Mens Health - Andropause, Impotence, Prostate Problems, Hair Loss

Male Menopause/Andropause

Normal male aging is accompanied by a decline in testicular function resulting in a fall in serum levels of free testosterone. Around the age of 40 the level of free testosterone begins to decline about 1% a year. Age related decreasing levels of free testosterone and/or increasing estrogen levels may cause a deficiency known as Andropause or “male menopause”.

The reasons why free testosterone levels decline with age include:

A protein called SHBG (Sex hormone binding globulin) rises as we age and more testosterone is bound up to it, reducing the amount of free and available testosterone.

More testosterone may be converted into estradiol (an estrogen) by an enzyme called aromatase which susequently may then be converted into another estrogen called estrone. Estrone is the strongest of all estrogens and tends to accumulate in the body. Increasing estrogen levels negatively feeds back onto the brain slowing down further testosterone production.

More testosterone may be converted into dihydrotestosterone (DHT) by an enzyme called 5 alpha reductase.

Less testosterone is made by the aging testicles.

Symptoms of Andropause include: decreased libido, erectile dysfunction, ejaculatory problems, decreased energy and strength, increase in body fat, loss of muscle mass, prostate enlargement, osteoporosis, depression, inability to concentrate, reduced mental agility and loss of enthusiasm.

Men with low testosterone levels also tend to have these heart disease risk factors: angina, atherosclerosis, diabetes, high blood glucose, high cholesterol, high triglycerides, high blood pressure, high level of blood clotting factors, low blood clotting inhibitors and a high body mass index.

Unfortunately for many needlessly suffering aging men traditional orthodox medicine denys the very existance of andropause. There are thousands of men in this country alone that have been treated for andropause and experienced a significant improvement in all their symptoms which will all testify to its very existance, not to mention hormone test results supporting a significant decline in normal hormone levels.

Testosterone deficiencies do not only occur in aging men and are occasionally seen in younger men also. This may be due to a variety of reasons including:

Adrenal exhaustion results with a decrease in DHEA production which in turn reduces testosterone production.
Xenoestrogens - exposure to estrogen like pollutants in the environment such as certain pesticides (DDT, DDE), petrolum based chemicals (PCB's, benzene), plastics (PVC), metals (cadmium, arsenic) and hormones from food sources may all cause a negative feedback in the brain which in turn reduces testosterone production.

There is no need for men to suffer through these mid-life changes and learn to live with it as they are all too often told by their doctor as Individualised Bioidentical Hormone Replacement Therapy (IBHRT) is able to effectively treat all these symptoms and may potentially prevent long term consequences of hormone imbalances. The approach taken in IBHRT is to formulate an individualised bioidentical hormone combination in doses that achieve optimal physiological hormone levels in each individual.

For more in depth information on the appropriate tests required for an accurate diagnosis and details on various treatment options for this condition you are required to log into the free members section of this website in order to comply with advertising laws.

Erectile Dysfunction

Erectile Dysfunction (ED) or male impotence is the inability to attain or sustain an erection satisfactory for sexual intercourse. Surveys show at least 30% of men over the age of 50 have ED although it is not inevitable with age. ED may be caused by several factors:

Psycological factors such as fear of intimacy, depression, low self esteem and stress. Psychic factors are implicated if the patient has situational ED, has morning erections, or can achieve a firm erection with masturbation. This type of ED can usually be treated by receiving some form of counseling.
Disease factors such as metabolic syndrome, diabetes, high cholesterol, heart disease, vascular disease, neurological damage, following certain surgical procedures and the use of certain drugs such as antidepressants, tranquillisers, amphetamines, antihypertensives, opioids, alcohol and tobacco.
Hormonal factors such as low testosterone levels, high estrogen levels, high prolactin and thyroid disease.
Pyronies Disease - curvature of the penis reducing circulation.

Age related ED is just one symptom of a larger syndrome known as andropause or male menopause. This syndrome is caused by decreasing levels of free circulating testosterone and/or increasing estrogen levels. Symptoms include: decreased libido, erectile dysfunction, ejaculatory problems, decreased energy and strength, increase in body fat, loss of muscle mass, prostate enlargement, osteoporosis, depression, inability to concentrate, reduced mental agility and loss of enthusiasm. Testosterone plays a fundamental roll in producing erections, but it is not the whole story. An adequate penile blood supply, neural control, and the presence of two erection building chemicals (nitric oxide and cyclic GMP) are also essential. Boosting testosterone levels can restore libido (sex drive) in men whose testosterone output is deficient. It can also restore their ability to achieve and sustain an erection.

