Male menopause: fate or opportunity?

Norbert Lindner, Naturopath, Zeuthen, Germany

Ladies and Gentlemen,

I am especially pleased to be able to talk to you today about a subject that has interested me personally for some time. We should perhaps think about whether only the men should be allowed to listen from this point, for the male menopause has been something of a closely guarded secret in the past.

But be prepared for your wife giving you a gentle nudge and saying she’s known about this all along!

The male menopause presents us with some difficulties, which we will examine in more detail over the next 30 minutes.

The male menopause (andropause) is the term used to describe a progressive, relatively slow and only partial decline in androgen secretion and concentration levels in men. This involves the sex hormones pregnenolone, dehydroepiandrosterone (DHEA), androstenedione and, in particular, testosterone, 95 % of which is formed in the testicles and 5 % in the adrenal glands.

The andropause is also referred to as PADAM – partial androgen deficiency in the ageing male. This is a natural ageing process, which in some men, however, can go hand in hand with a gradual impairment in sex drive, mood and energy. As with women, the andropause in men starts at a time of life which often comes with its own major challenges.

The andropause starts between the ages of 45 and 65 years.

Serum testosterone levels of the adult male lie between 12 and 40 nmol/l (3.6 to 12 ng/ml). Biologically active testosterone falls by about 1 % from the age of 25. By the age of 60 – 70 the hormone levels fall to approx. 40 – 50 % of what they were in younger years. Where the value falls below 12 nmol/l (3.6 ng/ml), this is an indication of a partial androgen deficiency.

Testosterone performs quite specific tasks:

Muscles: Strength, growth
Bone: Bone growth and closure of the bone plate at the end of puberty
Bone marrow: Blood production
Larynx: Breaking of the voice
Brain: Mood, mind, libido
Skin and hair: Beard growth, body hair,oily skin
Internal organs:

Liver: Protein synthesis
Kidneys:Messenger substance for blood production

Sex organs: Sexuality and fertility

Ladies, consider this, you too have the hormone testosterone.

Testosterone strongly influences our behaviour and the fight or flight decision. Eat or be eaten. First it was the mammoth, then came wars where men were required to fight in battle, while today our fight is with our boss, our partner, everyday stress, environmental stresses or the tax office.

The testosterone level in the blood of an adult man undergoes diurnal variations. In the evenings between 18.00 and 22.00 the values are at their lowest and early morning they are 35 % above the average values. A sign of the morning peak “value” is for instance the frequently occurring spontaneous morning erection.

First problem

Testosterone concentration is the only measurable parameter to test for the andropause. However, testosterone concentration varies considerably in young men. An important question here is also where to set the limit for a pathological testosterone level. Also the threshold beneath which clinical symptoms occur can vary considerably from one person to another.

There are too many individual differences. Some men at 70 still have normal testosterone levels and are still fertile at a very old age. Other men as early as 50 show clear signs of a lack of testosterone. These differences are partly genetic. But many other external factors have an effect on hormone production. Unlike women therefore not all healthy men suffer from a hormonal imbalance as they get older.

In the following you will find an overview of the typical symptoms of the andropause. As I already mentioned, the andropause often starts at 45. In the following list you will find many symptoms which are not always immediately diagnosed as the “early (male) menopause”. However, it is very important to consider the change of life and an appropriate hormone therapy when a 45yearold man presents with high blood pressure.

Organic disorders

Decreasing performance
Decrease in testicular volume
Decline in libido/loss of libido
Problems maintaining an erection (erectile dysfunction, ED)
Increase in body weight with increase in body fat
Declining muscular strength
Dry and rough skin
Joint, skeletal and muscular pain
Anaemia
Angina pectoris (chest discomfort)
Decline in the performance of the immune system
Lowered cognitive function
Loss of body hair
Reduced beard growth
Gynaecomastia
Reduced efficacy of endogenous insulin in target organs
Metabolic syndrome
Increase in visceral fat
Osteoporosis (bone loss)
Sarcopenia (agerelated excessive loss of muscle mass and muscular strength)
Vasomotorvegetative disturbances
Hot flushes and sweats
Circulatory problems
Emotional disorders
Reduced self esteem
Increased irritability
Chronic fatigue
Insomnia (sleep disturbances)
Motivational disturbances
Depressive mood
Poor concentration
Poor memory
Mood fluctuations
Fatigue (exhaustion)
Aggression

Second problem

Please note that no man comes into my practice saying: “I am no longer a man” or “Sexual feelings elude me.”

His manhood is essential for survival. He wants to demonstrate to himself and others that he is still the leader and is still in charge. Showing signs of weakness means being knocked off your perch by “young bloods”.

We know this time as the “Midlife Crisis”. The “Man” gets himself a tattoo, buys a sports car or a Harley. Some men leave their wives and find a 30yearold partner just so they can say to other men: “Look I can make a young woman happy, I’ve still got it.”

In the animal kingdom a younger male will often challenge the pack leader to a life or death struggle in order to wrest control from him, yet today we men need to understand and realise that becoming older and weaker is not so terrible nor does it mean that we are any nearer to death.

