energy
• Malaise
• Irritability, anxiety
• Lower exercise tolerance
• Reduced sex drive
• Difficulty getting and maintaining an erection
• Fewer erections
• Erectile dysfunction
• Genital numbness
• Reduction in the size of testicles
• Softening of testicles
• Lower ejaculatory volume
• Depression or mood changes
• An increase in body fat
• An Increase in belly fat
• Increase in fat in breast area (aka, “man boobs!”)
• A reduction in muscle mass, difficulty building muscle
• Reduced bone strength, unexplained fractures
• Reduced physical strength
• Hair loss — from head and body, including underarms
• Slower facial hair growth, less shaving
• Hot flashes
• Daytime and night sweat

If you have low testosterone levels, this already increases your risk of developing other illnesses, including diabetes, osteoporosis, and heart disease.

Risk Factors for Low Testosterone

You have a higher risk of developing low testosterone if you:

• Have other hormonal imbalances, such as thyroid disease or adrenal dysfunction
• Are obese
• Have diabetes
• Have high blood pressure
• Have high cholesterol
• Have asthma or Chronic Obstructive Pulmonary Disease (COPD)
• Have had an injury to your testicles
• Have testicular cancer
• Have HIV/AIDS
• Have chronic liver or kidney disease

Natural Ways to Increase Testosterone

Here are some natural ways to increase testosterone:

• Lose weight
• Incorporating healthy fats into your diet
• Avoid excessive soy consumption
• High-intensity exercise
• Strength training/muscle building
• Intermittent fasting (IF) diets (i.e., the 5/2 diet)
• Zinc supplements
• Vitamin D supplementation
• Get enough sleep
• Active stress reduction
• Avoid hormone-disrupting chemicals — like phthalates, parabens, BPA

Treating Low Testosterone

If testosterone doesn’t increase with natural approaches, you may need prescription testosterone. This can be done via injections, daily gel, patches, or via small implantable pellets. Response is monitored through blood tests, and evaluation of symptoms.

When Will You Feel An Improvement?

Typically, patients on the right doseage of testosterone will notice improvements in symptoms within a few weeks.

Risks of Testosterone Therapy

There are some risks to testosterone therapy. Testosterone treatment can raise red blood cell count which increases the risk of stroke, cause breast enlargement, contribute to the risk of sleep apnea and blood clots, cause acne, and accelerate prostate growth. There is also some evidence — thought it’s controversial — that testosterone therapy may increase the risk of heart attack in men over 65 and younger men with a history of heart disease.

Men who use testosterone gel are also cautioned to thoroughly wash their hands, and keep treated areas from contact with children, women and pets.

Men with breast cancer and prostate cancer are typically advised not to receive testosterone therapy. But some practitioners feel that some prostate cancer patients can, with monitoring, have testosterone therapy safely.

Many practitioners believe that for the majority of symptomatic men with subpar levels, the benefits of testosterone therapy outweigh the risks.