Times change and people change. Baby-boomers are resisting the effects of aging as no age group ever has before. People are living longer and expect far more from the "golden" years than did their parents. Men are now freer to discuss their sexual performance problems with their doctors, wives and friends without fear of being ridiculed or ignored. New treatments introduced over the last few years have also made doctors more willing to bring up the subject of Andropause and its symptoms with their patients.

Click on the Articles to the right for more information

Men "of a certain age" who are feeling less than their best should talk with their doctors about their symptoms. A complete medical examination that includes laboratory tests can determine if there are imbalances in male hormones. If low DHEA or testosterone is the cause of their symptoms, men will not have to wait long to feel benefits of treatment.

Top 10 Signs of Andropause - the male menopause:
• Irritability
• Sleep problems
• Diminished libido
• Erectile problems
• Muscle loss • Weight gain
• Memory loss
• Thinning hair
• Decreased bone density
• Depression

Fatigue, loss of a sense of well being -- 82%
Joint aches and stiffness of hands -- 60%
Hot flashes, sleep disturbances -- 50%
Depression -- 70%
Irritability and anger -- 60%
Reduced libido -- 80%
Reduced potency -- 80%
Premature aging
Changes in hair growth and skin quality

Sounds familar..... for women at midlife..... it is the same condition because the relationship between the ovaries, estrogen, the brain, and the pituitary are exactly the same as the relationship between the testis, testosterone, the brain, and the pituitary. Acute andropause in men is relatively uncommon, compared to acute menopause in women, because testicular function declines gradually in most men.

Since it occurs gradually it is often confused with male midlife psychological adjustment disorders because it exactly mimics depression in midlife men. Male hormones decline gradually. Testosterone (from the testis), human growth hormone (from the pituitary), and DHEA and androstenedione (from the adrenal gland) all begin to drop. For many men, this does not occur until their 60s or 70s but there are many instances where it occurs much earlier. In addition, there is proteins in the blood which bind testosterone in a biologically inactive form. These are called sex human binding proteins or globulins. Their levels can rise in response to many conditions including medical disorders and exposure to other hormones including phytoestrogens (estrogens derived from plant sources such as soy) and other environmental estrogen -like compounds (pesticides, hormones used in agribusiness to produce fatter animals, etc.) As an example, there is some data suggesting that men on low fat or vegetarian diets have lower testosterone levels. The overall effect of rising sex hormone binding proteins is that there is less bio-available testosterone.

The evidence is out this Syndrome Does Exists

First, men need to disassociate their ego from their testicles. Men need to realize and accept that this disorder exists, that it is a simple endocrine problem which is no different than thyroid disease or diabetes, and that it can be treated. Spouses and employers also need to be aware that this is real so they can identify these men at risk early before their work, home, and families are disrupted. Perhaps, more important, physicians, psychologists, and other health providers need to be taught about this condition. The current paradigm in medicine is that there is no biological basis for behavioral changes in midlife men so it is ignored. But the diagnosis is quite simple--namely measuring either free testosterone blood levels.

NORMAL ANDROGEN LEVELS mean range
Free testosterone -- men 700 ng/dl 300-1100
Free testosterone -- women 40 ng/dl 15-70
Free Androgen Index 70-100%

At a free androgen index less than 50% , symptoms of Andropause appears. Of course, good medical care dictates that a comprehensive medical and psychological assessment along with a thorough laboratory assessment are necessary.

The gradual decline, most often fully realized between the ages of 50 and 55, can produce a variety of changes and effects on the male body:

Erectile dysfunction (problems with erections)
Decreased libido (low sex drive)
Mood disturbances, including depression, irritability and feeling tired
Loss of muscle size and strength
Osteoporosis (bone thinning)
Increased body fat
Difficulty with concentration and memory loss
Sleep difficulties

Male Menopause or Andropause?
This syndrome has been nicknamed ADAM, which stands for androgen deficiency of the aging male. It differs most markedly from female menopause in the speed with which the symptoms occur. In women, the menopause (which means the ceasing of menses or periods) is a universal and comparatively sudden change. In men, the change is much more gradual and difficult to pinpoint. This difference suggests that referring to the syndrome in men as "male menopause" is not accurate and we prefer the term andropause.

Shocking as it may be to some men, male menopause, or andropause, is becoming more widely recognized and accepted by physicians for the changes many middle-aged men experience — from energy loss to depression to loss of libido to sexual dysfunction.

The changes that andropause wreaks in aging men may seem like they are going through a "mid life crisis". They have a far reaching impacting on middle aged men in the areas of "hormonal, psychological, interpersonal, social, sexual and spiritual areas."

Andropause is characterized by a loss of DHEA or testosterone — the hormones that make a man a man. Most men see testosterone levels drop as they age. However, some men are impacted more than others are. Dr. Rispoli says that as many as 25 million American males between ages 40 and 55 are experiencing some degree of male menopause today.

