If you remember last month's newsletter, Stephanie did
an article about female menopause. Well, we did not want
the guys to feel left out, so this month's articles are
about men's health. Yes, we do believe it is only fair
that they have equal time.
Dr. Mark Force submitted the first article, "The Measure
of a Man: Female Hormones?". In it, Dr. Force discusses
the significance of men being aware and maintaining
balanced hormone levels.
The second topic, continues the discussion with a detailed
explanation of "The Reality of Male Menopause". Is
there such a thing, or is it a myth? Do men actually
have physical symptoms (including hormonal changes) and
psychological symptoms (good 'ol mid-life crisis) that
reflect the aging process?
Interestingly enough, as I began researching this topic,
the majority of my tried and true resources had oodles
of information on women's menopause, and either very
little or no information on male menopause (also called
viropause or andropause).
My reaction, of course, was "hey, come on world!" After
all, the guys need some consideration, too - and with
all the baby boomer, "mid-life" men that all of a sudden
have the proverbial new "Harley" in the garage, or worse
yet, the new "woman" on the arm, seems that we could all
have more information and understanding of changes a man
goes through, as he approaches middle age and beyond.
Now, last month Stephanie told the men not to run away
from the article on female menopause, because women need
the support and understanding from the men in their lives.
In turn, the women need to provide the same support and
understanding for their men. So, women hang in there.
I promise you will find these two articles on male
menopause very informative.
Men, your masculinity is under assault. You are being
poisoned from all around you, and there is no way that
you can escape it. Infertlity, low sperm counts, lack
of libido, fatigue, impotence, prostate disease, lack
of muscle tone, and holding too much body fat; all of
these symptoms may have a common cause.
Plastics and pesticides have compounds in them called
xenobiotics that act like estrogen in your body. And,
they're everywhere! You can't get away from them, but
you can protect yourself from their effects.
So, check your estrogen (and DHEA, testosterone, and
progesterone). The balance between your body's
testosterone and estrogen has everything to do with how
masculine you are.
The way to find out is through a saliva test (we have the
kits here in the office) that measures the levels of
these hormones in your body.
Certain lifestyle habits, nutrients, and herbal preparations
can restore the balance. And, you'll be very happy!
Dr. Mark Force
7500 E. Pinnacle Peak Rd. Suite A-207
Scottsdale, AZ 85255
480-563-4256
Fatigue and losing sense of well-being - 82% Joint aches and stiffness - 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 - 60%
Sounds familiar, doesn't it? Right now, you are probably
thinking we goofed up and you are again reading last
month's article on female menopause. Guess again. . .
this is a list of symptoms that men report having as they
approach middle age, and begin experiencing hormonal changes.
Amazing but true, the same relationship that exists between
the brain, the pituitary, the ovaries, and estrogen levels
in a woman, exists between the brain, pituitary, the testis,
and testosterone levels in a man.
Did you know that men and women produce the same types
of hormones, only in different amounts? As an example,
in normal hormone levels women produce high quantities
of estrogen, but their bodies also contain a small amount
of testosterone. Men make more of the androgens, such as
testosterone, though they have a small percentage of
estrogen, too.
How many of you (women included) have ever heard about,
or thought about, male menopause. . .also known as
andropause or viropause?
Ever notice how so much is said about female menopause,
and so little is said about male menopause? For years,
there has been controversy as to whether or not men
actually go through male menopause. Studies have found
that few men have any concept or understanding of the
hormonal changes that they experience as they mature.
Because of this controversy, andropause has been poorly
defined as a collection of various symptoms in which
men typically have declining, but may also have normal,
androgen levels. (Yes, that sounds 'poorly defined' to
me, too.)
No wonder men do not recognize that they may be having
symptoms. Andropause involves the hormonal, psychological,
and physiological changes that occur in men, beginning
typically between the ages of 40 and 55,though these
changes can occur somewhat earlier, or in later years.
These changes effect every aspect of a man's life -
interpersonal, social, psychological, physical, and spiritual.
Though acute menopause symptoms in women are common, men
rarely have acute indications of andropause. Evidence
of andropause tends to be more subtle, because a man's
hormone levels usually decline more gradually than that
of a woman's.
