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What
is a Troche?
Natural
HRT
New
Male Awareness
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New Male Awareness
It's time for a male revolution. An insurrection.
A rebellion to the traditional thoughts, practices and denial of
the male welfare. The world must know and understand what happens
when our naturally-circulating testosterone begins to disappear.
It happens gradually and without notice. Like the sapling you planted
ten years ago that is now a tree. Or the little bit of money you
have been saving each month that will now buy a car. With regard
to sex hormones, it's been said women fall off a cliff and men role
down a hill. Either way, by the age of 80, 60 or even 50, the results
are the same.
But why should anyone notice or care? Denied by the patient and
unrecognized by the physician, most men don't even know it exists.
And in medical terms, there is no disease or condition until it
is given a name. So let's do it, once and for all. It shall be called
andropause. It shall be recognized by the medical community and
the male patient, and it shall bear the burden of our symptoms of
aging:
• Weakness
• Fatigue
• Disturbed sleep
• Reduced libido
• Osteoporosis (yes, in men)
• Heart disease
• Atherosclerosis
• Irritability
• Elevated cholesterol
• Increased use of alcohol
• Erectile dysfunction
• Slow wound healing
• Prostate problems
• Low sperm counts
• Depression, anxiety
• Reduced muscle mass
• Memory impairment
• Impaired blood cell formation
• Reduced cognitive function
• Dry skin
Certainly the first thing society associates with declining testosterone
is sex function. In fact, it is inappropriate, or at least misleading,
to refer to testosterone as a sex hormone. There are many other
significant facets of andropause that include heart disease, osteoporosis
and mental dysfunction. It could just as easily be called a heart
hormone or an anti-depressant hormone.
Unfortunately, these conditions are treated with the same approach
Western medicine uses for almost anything: prescription medications
that only affect symptoms of the disease, not the cause itself.
It is time to alleviate these symptoms and conditions with much
the same approach we use for women - diet, exercise, nutrition,
herbal therapy and natural hormone replacement.
Both men and women produce circulating testosterone during most
of our adult lives. Notable differences include much higher levels
in men than women, and the fact that testosterone is the only sex
hormone for men, while women also have estrogens and progesterone.
And while researches have found that total testosterone declines
in men about 1% per year after the age of 30, free testosterone,
or "active testosterone", declines by as much as 10% per year. Thus,
by the age of 60, you could be experiencing a serious testosterone
deficiency. As it turns out, the reasons for this are not simple:
1.
Testosterone-producing Leydig cells begin to die off, reducing the
amount of total testosterone available. 2. With aging, there is
also a loss of circadian rhythm (24-hour cycle) of testosterone
secretion. 3. Simultaneously, a protein called sex hormone binding
globulin (SHBG) increases with age, binding more testosterone and
decreasing the amount available for activity. 4. An enzyme increases
as we age, called aromatase. One of the actions of aromatse is to
convert what little bit of testosterone that is now left to estrogen.
It is perhaps this event that is most responsible for the many symptoms
of male menopause, and possibly even enlarged prostates and prostate
cancer.
The benefits of lifestyle modifications and testosterone replacement
are many, and read like the reverse of the symptoms mentioned above.
Beyond the improvements in libido and sexual function (Viagra poorly
imitates the role of testosterone here) lie important improvements
in heart disease, mental function and osteoporosis. Multiple reports
conclude that natural testosterone reduces cholesterol and triglycerides,
reduces blood glucose, decreases visceral fat mass and normalizes
blood clotting. Atherosclerotic disease (hardening of the arteries)
is known to increase as free testosterone decreases. Several studies
suggest depression in older men can be linked to decreased levels
of testosterone. Normalized testosterone levels can also positively
affect cognitive function, concentration, anxiety and confidence.
And did you know that one in three hip fracture patients is male?
Osteoporosis is not just a female disease, and a hip fracture in
a male carries an even higher risk of permanent disability and death.
Testosterone's role in bone health is undeniable and absolute. And
the role of testosterone in BPH (enlarged prostate) and prostate
cancer is a victim of medical mythology. The fact is, both of these
events are almost unheard of in teenagers and men younger than 50,
when testosterone is at its highest. Conversely, why do the risks
of BPH and prostate cancer continue to grow as levels of testosterone
continue to fall? Interestingly, studies have actually shown the
risk of BPH is higher in the presence of decreased testosterone!
As mentioned earlier, there is also compelling evidence that these
diseases are related to the increased conversion of testosterone
to estrogen.
As you can see, male menopause is real and deserves our attention
and respect. In this mutiny of tradition, we must take up our arms,
or at least our brains, and consider these events as we age. Awareness
must begin with men, and then we must work to make our female counterparts
and physicians enlightened as well. In the next article of this
two-part series, we will explore the natural options available for
addressing male health in general, and symptoms of andropause in
particular.
A major breakthrough has occurred in medicine that promises significant
advances in men's health. The miracle lies not in a cure, but in
the recognition of a condition called andropause.
A disease or condition endures only in the mind of the patient until
the utility of a name brings acknowledgment by the medical community,
as sufferers of PMS, fibromyalgia and chronic fatigue already know.
In the past, it has been convenient to consider impotence as a psychological
disorder. But with the word andropause, the male counterpart to
menopause, a handle has been exposed for the medical community to
learn, examine, diagnose and treat.
