When we talk about sex hormones declining as we age, more often than not, it’s a conversation about menopause, which is all well and good, that's a huge and very important topic (which I am very glad we are actually talking about now)..... but what about the gents ??? And for the record, when I refer to ‘gents, men, male’ etc in this article, I am referring to anyone with a predominantly androgenic profile of hormones (i.e. biologically male). 

 

We seldom talk about ANDROPAUSE (the male equivalent of menopause) which can involve a whole host of symptoms that sadly some men are just living with, not realising why they are seeing a decline in their health and vitality, and more importantly that there is plenty they can do about it. 

 

So today we’re going to be covering all things ANDROPAUSE including statistics, symptoms, causes and nutritional/lifestyle recommendations.

 

Firstly…. What is andropause and how many men does it actually affect??

 

It’s important to recognise that there is a natural decline in testosterone levels which occurs in both men and women in their mid to late 30’s but for some men this can be a much more significant decline, exacerbated with further hormonal imbalance. It’s this abnormal disruption in hormones that we are referring to as andropause and it occurs in approximately 30% of men in their late 40’s and 50’s. 

 

So it’s not all about low testosterone then?!

 

Nope, there are multiple hormonal changes associated with the symptoms of andropause. For example, an excess of oestrogen can contribute to some of the associated weight gain. The key players we’ll cover today are:

 

  • Testosterone 

  • Oestrogen 

  • Insulin 

  • Cortisol  

  • SHBG (sex hormone binding globulin)

  • Leptin

 

What are the symptoms to be looking out for?

 

Some of the potential symptoms of andropause include:

 

- Fatigue

- Weight gain

- Enlarged breasts

- Decreased libido

- Depression

- Decreased sexual function

- Prostate issues

- Decreased muscle tone

- Decreased memory

- Hair loss

- Headaches

- Irritability

 

What causes andropause??

 

There are a number of different risk factors, such as:

 

  • Excess refined carbohydrates - Poor blood sugar balance and associated insulin resistance results in weight gain, particularly around the waist. To dig a little deeper into the science…. insulin resistance occurs when muscle, fat and liver cells have reduced sensitivity to insulin, meaning they can’t uptake glucose for fuel. Fat storage hormones are then ramped up and this glucose is converted to triglycerides to be stored in fat cells. These raised levels of triglycerides also result in leptin resistance. Leptin is our satiation hormone, when we become resistant to it, our body essentially thinks ‘hang on mate, if I’m not satiated, I must be starving, best eat some more and store some fat’. This excess body fat results in increased levels of aromatase (an enzyme which converts testosterone to oestrogen in fat cells) which increases circulating oestrogen levels and decreases testosterone. 

 

  • Stress - When you’re in a state of stress your body will prioritise the production of the stress hormone cortisol rather than testosterone. Raised cortisol levels also increase your blood sugar and decrease thyroid function resulting in impaired energy for testosterone production. It’s also worth noting that raised cortisol levels also increases fat storage and fat cells release cortisol so it’s a vicious cycle. 

 

  • Excess alcohol - Essentially booze can suppress testosterone production directly at the testicle as well as decreased function of the HPG (hypothalamic– pituitary–gonadal) axis which also results in reduced testosterone production (basically your brain is doing a half-assed job of telling your balls to make testosterone)

 

  • Inadequate protein intake -  Higher levels of SHBG are associated with low protein diets, this is significant because it results in decreased circulation of active testosterone.

 

  • Inadequate fat intake - Cholesterol is the backbone of all steroid hormones, including testosterone. Fat is also key for slowing down the absorption of glucose so adequate fat prevents fluctuations in blood sugar. Double win! :)

 

  • Poor liver health - Impaired liver function results in reduced production of cholesterol as well as poor detox of excess oestrogens. 

 

  • Excess phytoestrogens - These are compounds found in some foods which can potentially mimic oestrogen such as REFINED soy, nuts and seeds when eaten in excess. These compounds can also increase levels of SHBG (= decreased active testosterone)

 

  • Excess exposure to xenoestrogens - Chemicals which can also mimic oestrogen in the body such as parabens, phthalates, BPA, pesticides.

 

  • Poor gut health - An imbalance of bacteria in your gut can result in metabolic endotoxemia (a fancy way of saying that toxins from your gut are creating inflammation which affects your metabolic health including impaired blood sugar balance and body fat storage). Furthermore, gents can also be affected by the estrobolome (you may have heard me talk about this in relation to women’s health). This is the collective name for gut bacteria which produce enzymes that release oestrogen back into circulation rather than being excreted in your stool. 

 

  • Low vitamins D levels - There is evidence to suggest a correlation between vitamin D deficiency and low testosterone levels, this is potentially due to vitamin D’s role as a steroid hormone.

 

  • Zinc deficiency - Not only is zinc a key precursor for healthy testosterone levels, but it also blocks the conversion of testosterone to DHT (dihydrotestosterone). Increased levels of DHT are associated with male pattern baldness, mood disorders and inflammation of the prostate. Zinc also helps to inhibit aromatase activity (zinc deficiency = tendency for testosterone to be converted to oestrogen). It’s my go-to mineral for men’s health.

