Andropause Part 1: What is it and How do I Get Tested?

One of my favorite movies is What About Bob. It’s the story of Bob Wiley, a neurotic obsessive-compulsive patient who has a very difficult time coping when his doctor goes out of town on a family vacation. He shows up on the doorstep of his doctor’s vacation house and chaos ensues. The video clip below is a classic scene where Bob goes sailing. It’s particularly appropriate for today’s article about Andropause…also referred to as “male menopause”, “low testosterone”, or “hypogonadism” to name a few. I’ll talk about what andropause is, and how to test for it. In a future article, I will discuss a wide variety of treatment options if you’ve been diagnosed.

What is Andropause?

The word “andropause” is a fairly recent term adapted from “menopause” – a process of change in women when they stop ovulating and hormone production rapidly declines. “Andro-” is short for “androgen”, because hormones like testosterone that influence male development are also known as androgens.

While not completely comparable to menopause, andropause in men can certainly cause undesirable symptoms that decrease quality of life. In some men, starting around age 30, hormone levels can begin to decline. Because this decrease can be gradual, it can go undetected for a long time. Some symptoms that develop include:

• Mental changes – feelings of depression, decreased self-confidence, lack of motivation, and fatigue. Patients often tell me they feel like someone has “taken the wind out of my sails.”
• Changes in sleep patterns – insomnia or increased sleepiness
• Physical changes – difficulty losing weight, decline in muscle mass, increase in breast tissue (“man boobs”), loss of body hair, changes in head hair thickness and growth
• Changes in sexual function – changes or decrease in libido and erectile dysfunction are the most common symptoms

How do you test for Andropause?

Hormone levels are very easily checked by labs that analyze either blood or urine. I’ll talk about both options here.

• Blood test This method has been around for a very long time. It’s a reliable way to check most hormones, especially in a guy who is not yet undergoing any hormone replacement therapy. Important notes for blood tests: You don’t need to be fasting to check hormones, but this should be an early morning blood draw – especially when measuring testosterone. For many measurable substances in your body, you follow a circadian rhythm. According to research published in the Journal of Urology, testosterone levels are at their highest in the morning around 7:00 AM for men under 45 years old. If you’ve previously had blood drawn later in the afternoon and have been told that you have low testosterone, this may not be true. It’s in your best interest to check again at the appropriate time of day.
• Urine test This is an exciting new frontier in evaluating hormones. Precision Analytical, a lab based out of Oregon, has developed a test called the DUTCH, which is short for Dried Urine Test for Comprehensive Hormones. By collecting samples of urine at specific times over 24 hours, we are able to very accurately measure hormone levels. Unlike blood testing, this urine test can also detect and measure metabolites, or “break-down” products of hormones. This is valuable information to determine cancer risk, problems with methylation, HPA axis (hypothalamus, pituitary, and adrenal gland) dysfunction, and more. With this single test, we can also measure 24-hour cortisol rhythm and nighttime melatonin production, something blood tests cannot do. Imbalance in cortisol and melatonin production can effect sleep quality, ability to lose weight, and so much more.

Put the Wind Back in Your Sails

If you’ve been shuffling around on the dock for the last few months or years wondering why you don’t feel well, give me a call. Let’s do some testing and figure out if hormone imbalance is affecting your ability to enjoy life and feel your best. I want you off the dock and out on the boat, wind blowing through your hair, pecs rippling, sailing with the killer whales. Just promise me you won’t start wearing a Speedo.

Later this month, I will be posting an article describing a variety of treatment options for balancing hormones in men. In the meantime, give me a call to come get checked out.