Andropause: Diminishing Male Hormone Production

Andropause is the natural decrease in the production of male sex hormones as men age. It is less well known than menopause because the onset and progression are more gradual and because there are fewer overt symptoms. Men continue to experience normal sexual function and are even fertile late into life, so little thought has been given to the effects of diminishing male hormone production until recently.

Testosterone, DHEA and the testosterone/estrogen ratio are important aspects for understanding andropause.

Testosterone

Testosterone is the most important male hormone, and it is produced in tissues all through the body. Testosterone is necessary for male sexual development and function, and is also needed by both men and women for muscle development. Vitality, energy, aggressiveness and competitiveness are also associated with testosterone.

With aging, male hormone production by the testes declines. This tends to cause a decrease in muscle mass and an increase in fatty deposits. Obesity becomes more common as men age. Diminishing testosterone levels may also be associated with metabolic syndrome, cardiovascular disease and other diseases of aging.

DHEA

DHEA is a steroid secreted by the adrenal glands that is a precursor to both estrogen and testosterone. DHEA levels also decline with aging, so there is less of it available for testosterone manufacture. Supplementing DHEA can sometimes normalize testosterone levels.

Testosterone/Estrogen Ratio

Men also secrete estrogen, and one tissue that is active in estrogen production is fatty tissue. As testosterone levels decrease, more fat is deposited, so more estrogen is produced. That changes the testosterone/estrogen ratio and initiates the hypogonadal/obesity cycle. Insulin resistance and elevated blood cholesterol levels may also occur as male hormone levels decline.

Treatment

Treatment for andropause involves replacing the male hormones. Testosterone is usually replaced, but sometime HCG (human chorionic gonadotropin) is used to stimulate natural male hormone production. Other hormones that may be replaced are DHEA, estrogen and human growth hormone.

If a man has prostate cancer, taking testosterone may make the tumor grow rapidly. Prostate cancer is the most common cancer among men, so it is important to make sure it is not present before beginning male hormone replacement. Most physicians monitor PSA (prostate specific antigen—a marker for prostate cancer) regularly while you are taking male hormones.

Andropause can be as distressing for men as menopause is for women. Male hormone replacement helps many men continue to feel well later into life, and may prevent some of the diseases of aging caused by declining hormone levels.