Although, men's symptoms may be less overwhelming than
what women experience, many men experience physical and
psychological changes while neither recognizing symptoms,
nor knowing what causes them.
Maybe one of the main reasons so little is known about
andropause is that most men who begin to experience a
decline in their virility, during their middle years,
are unwilling to talk about it. The man may be asking
himself, "what's wrong with me", but he can rarely bring
himself to ask someone else that most intimate question.
The majority of men are not comfortable admitting that
they are noticing changes in their bodies. Unless a man
is aware that these changes are normal and to be expected,
he can unwittingly be controlled by hormonal emotions and
changes in physiology.
Usually, men will not speak to their doctors about their
symptoms, unless a spouse or companion brings it to the
doctor's attention. Since men are often unaware of what
these changes mean, it helps to have an understanding
partner to help alleviate the powerful anxieties and
doubts, which may occur and possibly lead to total
impotence and sexual frustrations.
Recently, doctors have become more willing to diagnose
"male menopause". The Institute of Endocrinology and
Reproductive Medicine has developed a comprehensive
program for the treatment of male menopause.
In the past, this condition had received very little
attention from the medical community. However, in the
Spring of 1998, one of the main symptoms of andropause
- a loss of male virility - became the "hot media topic"
when Viagra was released.
Most endocrinologists and scientists believe that male
menopause correlates with the decline, or imbalance, of
male hormone levels (most predominately: testosterone).
Testosterone is the hormone that is responsible for a
man's sexual development when he is a child, along with
the development of bones, muscles, and sex drive as he
becomes a man.
In 1977, Dr. Karpas first published research results
about the effects of aging on men's hormone levels. He
found that even healthy men, by 55, had a significantly
lower testosterone level than ten years earlier.
As the testosterone levels decrease, this alters the
balance of the other hormones, and estrogen levels begin
to increase. Some scientists believe that too much
estrogen, which causes breast cancer, may also be a
contributing factor in prostate cancer.
As men in their 50's and 60's have decreasing levels of
testosterone, and accelerating levels of estrogen, they
may want to consult an alternative health care professional
about increasing the amount of natural progesterone in
their body to discourage the excessive build up of estrogen,
possibly avoiding the risk of prostate cancer.
Julian Whitaker, M.D., a nationally recognized alternative
medicine educator and editor of the newsletter Health
and Healing, believes most men are unaware that they
experience a predictable decline in hormone production
at mid-life.
Even though, after the age of 30 the hormone levels in
men begin to slowly decline, most men do not notice a
significant difference until they are in their forties
or fifties.
Gary S. Ross, M.D., who practices in San Francisco,
California, says that usually by the time a man has
reached his fifties, evidence of the "andropause complex
of symptoms" (another name for a condition of unbalanced
hormones in men) may be noticeable.
The physical and psychological symptoms are indications
that a man's hormonal levels are shifting into a different
balance. Though many of the symptoms are vague and
nonspecific, the beginning signs of andropause often
result in changes in a man's sexuality.
Dr. Ross says, "hormone levels, especially testosterone,
start off high in puberty and peak throughout the teenage
years. A healthy average for a man about 35 to 40 years
old is 600, so this is a desirable level to maintain if
a man wants to stay strong.
By the time he reaches age 55, a man's testosterone levels
will typically be averaging 500. Even so, this is below
the optimal level needed to stay young."
Typically, when a man has reached his mid-seventies, his
male hormone levels will have decreased below pre-puberty
levels. These testosterone levels decline in both the
central (pituitary) and peripheral (testes) areas. As
the amount of testosterone and other male hormones
decreases in the bloodstream, andropause symptoms increase.
Approximately 40% of men, when they have reached their
40's will begin to have some of these symptoms. These
may include increased fatigue, and diminishing physical
stamina, muscle strength/endurance, and sex drive.
Men may also notice longer time periods to recover from
injury or illness; aches in joints and muscles; weight
gain; increased nervousness and irritability; mood swings;
depression; increased difficulty in attaining and
sustaining erections, or complete loss of sexual enjoyment.
