Movember: The Male Menopause

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The Movember movement was established to inspire men to be more aware of their health needs, and to seek medical help if needed. Men are less likely to visit a doctor than women. They tend to put off making GP appointments which can mean that symptoms are more advanced and harder to treat. On the internet, television and in popular magazines, there seems to be less information about men’s health than women’s health.

A good example of this is the menopause. While there is a good awareness of the female menopause and its impact on women’s health, there is a lack of awareness of the male menopause, medically known as the andropause. The very notion of ‘male menopause’ is contentious and three quarters of British men have not even heard of it. Despite this, the symptoms of low testosterone are very real.

Andropause is marked by a decrease in testosterone levels that can affect men in middle age, causing symptoms such as low energy levels, decreased libido, erectile dysfunction, depression, irritability, increased body fat and loss of muscle mass. On average, from the age of 39, testosterone levels in men decrease by over 1% each year, while competing hormones such as oestradiol and prolactin begin to rise (1).

While andropause is often attributed to the inevitable ageing process, new studies suggest that dietary and lifestyle choices have a much bigger impact (2). Obesity and smoking have significant negative effects on testosterone levels. Stress levels, alcohol consumption, lack of sleep and exercise, nutritional deficiencies and environmental estrogens from plastics are all likely to affect men’s hormonal balance.

There are three key nutrients have been found to increase testosterone levels in clinical studies. The first of these is Vitamin D. Supplementing with this particular vitamin has been found to raise testosterone levels (3). The male reproductive tract is known to have Vitamin D receptors, suggesting that this is a key nutrient in male sexual health.

Magnesium supplementation has also been found to increase testosterone levels in both active and sedentary men after four weeks of supplementation (4). Magnesium is a co-factor in more than 300 biological processes in the body, and so ensuring sufficient intake is critical for anybody interested in achieving optimal health. Magnesium is needed for healthy metabolic pathways, which include hormone production. It also stops testosterone from binding to ‘sex hormone binding globulin’, meaning that it is more active in the body.

Finally, the mineral zinc has profound effects on hormonal health. Even marginal zinc deficiency is known to cause a drop in testosterone levels (4). Zinc is required for the production of testosterone from androstenedione. A deficiency in zinc leads to the conversion of testosterone to estrogen. It also increases the number estrogen receptors and decreases testosterone receptors. The best dietary sources are shellfish, beef and other unprocessed red meats.

Any man experiencing andropause symptoms should visit their GP for a routine check up. Hormone testing can confirm levels of circulating testosterone. The ‘free androgen index’, a measure of active testosterone levels, is a particularly important measure. As a general guideline, the normal range is between 0.7 and 1.0.

References

  1. 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;87:589-598.
  2. Endocrine Society. “Declining testosterone levels in men not part of normal aging.” ScienceDaily. www.sciencedaily.com/releases/2012/06/120623144944.htm (accessed November 10, 2014).
  3. Pilz S et al (2011) Effect of vitamin D supplementation on testosterone levels in men. Horm Metab Res Mar;43(3):223-5.
  4. Cinar V et al (2011) Effects of magnesium supplementation on testosterone levels of athletes and sedentary subjects at rest and after exhaustion. Biol Trace Elem Res. Apr;140(1):18-23.
  5. Prasad AS et al (1996) Zinc status and serum testosterone levels of healthy adults. Nutrition 12(5):344-8.
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