|
New From Dr. Lam!
Click here! |
 Video Channel my new Video Channel  |
|
Related Links
|
|
Client Reviews Actual Adrenal Fatigue Sufferer Talks About Recovery With Dr. Lam |
|
Have a Health
Question? Ask Me For Free! |
   |
|
Need to Know
|
Table of Contents
- Introduction
- Male Reproductive System
- Symptoms of Andropause
- Reproductive Capacity
- Mechanism of Andropause
- Other Hormone Deficiencies
- Andropause Treatment
- 1. Testosterone Replacement Therapy (TRT)
- 2. Growth Hormone (hGH)
- 3. DHEA
- 4. Pregnenolone
- 5. Melatonin
- 6. Normalization of Hypothalamic Function
- 7. Other Male Reproductive Enhancers
- 8. Prostate Protection
- 9. Nutritional Supports
- 10. Diet
- Summary
Reading Tips:
For fast reading, scan through the topic headings in BOLD BLACK, important conclusions in BOLD BLUE, and "Must Know" in BOLD RED. To jump to specific sections in this article, click on the respective LINKS in the Table of Contents.
Information presented here is for general educational purposes only. Each one of us is biochemically and metabolically different. If you have a specific health concern and wish my personalized nutritional recommendation, write to me by clicking here.
Andropause
www.DrLam.com
"Midlife crisis" -- this is often the transitional period for men when they experience what is termed as the "second childhood". This period usually starts from age 40 to 45. It is also called andropause or male menopause because its symptoms coincide with the decrease in a class of male hormones called androgen. All men are affected, although some to a larger degree than others. A thorough knowledge of the underlying hormonal and physiological changes will better prepare all males to deal with this phase of life.
The male reproductive regulatory system consists of four components:
- the central nervous system (CNS) including the hypothalamus
- the pituitary gland
- the testes; and
- the end organs where testicular steroids act.
The master control starts in the hypothalamus where gonadotropin-releasing hormone (GnRH) is synthesized and is released in a pulsatile fashion into a vascular network that connects the hypothalamus to the pituitary gland. GnRH production and release is controlled by numerous neurotransmitters, including norepinephrine, dopamine, and endorphins. GnRH regulates the release of two pituitary hormones - the gonadotropins - luteinizing hormone (LH) and follicle-stimulating hormone (FSH) in a pulsitile fashion. LH regulates the production and secretion of testosterone by the Leydig cells of the testes, and FSH stimulates spermatogenesis.
Testosterone circulates in the blood in several forms. It can be bound to both albumin and sex hormone-binding globulin (SHBG) where it is referred to as "bound testosterone." This is the least active form. It can also circulate in a free (unbound) form, which is considered the most active.
Testosterone can exert its effects directly on the testosterone receptors in cells. It can also be converted to two active metabolites - dihydrotestosterone (DHT) through the enzyme 5 alpha reductase, or by the enzyme aromatase to estradiol.
Testosterone, together with its metabolites, is collectively known as androgens. As a group of steroid hormones, they stimulate the development of masculine characteristics and are responsible for male puberty characterized by deepening voice, broadening shoulders, and moustache growth. The hallmark of andropause is declining testosterone levels.
Testosterone levels begin to decline with age after maturation. This is accompanied by the concurrent appearance of a myriad of related physiological changes commonly associated with aging. These changes include diminished libido, reduced frequency of sex (the "senior slump"), erectile dysfunction, infertility, changes in body composition, reductions in body and facial hair, and osteoporosis. Andropause is in effect the reverse of puberty.
In addition, mood inventory scores indicate that during andropause, men report levels of anger, confusion, depression, and fatigue that are significantly higher than those reported by men with normal testosterone levels. The average human male begins to feel some symptoms of andropause after 40 to 45 years old, which is followed by rapid deterioration after the age of 50.
Many of the symptoms accompanying the andropause and the aging processes in men are similar to those of hypogonadism. We can attribute at least some of these symptoms to a decrease in testosterone levels, including:
- Sexual Functions. Coital frequency declines rapidly with age from a mean maximal coital frequency of about 4 times per week at age 25, to once a week at age 50, 3 times a month at age 70, and 1.7 times a month between the ages of 75 and 79 years. Impotence also increases dramatically with age. It is rare before the age of 30. It is observed in 8 percent of people over 50 years old, 20 percent of those over 65 years old, close to 40 percent for those who are 70 years old.
- Body Composition. The amount of lean body mass in the sedentary person decreases by approximately 10 percent for every decade after the age of 30. You could have lost 30-40 percent of your lean body mass by age 60. Aging is accompanied by a decrease in lean body mass (LBM) and a concurrent significant increase in fat mass. Although aging itself is an important determinant of body composition, plasma total testosterone levels are not correlated to fat mass, regardless of age. The decrease of muscle mass is highly correlated to free testosterone levels, which persists after correction for age. Testosterone supplementation increases muscle mass.
Aging males, like hypogonadal men, accumulate preferentially visceral fat. This accumulation is a major cause of insulin resistance and the atherogenic lipid profile. This suggests that obesity in elderly men is a more important health hazard than in young men. Contrary to popular belief, clinical trials have shown that a low androgen status increases the risk of coronary artery disease (CAD) or atherosclerosis. It was previously believed that testosterone and other androgens had the opposite effect since men have higher rates of heart disease generally than women. Researchers now find that low androgen levels were associated with an increased incidence of CAD. Men with CAD had a 22 percent lower 'free androgen index'.
While decreased free and total testosterone levels can lead to increased fat mass, it could also be suggested that the decrease in testosterone levels in the aging male is the consequence of an increase in fat mass. In other words, there is a likely bi-directional relationship, the exact mechanism of which is still not fully known. Obesity is a multi-factorial disease that also includes genetic, social and psychological factors.