Other changes may include decreased short-term memory or
concentration; increased anxiety/fear (panic attacks);
irregular sleep habits or insomnia, indecisiveness; and
loss of interest and/or self-confidence. All of these
signs commonly are indicative of male hormone-production
levels dropping.
Although studies have proven the correlation between
decreasing hormone levels and decreasing virility, there
are still many urologists who question the importance of
hormones in the role of male sexuality. This is because
there are other circumstances that also contribute to
deficiency of testosterone levels and impotence.
Conditions such as obesity, hypertension, smoking, high
cholesterol and heart disease can all result in poor
vascular health, and contribute to impotence. Vascular
disease will cause a loss of elasticity in the arteries,
poor circulation and blood flow. This hampers proper
circulation and blood flow, which in turn interferes
with healthy erectile function.
In a study conducted at the Veterans Affairs Medical Center,
men were interviewed and responded to questions about 22
different topics. These included information on patient
demographics, their understanding of andropause, their
understanding of possible hormonal therapy, and their medical
history and social habits - such as smoking and drinking.
A total of 302 male patients were questioned, of which 71%
were above the age of 60. Though most patients knew little
about andropause, they were interested in obtaining more
information.
The results of this study showed the 50 to 60 year old
patients more frequently reported obvious symptoms of
andropause. Their symptoms included impotence, muscle
weakness and memory loss.
It was noted that some symptoms of andropause are similar
to an under-active thyroid, such as a sluggish metabolism,
sensitivity to cold, constipation or dry skin.
The second most common age to report symptoms was between
60 to 70 years old. Results disclosed an earlier onset
of symptoms from smoking, high alcohol consumption,
hypertension, various forms of vascular degeneration,
and other debilitating health problems.
A study testing impotency in men diagnosed with
cardiovascular disease showed that at least two-thirds
of the 40 year old men exhibited some signs of at least
moderate impotence.
Also, it was found that while a variety of drugs can
cause a probability of impotence, a small amount of
alcohol usually does not hinder most men's sexual
performance, until they reach mid-life. This is because
alcohol increases dilation of all the blood vessels,
making it more difficult to have a concentrated blood
supply in the penile tissues.
Long term effects of excessive alcohol can be even more
dangerous, where ten or more years of heavy drinking
and alcohol abuse can cause permanent damage to the
penile nerves.
Smoking can also be a major cause for male sexual
dysfunction, because of the damage smoking does to the
blood vessels throughout the body, including the penis.
Other health problems can cause various forms of impotency,
such as diabetes, chemotherapy, etc.
Hypertension and its medications (beta-blockers) can
also increase the chance for impotence, as do
medications for antidepressants, diuretics,
antihistamines, digestive medicines, and even cold and
flu remedies.
Warning is given to men who, because of penile vascular
disease, have been given medication, such as Viagra,
to dilate blood vessels. Most likely they have similar
vascular disease problems in the heart and other areas,
and are at great risk of major complications such as
heart attack or stroke, from drug use.
If a man is questioning whether male menopause may be the
cause of symptoms he is experiencing, he may want to have
either a blood test done by his doctor, or check with his
alternative health practitioner.
The saliva test that Dr. Force recommends in his
accompanying article in this month's newsletter can
provide an accurate measurement of the balance (or
imbalance) of key hormones.
Besides physical symptoms, even more difficult to recognize
are the psychological symptoms. As humans, we all have a
tendency to reflect our physical ill health in our
emotional or mental state. Feeling poor physically is
tightly woven into feeling poor mentally, even when we
know the cause of our physical illness.
Often times, with the decline in testosterone levels,
and other hormones, psychological symptoms are manifested.
The most typical response toward the decline in hormones
is depression. This may be due to outside psychological
influences, but most likely is influenced by a reaction
to the physical changes. Unbalanced hormones do have
psychological repercussions.
An article in the Postgraduate Medical Journal
(September 1997, 73 <863>: 553-6) says:
"testosterone decline/deficiency . . .may exhibit
considerable overlap with primary and other secondary
psychiatric disorders."
