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Male menopause? The (normal?) decline in testosterone.

As men age, testosterone levels decrease by approximately 1.6% per year. More importantly, free testosterone decrease more, by approximately 2-3% per year.

Does this mean it is normal to see your T levels slowly decline? I am not ready to agree to that, yet. As men age their testes, particularly the Leydig cells in your testes, begin to fall victim to years of oxidative stress and inflammation. This is what many new practitioners are calling male menopause, or manopause..


This is MUCH more common in today’s man, as approximately 35% of men in the USA have metabolic syndrome. Which means their body is metabolically dysfunctional leading to high blood pressure, obesity, insulin resistance and systemic inflammation. So when I see studies like this, I can absolutely believe it, but I won’t allow it to impact me and my patients.

Instead the way to fight this is off is to support your HPG (hypothalamic-pituitary-gonadal) axis using:


Sleep

  • Aim to achieve at least 7 hours of sleep, but ideally 8. Sleep deprivation is one of the #1 causes of hormone dysfunction.

Nutrition

  • Avoid a diet that contributes to high insulin levels, and aim for one that works to stabilize blood sugar levels. This does not mean going straight keto. Instead it means focusing on a low sugar, euglycemic diet. I like the Mediterranean diet for most men.

Exercise

  • If nothing else, just move! That is a move in the right direction. But if you really want to get granular on the best exercise for you and your health status, then it really can't be generalized. Instead, you need to fight a trainer/coach who knows how make the most out of your strengths but more so, focusing on your weaknesses from anaerobic, aerobic and stability perspectives. Rule of thumb, weight training, slow steady cardio (walking and slow jogging) plus some HIT and you're on your way to repairing your HPG axis.

Supplementation (herbs and nutrients) that is TAILORED to you, not the masses.

  • This is probably one of the most complex areas. You can go to Dr. Google and find any supplement to "boost testosterone levels," and you'll find a ton of "fixes". But if it were that easy, wouldn't T levels be increasing not decreasing or at the very least remain the same? Right, that's why you need to see a naturopathic doc or functional medicine doc who can understand what's going on. So I wish I could just tell you what to take and your hormones would just correct, but if I did and they didn't correct, then I look like a schmuck trying to promote snake oil. In fact, these things work but it's more sophisticated than just taking all the supplements.

I have recently been doing more research on certain herbs and nutrients that protect the testes and preserve T production. More on that to come this month!


References:

  1. Stanworth RD, Jones TH. Testosterone for the aging male; current evidence and recommended practice. Clin Interv Aging. 2008;3(1):25-44. doi:10.2147/cia.s190

  2. Feldman HA, Longcope C, Derby CA, et al. Age trends in the level of serum testosterone and other hormones in middle-aged men: longitudinal results from the Massachusetts male aging study. J Clin Endocrinol Metab. 2002;87(2):589-598. doi:10.1210/jcem.87.2.8201


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