Yes, gentlemen, you too can experience menopause, or should I say manopause. The terms “male menopause,” “low-T,” or “andropause” are getting significantly more attention than most men would like to admit! For reasons we have yet to understand, testosterone levels in American men have been declining rapidly over the last two decades, and the decline is age-independent. Research has now demonstrated that population-level declines are greater than the cross-sectional declines typically associated with age. Science hasn’t given any definitive answers yet as to why this is happening, but there are some environmental and lifestyle factors that may predispose a man to experience an early and unexpected drop in testosterone level. In metabolic syndrome characterized by obesity, diabetes, and insulin resistance, the level of total and free testosterone is reduced. For those who are obese, weight loss alone may increase testosterone by 50%. Men are now exposed to more xenoestrogens than at any other time in history. These environmental estrogen mimickers are found in pesticides, phthalates (plastics), tobacco smoke, heavy metals, and solvents, and can interfere with testosterone production. Lack of physical activity and stress hormone cortisol can down-regulate testosterone production. For some men, engaging in short, intense exercise, like weight lifting, can boost testosterone levels.
Almost every week I talk with a variety of men who are looking for something to increase their testosterone. Generally, I’m not seeing younger men looking to boost muscle mass at the gym, but middle-aged to older men (35-65) that are experiencing a decline in vitality. These men all have some easily recognizable commonalities; most have not had lab work to assess testosterone level, and they all share the same set of clinical symptoms: weight gain, moodiness/depression, loss of desire/drive, irritability, loss of muscle volume and strength, loss of energy, sleeping problems, and erectile dysfunction/loss of sexual desire. The most frustrating issue for me is not only the shocking level of misinformation about what low testosterone is and how to correct it, but the lack of doctor/patient education within the medical community. Chronic low testosterone is a serious medical condition that if not treated properly can increase mortality by 50%! Low testosterone is associated with metabolic syndrome (hypertension, high cholesterol), type 2 diabetes, cancer, cognitive decline, and cardiovascular disease.
If you suspect that your testosterone level is low, get a medical evaluation and have blood work done to determine both bound and free testosterone. If you have low testosterone or test out of the clinical reference range you will need to talk with your doctor about bioidentical testosterone replacement therapy. While there are lifestyle changes and nutritional products that may affect testosterone, they may not be strong enough to stimulate normal testosterone biosynthesis, especially if you have been diagnosed with hypogonadism. There are plenty of Internet scams, unreputable health stores, and greedy marketers that would love to sell you a testosterone enhancement supplement. More than likely it will not raise testosterone levels high enough to be clinically significant.
There is a lot of misinformation about prescription testosterone and prostate health. The majority of research suggests that testosterone replacement therapy does NOT cause prostate cancer in a healthy prostate gland. In fact, Dr. Morgentaler, an associate professor at Harvard Medical School suggests that low testosterone may increase the risk of developing prostate cancer.
With that said, I understand there are men who don’t want to take prescription testosterone and/or don’t think a medical evaluation is necessary even though they are presenting with common symptoms of hypogonadism. If you want to try a nutritional supplement some are more evidence-based than others, so here is a list of nutrients that have demonstrated some effect on testosterone level:
1) ZINC – Required for testosterone metabolism. Studies have shown an increase in sperm count and testosterone.
2) FENUGREEK – The proprietary extract Testofen has been shown in some studies to boost libido and testosterone levels.
3) TRIBULUS – Some clinical evidence that it may raise testosterone level.
4) TONGKAT ALI (Eurycoma longifolia) – This Malaysian adaptogen has been shown in some studies to stimulate the production of androgens.
Regardless of which approach you take your goal should be a level of testosterone that is within the clinical reference range. Living with low testosterone should not be an option. Your physical and psychological health will suffer.
Michael Chase, MS, NTP
Nutrition Science and Dietetics