Drs. Caroline and Andrew Dott, teachers and professional
lecturers, often speak about the influence of hormones
on psychological and biological behavior in men during
andropause.
Depression and anxiety can produce symptoms of "psychogenic
impotence". In reverse, it is true that biological
impotence problems can aggravate depression and anxiety.
Biological impotence can be effected by declining hormone
levels, cardiovascular health, and/or general health condition.
External factors may contribute to psychological stress
and depression experienced during andropause, leaving
a man feeling vulnerable, inadequate, obsolete, or like
a failure.
Some of these factors may include children leaving home;
job opportunities diminishing or displacement by a younger
male; an unhappy marriage, or going through a divorce
(sometimes 2nd and 3rd time). Other occurrences may
include, becoming a grandparent; friends and parents
getting sick or dying; and having minor or acute virility
problems - causing a major concern about sexual dysfunction.
Men often express depression far differently from women,
so again, the symptoms may be more difficult to recognize
and understand. Men typically deny the problem, because
of their belief that they have to "be strong". A man's
most major concern could be his sexuality, which would
be the last symptom he would want to discuss. This alone
could have an increased effect on depression.
Family members, physicians, or mental health professionals
rarely recognize symptoms of depression, and this can
lead to devastating consequences. Jed Diamond, in his
book Male Menopause, reports that 80% of all suicides
in the U.S. are men, with the rate during mid-life being
three times higher; for men over age 65, it is seven
times higher.
Of the 20 million Americans who will experience depression
in their lifetime, 60-80% will never seek professional
help. For those who do seek help, it will take an average
of ten years, and three health professionals to properly
diagnose the disorder. Shocking statistics!
(For a brief explanation describing differences between
male and female depression, refer to the section
following this article.)
Now for the women reading this, if the signs of male
depression sound familiar, and you are concerned about a
particular man in your life, is there anything you can do?
The most important first step is to recognize the problem,
because most men will not see it within themselves.
Remember that their most basic psychological defense is
denial. Keep in mind, men will probably not seek help
on their own unless pressured to do so, by people they
care about.
Men need to be reminded that there are various approaches
that will help them: exercise, healthy diet, individual
or group therapy sessions, seeing an alternative health
care practitioner who can help them balance male hormones
through natural means, or seeing their regular physician.
It is also important to encourage men not to give up, if
at first they do not receive the expected support from
others. With determination, they will eventually find
the individuals who can offer help and encouragement.
Men in depression also need to be encouraged to love and
accept themselves, and to learn to focus on their positive
qualities, not the negative.
Certainly, there are proactive steps a man can take to
improve his overall health during andropause. He can
improve his health with certain lifestyle changes, such
as limiting alcohol intake, eliminating smoking (if
applicable), choosing correct eating habits, and
appropriate exercise (reports have shown that men who
exercise regularly have a stronger sex drive than men
who are inactive).
Fortunately, there are alternatives that can provide
nutritional support for men during andropause, without
the typical side effects that accompany most drugs. It
is definitely worth researching or visiting with
alternative health care practitioners to see what choices
are available.
A variety of vitamins and herbs can be beneficial, such
as St. John's Wort for depression, valerian root for
insomnia, ginkgo biloba for improving memory. Studies
done on Vitamin C, E, zinc, and HCL show their
effectiveness in promoting prostate health and fighting
prostate cancer.
The article "Herbal Medications For Common Ailments in
the Elderly" by E. Ernst (The Department of Complementary
Medicine, School of Postgraduate Medicine and Health
Sciences, University of Exeter, England) states:
"It has been well documented that Aesculus hippocastanum (horse chestnut) seed extracts . . . reduce the objective signs of chronic venous insufficiency. Serenoa repens (saw palmetto) is effective in improving the symptoms of benign prostatic hyperplasia. Finally, yohimbine has been shown to be effective for erectile dysfunction. It is concluded that several plant-based medicines can be useful additions to our therapeutic repertoire for treating common conditions. . ."
In conclusion, though doctors have a variety of different
opinions about andropause, the majority agree that a
general decline in a man's hormone levels and potency,
at the approach of mid-life, are to be expected in most
of the male population.
