THE AGING MALE AND ANDROPAUSE

As men age, they begin to experience changes in their bodies. Abdominal fat increases and muscle mass decreases. They also experience a distressing decline in their sex drive. At the same time, the risk of serious health conditions such as depression and heart disease rises. The common belief among the medical community addresses this decline as the signs of “natural aging,” often characterized by the underlying and identifiable cause of these symptoms—the gradual decline of important sex hormones, especially testosterone. The results of the decline, however, are strikingly apparent.

Low testosterone levels in older men increase the risk of death, this report was published in the August 14/28, 2006 issue of American Medical Association. 

The study concluded men who have a low testosterone level after age 40 may have a higher risk of death over a four-year period than those with normal levels of the hormone. Unlike women undergoing menopause, middle-aged men generally do not experience a dramatic decrease in the production of sex hormones, according to background information in the article. Testosterone levels gradually decline as a man ages, decreasing approximately 1.5 percent per year after age 30. The effects of low testosterone levels include decreased muscle mass and bone density, insulin resistance, decreased sex drive, less energy, irritability and feelings of depression.

Molly M. Shores, M.D., and colleagues at the VA Puget Sound Health Care System and University of Washington, Seattle, studied the relationship between hormone levels and death in a total of 858 male veterans older than age 40 years. All participants received care in the VA Puget Sound Health Care System and had their testosterone levels checked at least twice between 1994 and 1999, with at least one week and no more than two years elapsing between tests. The men were followed for an average of 4.3 years and a maximum of eight years, through 2002.

About 19 percent (166) of the men had a low testosterone level; 28 percent (240) had an equivocal testosterone level, meaning that their tests revealed an equal number of low and normal levels; and 53 percent (452) had normal testosterone levels. One-fifth (20.1 percent) of the men with normal testosterone levels died during the course of the study, compared with 24.6 percent of men with equivocal levels and 34.9 percent of those with low levels. Men with low testosterone levels had an 88 percent increase in risk of death compared with those who had normal levels. The researchers considered other variables that may influence risk of death, such as age, other illnesses and body mass. Previous studies have found that testosterone levels may dramatically decrease one to two days after surgery, trauma or critical illness-all factors that can increase the risk of death. To eliminate these effects, the authors reanalyzed the data excluding men who had died within the first year of follow-up. Men with low testosterone levels were still 68 percent more likely to have died. (Arch Intern Med. 2006;166:1660-1665. www.jamamedia.org)

Testosterones function within the body
Testosterone, is abundantly produced during puberty, is responsible for the development of secondary sexual characteristics and has profound effects throughout the body. Testosterone receptors are found in virtually all body tissues, so levels of testosterone affect the function of most organ systems. An example, testosterone causes growth of facial and body hair in skin cells, increased fiber size and strength in muscle cells, and maturation of the external genitalia. Testosterone also affects the central nervous system as well, governs such behaviors as aggression, risk taking, and territoriality. It is now recognized as an important factor in mitigating depression.

Testosterone begins within cholesterol, the building block for hormones. Pregnenolone, is the “grandmother hormone,” and is produced directly from cholesterol. In turn, dehydroepiandrosterone (DHEA; a precursor to testosterone), is the “mother hormone,” and estrogen (and its metabolites) are produced from pregnenolone. Both testosterone and estrogen are produced by enzymatic reactions from DHEA. This ubiquitous molecule is the steroid found in highest quantities in humans. Changes in the supply of DHEA (and/or changes in the levels of the enzymes that convert DHEA to the sex hormones) can have powerful effects on sex hormone–dependent systems.

Many changes occur as men age, the testosterone levels available to the body are reduced and that change alters the ratio between testosterone and the principal female hormone, estrogen. This condition is referred to as androgen deficiency of aging men, now commonly referred to Andropause.

Aromatase is the enzyme responsible for converting testosterone into estrogen, thus altering the ratio of estrogen to testosterone. Men who have excessive body fat, especially abdominal fat, are likely to have increased estrogen levels caused by aromatase activity and a dramatically increased estrogen level compared to testosterone. This imbalance in estrogen levels is linked to a host of disorders, including decreased insulin sensitivity and blood glucose problems. Some studies suggest that there is an association between a low testosterone level, insulin resistance, an elevated estrogen level, and increased body fat in aging men.

