Andropause, sometimes referred to as “male menopause”, describes the gradual decline in testosterone that can occur in men as they age, typically starting in their 40s or 50s. Unlike menopause in women, this process is slower and more variable. Some men may notice symptoms such as reduced energy, lower libido, mood changes, decreased muscle mass, increased body fat, and difficulty concentrating or sleeping. An important thing to make note of is this process usually begins years before symptoms are noticeable. A naturopathic doctor can support men during andropause, however, it is optimal for a plan to be in place beforehand to prepare the body and mind for these changes.
A naturopathic doctor can help assess whether symptoms are related to hormonal changes or other underlying factors like stress, poor sleep, and metabolic changes. Treatment is often focused on addressing root causes and may include comprehensive lab testing (hormones, liver, cholesterol, nutrient levels), medical nutrition, exercise prescription, stress management, herbal medicine and targeted supplementation to support hormonal health. Some goals we are looking to achieve are:
- Optimize testosterone production and release into the system for the body and mind to use effectively (better concentration, energy, workouts, sex drive, mood)
- Reduce estrogen levels that may be contributing to fatigue and body composition changes
- Support the nervous system, sleep and stress response (balance cortisol)
- Rule out nutrient deficiencies or chronic conditions that may be contributing to symptoms
- If medication is being used or considered, help reduce the risk of adverse effects and optimize effectiveness of medication.
Collaboration with medical doctors for therapy may also be explored. TRT (testosterone replacement therapy) is sometimes recommended, but there are adverse effects that can occur with this type of therapy. Some points to consider:
- Testosterone follows a diurnal pattern (rise and fall every 24 hours) that we want to optimize before medication is needed. Some medications do not follow a diurnal pattern.
- Daily injections are not often recommended. Daily creams can potentially be passed onto partners and may be harder to dose appropriately.
- Weekly injection therapy is the most convenient and better researched, but may spike Testosterone to higher-than-normal daily levels initially
- This spike may increase total estrogen, irritability and may negatively affect cholesterol and heart health
- By the end of the week, levels may drop lower than normal, leading to low energy, mood swings, poor sleep, and low sex drive.
- There are testosterone pellets that can be surgically placed (in-office-procedure) underneath the skin to slowly dissolve over a 3–6-month period. This is more invasive for patients but can be a better option for some.
- There are oral medications (used in fertility support) that can also be used to help increase testosterone levels, but these can also have adverse effects and require close monitoring.
The goal of naturopathic care is to support overall vitality and healthy aging, rather than simply masking symptoms, helping men maintain energy, mental clarity, and quality of life over time.
