Andropause, the midlife decline in testosterone, can affect body and mind – but treatment and healthy habits can boost well-being.
Midlife testosterone decline can affect physical and mental well-being
Men and women both experience hormonal changes as they age. In women, it’s called menopause, while in men the term is referred to as andropause or androgen decline. According to Christopher Michaelis, DO, a board-certified emergency physician specializing in wound care and founder of Charleston Wound Care and Luminus Aesthetics, androgens are a group of sex hormones, such as testosterone, that impact male development and physiology. Andropause, a naturally-occurring, age-related reduction in testosterone levels, happens gradually over time and usually starts when men are in their 30s and 40s. “So, that’s just a normal part of aging,” Dr. Michaelis explained.
Men’s testosterone levels generally fall by about 1% year after age 40, according to the Mayo Clinic. However, a majority of older men still have testosterone levels within the standard range, with only 10% to 25% of men having levels that are considered to be low.
Testosterone plays a variety of important roles in a male’s body, impacting sex drive, muscle growth and development and mental and physical energy. Andropause symptoms include fatigue, decreased libido, reduced muscle mass and exercise tolerance, weight gain, mood changes and depression. “All the things that just start making you lose your vibrance in life,” expressed Dr. Michaelis.
All is not lost, though. Testosterone treatments combined with lifestyle choices such as eating healthier and exercising regularly can help improve your quality of life and keep your vibrance, he said.
Psychological impact and loss of confidence
So why does this dip in testosterone levels impact men psychologically as well as physically?
“I think such a powerful drive in a lot of men is their competitive edge, their self-confidence as far as their physique and energy levels – and all that really comes from testosterone,” stated Dr. Michaelis. “And as those levels start to drop, you kind of lose that spark.”
He added that many men with low testosterone tend to reminisce about the “good old days,” when they had a better physique and more energy. “As all that stuff goes, you feel like your best years are behind you,” noted Dr. Michaelis. “Which is not the case.”
While some individuals will say, “I’m just seeking to maintain as far as my weight or exercise levels,” he believes men can do more than simply maintain.
“I hate the term ‘maintain anything.’ I feel like there’s no reason you can’t grow stronger, grow better, every single day of your life until the day you die,” he asserted. “I think once you change that perspective for a person – that the best is not behind them and they have something to look forward to – it’s amazing to see the transformation in their attitude and in anxiety and depression – all those things. It’s incredibly impactful.”
Treatment options and lifestyle strategies
Many consultations Dr. Michaelis does at Luminus involve men who feel depressed, lack energy and are gaining weight. “All these things are tied together,” he explained. “So I think diving into the root of the problem and changing some behaviors and potentially supplementing with testosterone or other medications and getting them on a good exercise program is a complete game-changer.”
Testosterone comes in multiple forms, though injections and pellets are the most effective, shared Dr. Michaelis. The benefits of testosterone replacement therapy include increased energy, libido and exercise tolerance, the capacity to build muscle, mood stabilization and mental clarity.
There are a few drawbacks, however. For example, Dr. Michaelis said testosterone can potentially be converted into estrogen, so you could develop some extra breast tissue or sensitivity in that area. “But if you’re actually monitoring that, that can be reversed and blocked and completely negated,” he emphasized.
Sleep, stress and long-term hormone support
Sleep deprivation and depression can impede testosterone formation, but this is where lifestyle choices become impactful.
“One of the first things we tell people is to start exercising, have a healthier diet and really address their sleep and their anxiety and all those things,” said Dr. Michaelis. “It’s all connected, and all that stuff drives your testosterone levels down. They’ll come up a bit by addressing those things, but, ultimately, with age, your testicles produce less testosterone over time.”
The No. 1 thing Dr. Michaelis advises patients is to start an exercise program where you build muscle. “So if you get them on a good diet and exercise program, you’ll for one start slowing that process down – but it will trigger your body to produce more testosterone,” he explained. “I think the main thing is to be proactive in your health, and don’t accept these symptoms as something you just have to accept because you’re aging. Your quality of life can very easily improve with just some minor lifestyle changes.”
Additional sources:
Mayo Clinic: mayoclinic.org/healthy-lifestyle/mens-health/in-depth/male-menopause/art-20048056
Healthline: healthline.com/health/menopause/male
Harvard Medical School: health.harvard.edu/staying-healthy/testosterone–what-it-does-and-doesnt-do
By Colin McCandless