Nervous system effects
Low testosterone levels have been associated with depression and other psychological disorders, many conventional antidepressants suppress libido. If your libido is reduced and you are taking antidepressants undergo testing and have your testosterone levels checked. Testosterone therapy might reduce the need for the antidepressants themselves.

Sexual enjoyment and function
Falling levels of free testosterone diminish sexual desire, as well as pleasure and performance in sexual activity. Evidence suggests that men with low free testosterone levels can improve sexual function with Testosterone therapy.

Cardiovascular disease and metabolic syndrome
There is a clear relationship between low levels of testosterone and increased incidence of cardiovascular disease. This syndrome is called “Metabolic” the combination of abdominal obesity, high blood pressure, insulin resistance, and lipid disorders in the same person. This condition is associated with a high risk of cardiovascular disease. Studies have shown that testosterone administration (500 milligrams [mg] of intramuscular injections) in middle-aged, obese men was able to increase insulin sensitivity. These results were confirmed in another study in which testosterone treatment led to reduced insulin resistance. These studies also showed that testosterone administration is helpful in the context of metabolic syndrome.

The musculoskeletal system
Bone integrity depends upon a balance between bone formation and bone re-absorption, which are controlled by multiple factors including estrogen and testosterone.  Clinical trials demonstrated that testosterone increases bone mineral density in elderly men, testosterone supplementation also has a positive effect on muscle metabolism and strength.

Restoration IS Needed
Too often, men who have problems related to a low testosterone level are advised to treat only the symptoms of their conditions (such as taking antidepressant and/or cholesterol-lowering drugs). Fortunately, progressive physicians, along with the Naturopathic community, now recognize the connection between hormones and the diseases of aging. Restoration of youthful hormone levels is associated with optimal sexual function, energy, and vitality, while declining hormone levels correlate with many age-related conditions, including high blood pressure, atherosclerosis, diabetes, loss of muscle and bone mass, and fatigue.

WARNING : It is not safe to use large amounts of testosterone in any form. Hormone replacement should not be initiated without medical supervision and comprehensive testing. Many existing health conditions can worsen; prostate cancer in particular, can be made worse by increasing available testosterone.

Any person contemplating taking hormone replacement, whether through a prescription or through supplements, should work closely with a qualified physician; plan a rationale approach to treatment and continued monitoring and screening.

NATURALY Boost AND BALANCE Testosterone

While a large number of studies document the benefits of saw palmetto by itself, European physicians frequently prescribe saw palmetto extract that is combined with additional herbs that interfere with other factors involved in prostate enlargement.

DHEA produced by the adrenal glands and is the sole precursor and regulator for the natural production of every steroid and sex hormone in the body. Testosterone regulates all of the male reproductive organs and testosterone derivatives such as DHT (dihydrotestosterone) and estrogen. Boron helps slow elevation of PSA and protect against protein-degrading enzymes in the prostate gland. The Pituitary gland is called the "master" gland of the endocrine system, because it controls the functions of the other endocrine glands. The Adrenal gland affects the sex hormones, similar to that secreted by the testes. The Prostate gland is part of male mammalian sex organs, its main function is to secrete and store a clear, slightly basic fluid that is part of semen. Progesterone is active in both the aromatase and 5-alpha-reductase systems to moderate or block conversion to estradiol and dihydrotestosterone, respectively. In low (5-10mg) doses, progesterone can be an important adjunct in andropause therapy. Folic Acid, new research shows that men who have a folic acid deficiency could notice a 90% reduction in their sperm count. Boron helps to prevent post-menopausal and andropausal, osteoporosis and builds muscle. Lycopene (derived from tomatoes) help maintain healthy gene function in prostate cells. Yohimbe affects nerve impulse transmission and the stimulation of testicular functions, which in turn release increased levels of endogenous testosterone within the body. Boswellia helps reduce inflammation. Nettle root extract may provide a unique mechanism for increasing levels of free testosterone by binding to SHBG, the globulin that inactivates sex hormones. Saw palmetto extract to interfere with DHT activity in the prostate, inhibit the alpha-adrenergic receptor (to support normal urinary flow), and impede inflammatory actions in the prostate gland. Pygeum enhances healthy prostaglandin function, which helps keep the prostate gland placid and promotes prostate comfort.  Pumpkin seed oil appears able to interrupt this triggering of prostate cell multiplication by testosterone and DHT, although the exact mechanism for this effect is still a matter of discussion.