 

  • Poor sleep - Testosterone levels rise during sleep and decrease during waking hours so it’s a bit of a no-brainer that poor sleep patterns will contribute to lower levels of testosterone. One study found that getting just 5 hours of sleep each night reduced testosterone levels by 10 - 15 % (this was over the course of a week!). Again, this is a bit of a vicious cycle, as lower testosterone levels are associated with higher cortisol levels which will hinder sleep further (cortisol is your wake hormone).

 

  • Excessive calorie restriction - Not only does this decrease thyroid function (and therefore testosterone production), it also increases levels of SHBG (again, this has the potential to decrease levels of active testosterone)

 

  • Inactivity - To put it simply, the less active you are, the higher your levels of circulating blood sugar will be, which (you guessed it) means you’re at higher risk of insulin resistance and weight gain which results in higher levels of aromatase (= decreased testosterone and increased oestrogen) and cortisol. Maintaining adequate lean muscle mass is key to managing blood sugar levels (active muscles can use glucose without the need for insulin, pretty cool huh?!). Low testosterone levels will also make it hard to build and maintain muscle mass. 

 

  • Limited fasting - If you are grazing all the time (especially eating late at night when we are least sensitive to insulin) then you can expect that your blood sugar is all over the place, this again contributes to insulin resistance (our management of blood sugar is pretty key in all aspects of health)

 

So how is andropause avoided?

 

From supplementation to lifestyle and nutrition, there is plenty you can to do mitigate the hormonal disruption associated with andropause:

 

  • Decrease your intake of refined carbs and include plenty of protein and fat in your diet - Don’t be scared of saturated fat either, remember cholesterol is key for testosterone production. When it comes to protein sources, think wild caught, free range and organic. For fat sources include plenty of whole food such as eggs, nuts, seeds (in moderation), avocado, olives, hemp/walnut/flax seed oil, coconut, fatty fish and meat. Avoid refined seed oils like rapeseed and sunflower oil which are highly inflammatory.

 

  • Needless to say avoiding chemicals such as BPA and phthalates and leaning towards natural organic products is another no-brainer, but with phytoestrogens the research is mixed. In some people these compounds seem to block oestrogen receptors (decreasing circulating oestrogen), this is largely found with fermented soy such as tempeh, natto and miso. I still recommend reducing any refined soy (eg soy sauce and highly refined protein bars etc) and avoiding eating an excessive amount of nuts and seeds (these are still an important part of a balanced diet when tolerated).

 

  • Address your stress levels. This is so key and such a prevalent need with today’s fast paced, stressful way of living. Take some time to relax, meditate, breathe and get out in nature. You may also find it helpful to include some adrenal adaptogens such as ashwagandha.  

 

  • Get regular exercise. You’ll definitely want to include some strength/hypertrophy training to ensure you are maintaining a healthy amount of muscle mass as well as including regular activity be that walking, running, sports etc.

 

  • Reduce your alcohol intake. I don’t think I need to elaborate on this one. 

 

  • Look after your liver. As well as reducing alcohol and toxins, you could also increase your intake of cruciferous vegetables (especially broccoli sprouts) which help to support liver detox, as well as minerals such as zinc and molybdenum and herbs such as milk thistle. 

 

  • Optimise your gut health. This is a huge topic, but in a nutshell: cut out the processed shit, figure out your intolerances, eat plenty of veggies, add in some probiotic foods such as sauerkraut, kimchi or kefir, boost sources of prebiotics eg polyphenols and resistant starch, stop scoffing down your food at a million miles an hour, support your stomach acid levels, digestive enzymes and healthy fat digestion, add in some antimicrobials and probiotics where appropriate and you’re half-way there. Yeah this is a deep-deep-dive kind of topic and that was the mother of all nutshells :) 

 

  • Increase food sources of vitamin D and zinc such as egg yolks, fatty fish and shittake mushrooms for vitamin D and oysters, pumpkin seeds and red meat for zinc. Get yourself outside to soak up that vitamin D and supplementation may also be appropriate. 

 

  • Incorporate some time restricted eating. If you’re a grazer, start with a 12 hour fast overnight. As gents, your hormones respond well to fasting so you can gradually increase this up to 16 hour without too much hormetic stress on the body. The only time to tread carefully with fasting is if you are already under a lot of stress, this could be counterproductive. With any form of fasting, one thing to be mindful of is prolonged calorie deficits which, as mentioned, can down regulate your metabolism and decrease testosterone levels. Make sure you’re still getting enough calories into your eating window (‘enough’ is going to be very individual).

 

  • Optimise your sleep. Aim for a minimum of 8 hours sleep each night, create a cool, dark environment, avoid blue light in the evenings and expose yourself to daylight first thing (so that your cortisol is peaking at the right time).



There’s a lot more you can tweak too in terms of specific herbs/nutrients that have been found to boost testosterone levels, inhibit DHT and decrease aromatase, but I recommend starting with one or two of the basics above. 


As you can see, ANDROPAUSE is a pretty extensive topic, but an important one that I’m sure you’ll agree needs to be discussed more. I hope you’ve found this article helpful and if you’re living with any symptoms of andropause and need some help with a tailored plan, please get in touch. 


Stay healthy folks :)


Harri  

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The content in this article is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of a qualified health provider with any questions you may have regarding your health.