Even with the resulting symptoms, men can choose options
that will help ease them through the psychological and
physical changes of andropause. In addition, they can
learn to reassess their lives, review their priorities,
become better people by learning, and growing from their
experiences (good and bad).
With the appropriate tools, men can go through this
transition into what can be the "better" half of life
- with confidence.
References:
"Age-Associated Testosterone Decline In Men" by Sternbach H. Department of Psychiatry, UCLA-Neuropsychiatric Institute, Los Angeles, CA. American Journal of Psychiatry, Oct. 1998; 155(10):1310-8.
"Environment, Human Reproduction, Menopause, and Andropause" by Vermeulen, A. Department of Endocrinology and Metabolism, State University of Ghent, Belgium Health Perspective, July 1993; 101 (2:91-100).
"Men's Health In Action", by Gary S. Ross, M.D. Creative Health Works, P.O. Box 2889, San Francisco, CA 94126
(For more information about the following books, visit our website at www.appliedhealth.com, and click on "book search".)
"Male Menopause", by Jed Diamond, 1998.
"Maximizing Manhood : Beating the Male Menopause" by Malcolm Carruthers.
"The Testosterone Syndrome: The Critical Factor for Energy, Health, & Sexuality--Reversing the Male Menopause", by Eugene Shippen, William Fryer.
"Dr. Whitaker's Guide to Natural Healing" by Julian M. Whitaker.
====================================
Depression:
The following comparative list, from "Male Menopause"
by Jed Diamond, describes the differences between male
and female depression.
When Bill took one look at this list, he said:
"hey, based on this criteria, I've been depressed
since I was twelve!"
To which, I responded:
"That could be true. Sometimes signs of
depression can be confused with the typical signs
of 'personality disorder'!"
(Even at our age, it's still fun to have some of that
'sibling combativeness' left.)
With all joking aside, it is important to note that
similar symptoms can be observed in someone going
through puberty, or just be someone's normal personality.
The most definitive sign would be in "change" - if
someone you know does not typically have, yet is
beginning to demonstrate, some of the following symptoms.
(Be aware that a person with manic-depressive disorder
would not have a sudden onset of these symptoms.
Manic-depressive or bi-polar personality disorders
need extensive research, themselves, because these
problems are even more complicated than clinical
depression. Though it may take multiple visits to various
qualified professionals, it is worth the search to find
someone who can properly diagnose any mental illness.)
Most Common Symptoms of Clinical Depression - Women vs. Men:
1. Women are more likely to turn their feelings inward. Men tend to "act out" their inner turmoil.
2. Women blame themselves, while men blame others.
3. Women feel sad, apathetic, and worthless. Men feel angry, irritable, and ego inflated.
4. Women feel anxious and scared. Men feel suspicious and guarded.
5. Women avoid conflict at all costs. Men create conflicts.
6. Women always try to be nice. Men become overtly or covertly hostile.
7. Women withdraw when feeling hurt. Men attack when feeling hurt.
8. Women have trouble with self-respect. Men demand respect from others.
9. Women feel they were born to fail. Men feel the world set them up to fail.
10. When depressed, women slow down and are nervous. Men become restless and agitated.
11. Women become chronic procrastinators. Men become compulsive timekeepers.
12. Women sleep too much. Men sleep too little.
13. Women have trouble setting boundaries. Men need control at all costs.
14. Women feel guilty for what they do. Men feel ashamed for who they are.
15. Women become uncomfortable receiving praise. Men are frustrated for not receiving enough praise.
16. Women find it easy to talk about weaknesses and doubts. Men are terrified to talk about weaknesses and doubts.
17. Women have a strong fear of success. Men have a strong fear of failure.
18. Women need to "blend in" to feel safe. Men need to be "top dog" to feel safe.
19. Women use food, friends, and "love" to self-medicate. Men use alcohol, TV, sports, and sex to self-medicate.
20. Women believe their problems could be solved only if they could be a better (spouse, co-worker, parent, friend). Men believe their problems could be solved only if their (spouse, co-worker, parent, friend) would treat them better.
21. Women constantly wonder, "Am I lovable enough?" Men constantly wonder, "Am I being loved enough?"
