There is a growing interest, as well as a booming industry, in the use of testosterone therapy for middle-aged and older men. This interest has led to the definition of a new condition, termed 'andropause' implying that this condition is due to falling levels of testosterone. This trend risks replicating both the rejuvenation fads of a century ago and the recent experience in estrogen therapy for menopause that has been propelled for decades by advocacy substituting for reliable scientific evidence. Is testosterone therapy appropriate for men with symptoms of male menopause? There is no scientific agreement on this topic. My personal opinion is that hormones should be used only as a last resort since they have serious risks if misused.

Andropause Symptom
Approximately 30% of men 60-70 years of age and 70% of men 70-80 years of age have low free testosterone levels. Symptoms and findings of testosterone deficiency are similar to those associated with aging. Andropause symptoms may  include loss of energy, depressed mood, possible decrease in cognitive decline, decreased libido, potential erectile dysfunction, decreased muscle mass and strength, increased fat mass, frailty, osteopenia, and osteoporosis. These andropause symptoms may be reversed by andropause treatment with hormones, however, at this time, medical doctors do not have a good understanding on how to reverse these symptoms without potentially exposing men to the potential harmful effects of long term exposure to androgens or other hormones.

Andropause Treatment
Several small clinical trials indicate that testosterone replacement therapy can improve many of these findings; however, the studies have not been powered to assess potential risks, such as the need for invasive treatment of benign prostatic hyperplasia, development of a clinical prostate cancer, or cardiovascular events. Thus, the benefit / risk ratio of testosterone replacement therapy and andropause treatment in aging men is not known.
   An alternative to testosterone replacement as andropause treatment is the use of the over the counter hormone DHEA. However, DHEA has similar side effects to testosterone.
   Another potential andropause treatment option is to address each of the andropause symptoms individually with diet, lifestyle changes, and natural supplements. For instance, the andropause symptom of osteoporosis can be helped with increasing calcium and vitamin D intake. The decrease in libido can be addressed by the use of sexual herbs or products such as Passion Rx. The decrease in muscle mass can be helped by the use of creatine. Low energy can be helped by doing yoga on a regular basis. Low mood and cognitive decline can be helped by the use of Mind Power Rx, St. John's wort, or SAM-e supplements. It is preferable to not mix these supplements together until you have a clear understanding how each of them makes you feel.

Andropause treatment emails
Sir: I have read with great interest your Online articles on dozens of subjects and supplements - and have increased my overall health as a result. For which I thank you! But I am 69, and suffer from the andropause dysfunction syndrome. Sigh. As in - loss of libido and erections that are so weak that I hesitate to mention them even in this e-mail! (grin). After consultations with several doctors - most of whom have NO knowledge of natural substances and nutrition - I began taking low-dose Arimidex, an average of a half-mg twice a week. This initially seemed to overcome my saliva-tested estrogen excess - but it did little to boost the libido or erection function. Then - after buying and reading Natural Sex Boosters - I went through a long list of herbals, to little avail. Despite your warnings, I finally went to Vitamin Shoppe and got some 5mg tablets of DHEA. One in the morning, and suddenly there were feelings that I'd not had in decades! But still nothing that satisfied me. Then, I upped the dose to about 7mg - and the difference was, uh, "uplifting." It would seem to me that the combination of DHEA and Arimidex has a good balancing effect on my body - but I would like some input from you and your research staff, please. Does this combination work for other people? Logic would dictate that the Arimidex would keep the DHEA from aromatizing to estradiol - and thus boost the testosterone. I surely hope there are good tests on this combination! Please?!? When I read in two Online research postings that DHEA elevates estrogen in elderly males (me) while NOT increasing testosterone, well, I got rather upset. Obviously, DHEA by itself is a no-no for me. But, sir, with the Arimidex (which I buy at steep discount) there is a balance. All I can say is that, with about 7mg of DHEA five days a week (off two) and a half-mg dose of Arimidex twice a week - I get erections that I've only dreamed about for many, many years. Makes an ole chap with andropause feel SO much better!

Q. I am male 50 years old. My doctor has diagnosed me of undergoing an andropause at a very early age. He warns me of undergoing testosterone replacement therapy because of its dangers and side effects. There was a point that my body was so weak that i can't even walk due to low testosterone in my blood. He advised me to go on herbal remedies instead of synthetic drugs. Few months later, I recovered. I just want to know which supplements is best for maintaining the level of testosterone. Way back in the Philippines I supplemented with local tongkat ali, rhodiola and male balance. As i surfed through the internet I came across of variety of supplements that may be good for andropause. I just want to know which supplements are best in my case (andropause).
   A. We are not in a position to know which supplement will help any one individual in terms of andropause treatment or testosterone increase. Little research is available on the long term use of natural herbs and hormones as an alternative treatment to andropause. One possible option is to try, at separate times, very small dosages of DHEA or tribulus or tongkat ali or mucuna pruriens for a few days with periods of a week or two when nothing is taken. We can't be any more specific. Rather than focusing on the blood levels of one hormone, such as testosterone, it is better to evaluate the whole body and symptoms and have a comprehensive approach through diet, exercise, yoga and deep sleep to treat fatigue and low energy levels.

During an annual physical, are androgen levels checked to determine if a male is going through andropause?
    Blood tests for androgen hormone levels are not necessary during an annual physical unless clear symptoms of andropause are present. Find out annual physical testing benefits and risks.