This is however the most difficult challenge for a man during the years of change.

Triggers for the andropause

If we consider the triggers for the andropause, then you will see at which points therapy can start.

Biographical causes

Age – with advancing age the level of biologically active (free) testosterone falls. Hormonal disturbances with primary hypogonadism – diseases which are associated with a lack or deficit of testosterone, e.g. lack of testosterone in the case of congenital anorchia (absent testicles).

Behavioural causes

Nutrition
Continuous fasting or constant dieting
Malnutrition
Vitamin and mineral deficiency (micronutrient deficiency)
Tobacco consumption
Alcohol
Physical activity
Lack of physical training

Psychosocial situation

Stress
Longterm exhausting work,
(“Burnout syndrome”)
Drug abuse

Heroin
Marijuana
Amphetamines

Android body fat distribution
This means: abdominal body fat concentrated around the middle and the trunk, (apple shaped); this leads to a drop in free testosterone Overweight (BMI ≥ 25; obesity)

Diseaserelated causes

Arteriosclerosis
Diabetes mellitus
Chronic infectious diseases
Chronic obstructive pulmonary disease (COPD)
Moderate to severe dialysisdependent final stage kidney disease
HIV / AIDS with sarcopenia (loss of musculature)
Liver diseases – hepatic steatosis (fatty liver), cirrhosis of the liver
Secondary hypogonadism – e.g. in cases of anterior pituitary insufficiency

Medicinal products

The following medications inhibit the production and action of testosterone:

Antihypertensives for high blood pressure
Chemotherapy drugs such as Vincristine, Methotrexate and alkylating agents
Hormones such as:
Anabolics
Cyproterone acetate
Glucocorticoids
Opioids
Psychotropic drugs

Other

Anorchia (congenital, acquired; lack of or complete nonfunctioning of both testicles)
Radiotherapy (radiation therapy)
Trauma

Below are the most important diseases or complications which may be caused by the andropause:

Arteriosclerosis
Cardiovascular disease – myocardial infarction, stroke
Arterial hypertension
Heart failure
Insulin resistance – type II diabetes mellitus
Metabolic syndrome
Dyslipoproteinaemia
Osteoporosis
Immunosenescence (change of the immune system in old age)
Malignomas

Third problem

Women consult the doctor 150 % more often than men, although men cost the health care system more because they often present in the later stages of a disease. Women go to the doctor for preventative reasons, men go for “repair”.

It is important to accept that you no longer have the physical ability you had when you were 25. Our wives could write a book on how difficult it is to motivate us men to go to the doctor. “It will go of its own accord” or “It’s nothing” are often our answers. It is also not at all acceptable to show weakness.

What can we do?

Please don’t just think in terms of Viagra. We’ve all seen the TV adverts showing an older man putting Viagra into the fuel tank of a car by mistake and the car suddenly becoming bigger and more powerful. This option helps but should not be the only therapy.

In Japan there is a special testicular massage which is meant to increase testosterone production into old age. You can of course google this therapy.

Effects of testosterone substitution

A direct comparison of the data from current studies of testosterone substitution is difficult because different base testosterone levels are defined as the substitution threshold value and they all apply different doses, different testosterone derivatives and different methods of application.

BEWARE: No testosterone substitution may be given where prostate cancer is present.

Suitable nonpharmacological measures: Nutritional optimisation (avoidance of animal fats)
Reduction or doing without luxury foods
Tobacco / alcohol / caffeine
Increase physical fitness
Improve sleep hygiene
Reduction and management of stress
Reduction of individual risk factors (Changes in behaviour)
Reduction in environmental toxins (ozone, formaldehyde, pesticides, insecticides, mercury etc.)
Balancing any deficiency in vital substances
Fundamentally therapy is a comprehensive holistic therapy which results from the list of non-pharmacological measures. Of course treatment of the glands, hormone regulation and applying testosterone are paramount.

To this end you will find in the second channel a substance complex for lack of testosterone, please let this run throughout the whole therapy time.

Recommendation for therapy without testing

I have had good experiences with two program series. As a general detoxification I use series 10046 with a program for the liver, the kidneys and lymph activation, which I run after the conductance reading and the basic program. After the third treatment I use program series 10179 for menopause complaints. Besides hormones, this series also includes toxin elimination, metabolism therapy and a program for activating vitality.

This program series 10179 is top priority when treating the change of life in men and women.

Recommendation for therapy with testing

Of course I use basic therapy here too and open the eliminating organs. An important step, however, is the test for “hormonal disorders”. I run a full test for this category and make a note of the programs.

From this I create an individual therapy plan, with the focus on hormone treatment. However, I must admit that the 10179 series is very effective and when testing I often only need to supplement programs in isolated cases.

Please don’t forget channel 2. Here you will find more programs to combat hormone deficiencies.

In my practice giving minerals has also proved its worth, and I make these separately from the channel 2 substance complex “Lack of testosterone”.

I hope my presentation has given you some insight into some of the “difficulties facing older men” and thank you for listening today.