Androgen Deficiency in the Ageing Male (ADAM)
by Vanita Dahia
As a man ages, he goes through lots of changes called andropause pretty much what women go through in menopause. About 30% of men in their 50’s experience andropause. In Australia, about 1 in every 200 men under the age of 60 and about 1 in every 10 men over 60 have low testosterone. At the age of 59, a mans estrogen can match that of a female.
The Play of Hormones in Andropause
Andropause is a condition of androgen deficiency in the ageing male (ADAM), relating to a decline of androgens or male hormones, namely testosterone and dehydroepiandrosterone DHEA.
Depletion of these male hormones lead to symptoms of andropause.
Testosterone depletion can start from late 30’s and progress with approximately a 10% decline
every decade after the age of 30. Depletion is testosterone will raise sex hormone binding globulin (SHBG) levels. The consequences of lowered hormone levels are associated with a decrease in Leydig cells (cells within the testicle that secrete testosterone).
Testosterone in particular has a greater tendency to convert to estrogens, predominantly female hormones which is associated with weight gain and grumpiness. Premature andropause can occur in males who experience excessive female hormone stimulation through exposure to oestrogen or xenoestrogens.
Xenoestrogen exposure is pervasive and affects males world-wide. Low sperm count and quality are also attributed to xenoestrogen exposure. Xenoestrogens are found in plastics, near incinerators, and on farms that use pesticides. These are males who are at high risk for early andropause. Testosterone is responsible for hair loss and thinning of the hair and also involved in hirsutism ( facial or body hair growth)
Signs and symptoms of Andropause
- loss of libido
- Nervousness, depression, irritability
- Decreased muscle mass and strength
- Impaired memory, the inability to concentrate
- Fatigue, insomnia
- Hot flushes, sweating
- Common signs and symptoms of andropause include the following:
- Decrease muscle mass and strength
- Difficulty maintaining an erection
- Increased body fat
Andropause can be enhanced if men experience:
Factors that can hasten the decline in testosterone and worsen the symptoms experienced include:
- Increased Age
- Adrenal insufficiency
- Toxicity (pesticides, smoking, alcohol, heavy metals)
- Insulin Resistance must be
Management of Testosterone Imbalances
Testosterone balance should ensure optimal levels are reach if deficient and cleared via metabolism if excessive. Androgen balance is aimed at supporting healthy testosterone metabolism and balance and healthy blood sugar levels and glucose disposal.
Improve Metabolism of Testosterone
Liquorice and white peony are aromatase stimulators. Aromatase is responsible for converting testosterone to oestrogen.
Liquorice blocks the activity of enzymes involved in androgen synthesis and the active components of peony antagonise androgen receptors, resulting in an anti-androgenic effect.
Inositol is required for healthy glucose disposal as it is converted to D-chiro-inositol, a second messenger associated with healthy glucose uptake, in healthy people.
Chromium and Vanadium also maintains healthy blood glucose levels by augmenting insulin-dependent GLUT4 membrane translocation thereby aiding the transport of glucose into cells.
Elevations in androgens is associated with abdominal adiposity or the belly fat pad.
Though unrelated to men, Inositol has been shown to assist women with hormone-mediated hair growth. A clinical trial on 46 female subjects with mild to moderate hirsutism showed that when they took 2.0 g inositol plus 200 μg folic acid, twice daily, there was a significant reduction in hirsutism and testosterone
Build testosterone levels
Support healthy Androgen levels to improve sexual function, sexual desire, restore and build vitality.
Supplementation of testosterone orally or by injection required a Drs prescription.
Tribulus has been shown in animal studies to increase androgen levels which influence nitric oxide and nitric oxide synthase in the brain. Nitric oxide is present in the regions of the brain that regulate sexual function. Tribulus terrestris (puncture vine) fruit is used in traditional Chinese and Ayurvedic medicine
as a tonic which increases virility, fertility and sperm production, and rejuvenates the
reproductive system. It is used in impotence and is an aphrodisiac.
Turnera diffusa (damiana) leaf is used in both traditional Western and Mexican medicine for
sexual inadequacy, sexual anxiety, impotence, and as an aphrodisiac and invigorator.
Epimedium sagittatum (horny goat weed) herb is used traditionally for impotence, as an
aphrodisiac and to enhance sperm production.
Nelumbo nucifera (lotus, also known as Nelumbium speciosum) seed has its history of use in
Ayurvedic medicine where it is used as an aphrodisiac and reproductive tonic for men. It is also
used in the female for promotion and fertility.
Lotus seed has also been traditionally used in Ayurvedic medicine as a reproductive tonic to increase arousal and intensify sexual desire.
Zinc assists healthy reproductive function in men by playing a role in the metabolism of androgen hormones.
Assessment of Androgens
Androgen status can be measured in a urine, saliva or blood sample. Though analytes may vary in each sample, the hormones that can be measures include:
SHBG, Testosterone, calculated free Testosterone, Estradiol, Estrone, Estriol,16-OHE1, Pregnanediol, Allopregnanolone, Testosterone, Epi-Testosterone, 5-DHT,Androstenedione, DHEA,5,3-Androstanediol, Total Cortisol, Total Cortisone, Tetrahydrocortisol, Tetrahydrocortisone
Access the ADAM Questionnaire here