Treatments for ED can include penile injection drug combinations, lozenges and/or nasal sprays.

Prostate Health

Benign enlargment of the prostate gland effects most men over the age of 60. Those afflicted with benign prostate hyperplasia (BPH) have trouble urinating and voiding and are overly sensitive to any residual urine left in the bladder resulting in a feeling that they have not completely emptied their bladder. Men with BPH are also at a higher risk of developing prostate cancer.

According to conventional views BPH/prostate cancer develops due to the presence of a metabolite of testosterone known as dihydrotestosterone (DHT). Testosterone is converted into DHT by an enzyme known as 5-alpha-reductase. When DHT binds to receptors in the prostate gland it activates growth factors that stimulate cell proliferation. Although this is the most widely accepted theory there is insufficient scientific evidence to support it in its entirity. If indeed this was the case we would expect the highest incidence of prostate problems to occur when either testosterone levels were at their peak (ages 18 to 25) which is obviously not the case, or alternatively when DHT levels rise. There is no evidence which suggests an increase in 5-alpha-reductase activity occurs with the aging process as DHT levels remain fairly constant throughout life for most men. This theory therefore does not adeqately account for an increase in prostate problems with age.

Recent evidence and a new emerging theory suggests estrogen dominance may be responsible for BPH/prostate cancer, not DHT as previously believed. It is accepted fact that as men age their testosterone levels decline reducing their testosterone/estrogen ratio thus allowing estrogens to adhere to receptors on the prostate due to a lack of competition with testosterone causing prostate growth. In addition German researchers have clearly documented a dramatic, age-related accumulation of estrogen in human prostate glands. This work correlated age, estrogen accumulation, and the presence of benign prostatic hypertrophy. This finding highlights the role of estrogen as a growth promoting hormone in prostate. Recent work also shows that estradiol provokes increases in prostate specific antigen (PSA) production in human prostate tissue. This increase in PSA is as great as that seen with testosterone. In addition it was found that PSA production was specifically inhibited by 2-methoxyestradiol, the beneficial estrogen metabolite whose production is promoted by DIM (see below).

In addition recent research findings also suggests that prostate cancer may be caused not by the estrogens themselves but by one of their metabolites. Research on the minor metabolites of estrogens, specifically the metabolites 2-hydroxyestrone and 16-alpha-hydroxyestrone has revealed the 2-hydroxyestrone metabolite is a "good" estrogen, while the 16-alpha-hydroxyestrone metabolite is a "bad" estrogen because it tends to damage DNA and cause abnormal cellular proliferation. In a variety of animal models, it is definitely associated with a higher risk of cancer and with the progression of that cancer. In these same animal models, if the proportion of 16-alpha-hydroxyestrone can be made to go down and that of 2-hydroxyestrone to go up, the incidence of cancer is reduced.

At this stage until more research is done to determine a definite cause BPH/prostate cancer should be considered to be the result of possibly a combination of increasing DHT levels, estrogen dominance and unfavourable estrogen metabolism. In addition an age related decline in progesterone levels may cause an increase in DHT in some men as progesterone is a potent 5-alpha-reductase inhibitor.

The treatment of BPH should include regulating hormone levels and estrogen metabolism in conjunction with ceratin beneficial supplements.

Hair Loss

95% of people who suffer from hair loss have androgenic alopecia. In men, the pattern of hair loss usually starts with thinning on the crown or a receding hairline which advances to the top of the head. In women, it appears as diffuse hair loss or thinning over most of the scalp.

The cause of androgenic alopecia is due to the presence of the hormone dihydrotestosterone (DHT). DHT is produced by the enzyme 5-alpha -reductase which converts testosterone to DHT. Inhibiting the action of this enzyme prevents DHT production and therefore treats the cause of hair loss which has become the focus of much research on hair loss. Excessive DHT is thought to cause hair follicles in specific areas to begin to change to smaller less active ones. The hair shaft narrows, producing progressively finer hairs with each new growth cycle until eventually the hair becomes transparent and does not emerge.

Hair loss treatments can involve using certain scalp lotions which promote hair growth and prevent DHT formation in the hair follicle. We provide a range of scalp lotions at a fraction of the price of those offered by certain hair loss clinics in this country.

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