"Male Andropause can be very insidious," explains Dr. Rispoli, a Nutritionist who specialises in Anti-aging and natural hormone balancing. The loss of testosterone, which can happen to men as young as 35, is gradual, with testosterone levels dropping just 1 percent to 1.5 percent annually. Unlike the precipitous loss of estrogen that women hitting menopause face, the gradual loss of testosterone may take years to exact its mark on men with a host of symptoms not unlike changes menopausal women experience.

What Are The Hallmark signs of Andropause?
Irritability, fatigue, depression, reduced libido and erection problems. "I had no desire for my wife and felt depressed with no energy. I almost ruined my marriage because I thought A younger woman could awaken me sexually. I was wrong" said the 58-year-old handyman, who discovered via a blood test nearly four years ago that his DHEA levels and testosterone levels were low. The test literally saved his marriage and a lot of embarrassment!

Typically, men suffering from the symptoms of Andropause are treated for a specific medical condition. And therein lies the problem, says Rispoli. For example, an Andropausal male may be diagnosed with depression and prescribed an antidepressant, and both doctor and patient think the man's problem has been addressed. However, if that man has other symptoms of male menopause such as loss of libido, the antidepressant will only exaggerate that problem.

A holistic approach vs Conventional Therapy

Rispoli advocates a more holistic approach to Andropause, to address all of the symptoms. This may include holistic counseling, herbs, diet and exercise. Natural Hormone replacement and hormone precursers are often all that is needed without the nasty side effects and risks of synthetic hormone replacement.

Pros and Cons of Testosterone Replacement

Testosterone replacement therapy is the primary means of treating men with declining levels of testosterone, and this is still a controversial area. "What are the problems faced and can they be treated with testosterone? That's where the question lies," Dr. Rispoli says.

Instances where testosterone replacement therapy is advised, Rispoli says, include men with clear bone density loss, which can lead to osteoporosis and decreased height, and in treating sexual dysfunction in cases where Viagra or other often prescribed remedies don't work. Another area of possible benefits of testosterone therapy may be in cases to maintain body composition and muscle — for instance, in patients fighting cancer.

Specialists say that men considering testosterone replacement therapy—whether by injection, patches, cream, gel or oral form—should get their PSA levels checked as testosterone replacement therapy could increase the risk of prostate cancer. (A PSA blood test identifies a man's risk for prostate cancer.) Other risks associated with hormone supplementation, particularly with injections, include the risk of stroke, an increase in liver toxicity and breast development. Ironically, testosterone supplementation also shuts down the production of sperm, Werner says.

Dr. Rispoli also advises her male clients suffering from the symptoms of Andropause to cut out alcohol from their diet and increase exercise. The aromatase enzyme is also turned on by alcohol and fat, so men with declining levels of testosterone are particularly vulnerable.

To help increase testosterone production, Rispoli, Founder of Complete Health in Agoura California suggests men take zinc and vitamins C and E. Rispoli also suggests herbs, such as muira puama, and L-arginine to increase a man's libido.

Loss of libido, for example, can be treated with the vasodilator ginkgo biloba, suggests Rispoli. For men hitting midlife, Rispoli recommends, eating soy products, lower fat foods, cruciferous vegetables and tomato products, the last of which can reduce the risk of prostate cancer. Drinking plenty of water is a key component for healthy living.
Rispoli does a blood screen for all her male patients older than age 50 to check their hormone levels.

Which hormones do we test?
Testicular Hormones - What makes you a man
• Testosterone - The total amount in your system, including how much is actively available to your body
• Dihydrotestosterone - The total amount of used testosterone in your body
• Estrogen - To make sure it’s not too high
• PSA - Prostate specific antigens – your prostrate health
Adrenal Hormones - Your immune system, your energy level, and your ability to handle stress
• Cortisol – the stress hormone
• DHEA – the “mother of all hormones”
Thyroid Hormones - Your metabolism
• TSH – Thyroid Stimulating Hormone
Your Body's System
• Prolactin and Luteinizing hormone
• Complete blood count, complete metabolic profile, Hemoglobin A1C, Insulin and Lipid Panel
• Zinc and Vitamin D

Other Hormone Tests - The physician may suggest other tests for you

Teresa Rispoli Founder of Complete Health in Agoura Hills, has a Ph.D. in Nutrition and has been in clinical practice for 25 years. To contact her for an appointment call (818) 707-3126.

Call to set up a nutritional consultation so that tests can be performed and a comprehensive strategy of lifestyle, dietary modification and nutrient supplementation can be implemented to aid you in reversing this disorder.

For an appointment, contact our office at: 800-956-7083 and visit our web site www.completehealthinstitute.com go to lab tests and click on appropriate test for information.

Dr. Rispoli, Ph.D., L Ac. has had a clinical practice for over 20 years. Her programs work because she is so thorough in testing and providing a nutritional approach. Remember that the body can heal itself if given the proper nutrients.

The information herein is not intended as diagnosis, treatment or a cure. Should you have a medical condition please seek the advice of your medical doctor.