In part one of this two-part series, we explored the encompassing
symptoms of andropause. In this issue, we will offer options for
dealing with the abundant symptoms of andropause. Sounding suspiciously
like the aging process, symptoms include reduced muscle mass, osteoporosis,
irritability, memory impairment, prostate problems, reduced libido,
impotence, depression and heart disease (indeed, there are more
testosterone receptors in the heart than any other muscle in the
body).
The two-edged sword of andropause, wielded by time, is a dwindling
supply of testosterone and an increase of an enzyme called aromatase.
Aromatase converts the shrinking supply of testosterone to estrogen,
and it is elevated estrogen that has recently been credited with
many of the negative symptoms of andropause, including an enlarged
prostate, heart disease, stroke and others. In fact, a 1988 UCLA
study found that the most significant hormonal association with
impotence was elevated estrogen.
Other rogue players in andropause are obesity and alcohol. Aromatase
activity is higher in fatty tissue than in other areas of the body,
further increasing the conversion of testosterone to estrogen. The
problem is, decreased testosterone and increased estrogen tend to
increase fatty tissue and decrease lean muscle mass - so the negative
cycle continues. Men are all too familiar with the battle of the
bulge that interestingly begins in middle age, just as our testosterone
starts to wane.
Similarly, because of the hormonal imbalance, depression and anxiety
surface, and men often turn to alcohol as a short-term solution.
Unfortunately, alcohol also increases aromatase activity and, again,
the problem perpetuates.
A natural approach is always prudent in dealing with any chronic
condition, and can even be combined with traditional allopathic
medicine. There is no claim of a cure with diet, exercise and nutritional
supplements; only a promise that any malady becomes more manageable,
and andropause is no different.
A diet rich in fresh fruits, vegetables and complex carbohydrates
is a cornerstone of health and healing, with a special emphasis
here on the reduction of saturated fats. As mentioned, it is important
to maintain an ideal weight to minimize aromatase activity. But
as the body tries to excrete estrogen through the digestive tract
and stools, a high-fat diet causes some of this estrogen to be reabsorbed,
contributing to the problem of elevated estrogen.
Taking steps to reduce the conversion of testosterone to estrogen
seems logical, and nutritional supplements can help. Zinc and the
essential fatty acid omega-3 (flaxseed oil) share the spotlight.
Zinc is a common deficiency and supplementation thankfully interferes
with aromatase activity. Vitamin C also inhibits aromatase, and
along with vitamin E, increases longevity in men. Omega-3 has many
balancing benefits for symptoms of andropause, including reduced
prostate size and cardiovascular improvements. However, it is usually
best not to focus on a few nutrients at the expense of ignoring
others. A complete nutritional program is best.
Other noteworthy supplements for men include saw palmetto for prostate
enlargement and L-arginine, muira puama and ginkgo biloba for erectile
dysfunction. Ginkgo also helps with circulation and memory. Once
these are addressed, and if symptoms persist, it might be worthwhile
to visit your doctor for testosterone and estrogen blood tests.
Many men will be candidates for supplemental testosterone, based
partially on blood tests and substantially on symptoms.
Since there is a considerable range for what is considered "normal"
testosterone levels, it is perhaps more important to judge use,
dose and progress on the basis of symptoms. An effective medical
evaluation might include the question, "How are you feeling?"
It is important to note maintaining a "normal" blood level of a
60 year-old man will likely be inadequate to reverse symptoms of
andropause. That is, it would be reasonable to restore levels to
an equivalent age range of a 30-year-old.
Once the decision has been made to boost the testosterone levels,
the question becomes, how? One option would be to supplement with
dehydroepiandrosterone, better known as DHEA, which is available
without a prescription. DHEA is a precursor to testosterone, and
also has some testosterone-like activity itself. For many men experiencing
mild symptoms of andropause, supplementing with DHEA can make important
improvements.
But if actual testosterone replacement therapy is warranted, several
items should be remembered. First, few people, including medical
professionals, understand the difference between natural testosterone
(not patentable) and the patentable, and therefore profitable, synthetic
versions offered by drug companies. Medical professionals will all
too commonly and incorrectly refer to this entire class of chemicals
as "testosterone" when, in fact, there is only one such molecule.
Although these compounds are chemically similar, the complex biochemistry
of your body does not understand the game of horseshoes, where being
close has value. The chemical must be absolutely exact.
When the patient receives a synthetic version of testosterone, they
may see improvement in some symptoms, but adverse and dangerous
side effects can occur, including liver disease, worsening of cholesterol
profiles and heart disease. Not only does natural testosterone avoid
these adversities, it improves cholesterol profiles and reduces
heart disease as well.
Next, we must pay attention to the method of introducing natural
testosterone into the body. Since it is poorly absorbed in the digestive
tract from a capsule or tablet, this is not an option. Injections
circumvent the problem, but are inconvenient, painful and produce
a roller coaster of blood levels - perfect if you like mood swings.
The best option is transdermal or "across the skin" delivery of
testosterone. Creams, gels and patches are being used to effectively
administer more and more medications. And a small lozenge, called
a troche, that is slowly dissolved in the mouth is gaining popularity
as an efficient method of medication dosing. Transdermal dosing,
especially in regard to hormones, gives much more natural results
than pills or injections, and also avoids certain complications.
It is convenient, painless, and can be dosed twice daily for more
even blood levels. Largely beings of unawareness, men are finally
awakeing.
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