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MALE MENOPAUSE, THE TRUE EQUALIZER

By: Clifford Sonnie, M.D.

I was channel surfing this past weekend and I was amazed with the number of infomercials that were about woman’s hormones and menopause. Just look at any magazine and the ads are everywhere. I however did not see one ad about andropause aka “men’s menopause” (the singular is manopause, sorry bad joke). I was curious about this. Even though I am sure there are many women out there who would disagree with me, men are people too. The fact is, that just as a woman’s hormones will decrease over time, so will a man’s. In fact everyone has all three hormones in them, men and women alike. The difference of course is that men have higher testosterone and women have higher progesterone and estrogen. I would like to talk about men and their testosterone.

First some science. (Like you weren’t expecting this). Cholesterol is the stuff from which literally all hormones are made. (Remember the article a few weeks back? It is not the bad guy!). In addition hormones can be converted to any other hormone pretty easily as the body sees fit. So when testosterone is formed by the reproductive organs it exists in two different forms, “bound” and “free”. The bound testosterone can be attached to a protein called SHBG (sex hormone binding globulin) and doesn’t work at all. The free testosterone is the active stuff. And just like any other hormone it can be changed into something else. In this case estrogen or DHT (dihydrotestosterone). Ok enough. Let’s try to make some sense of this.

When men were in their teens and early twenties, their testosterone levels were sky high and the estrogen levels were low. In essence we were all nothing more than walking glands. As time goes on the testosterone will decline. Some will decline at a fast rate and some will decline ever so slowly. Why is this? Well, first the body could be making too little testosterone. Second, the body could be making too much SHBG and the “free” is becoming “bound” and worthless. Third, the testosterone that is being made is turning into estrogen. More later.

What are the symptoms that your testosterone, or at least the good testosterone, may be too low? They are, in no particular order; loss of libido, fatigue, moodiness, weakness, depression, decreased mental clarity and erectile dysfunction. This is not really complete because testosterone plays a very important role in cardiovascular health, hypertension, and insulin resistance as well. Additionally one last controversial issue is prostate problems. The number of cases in recent decades has increased and testosterone was always blamed. I believe it is not the testosterone but the estrogen instead. Today we are inundated with estrogen tainted foods. (Dead chickens are not that big nor should they be yellow). Second, if testosterone is the cause we should see most cases of prostate problems in a man’s teen and twenties. Not so. Sorry, I digress. Men who have any of these symptoms should have their testosterone, free testosterone, SHBG, estrogen, and yes even the PSA (prostate test) levels checked.

So why is the testosterone low? Let’s look at each cause. First, why does the body not produce enough testosterone? One reason is the reproductive organs are not making it and a good detoxification program especially for toxic metals may help. Secondly, a lack of exercise, a sedentary lifestyle, obesity, and improper diet (processed foods and what not) all have been proven to decrease the amount of testosterone the body makes. The second reason can be too much SHBG. Well, the treatment is essentially the same as it is if the body didn’t make enough testosterone. There is one additional issue which brings us to the third reason. The testosterone is turning into estrogen. Again, this can be due to nutritional reasons as well as toxins.

Treatment is pretty easy. To bring up the testosterone, exercise. Get mobile! Adequate minerals such as zinc are vital to testosterone production. So a diet rich in dark green veggies as well as Omega 3 oils will not only solve that, it will also keep the estrogen and SHBG in check. Herbals too will help. Chrysin for example will keep testosterone from becoming estrogen. Adequate protein intake will help keep SHBG low. Detoxification programs especially for toxic metals will also result in better testosterone production. Lastly, testosterone can be given as a hormone replacement or treatment. This must only be done under the guidance of an MD or DO. I only recommend compounded bio-identical hormones in lieu of the synthetic brands. Plant based hormones are also available “over the counter” without prescription and can be dangerous. So if you elect to use these, do so with caution. Remember, too much of anything can be harmful.

Clifford Sonnie, M.D., M.P.H.