So what is MANOPAUSE?

The Complexity of ‘Manopause’ 🧔

When we think of testosterone, the first images that tend to spring to mind are those of hulking muscle men with insatiable libidos and short tempers. Testosterone is responsible for much more than this though, playing a vital role in numerous aspects of male health and ageing including cardiovascular health, body composition, cognitive function and mood. Compared to females, men are often considered to be simple creatures, however testosterone production and utilisation is subject to a complex web of influences, being affected by ageing, nervous system and immune function, nutrient intake, psychological factors and body composition.

Testosterone levels begin to rise in puberty, reach their maximum in a man’s early twenties, and gradually begin to decline from then on. From about the age of 30 men tend to lose about 1% of their testosterone each year – this is normal.

However, as average peak testosterone levels in men have dropped by approximately 20% over the past 40 years, more and more men are experiencing the negative effects of lower testosterone as they age.

Everyone has heard of menopause, the stage of life whereby a women’s sex hormone levels begin to decline. The use of the term ‘manopause’ (or andropause) however is becoming increasingly common, used to describe the correlating condition in ageing males. Some cardinal symptoms of ‘manopause’ include:

  • A reduction of sexual thoughts or desire;
  • Trouble achieving or maintaining an erection;
  • Lower energy levels;
  • Mood changes;
  • Loss of muscle mass and bone density;
  • Reduction in cognitive function; and/or
  • Mood disturbances.

Under normal circumstances, testosterone production is tightly regulated within the body. Initially, signalling hormones are produced by the brain, and travel to the testicles to stimulate testosterone production. As testosterone production increases, the brain receives the message there is enough testosterone within the body and stops telling the testicles to produce it. Once levels start to fall, the brain then produces more signalling hormones to stimulate the production of testosterone. This feedback system is what keeps levels of testosterone optimal and the male body healthy.

However, there are a number of factors that can interfere with normal testosterone production and utilisation:

  1. Once produced, testosterone can be converted into other hormones by enzymes, the two most important called aromatase and 5-alpha reductase. Increased activity of these enzymes can contribute to symptoms of ‘manopause’ by reducing levels of available testosterone.
    • Aromatase is found particularly in fat tissues, and it’s activity is up-regulated by inflammation. Aromatase actually converts testosterone to oestrogen, meaning excess weight and inflammation can cause a reduction in testosterone and an increase in oestrogen (which we don’t want too much of in men).
    • 5-alpha reductase converts testosterone to a very active form of testosterone called dihydrotestosterone (DHT). While DHT promotes growth in skeletal muscle, too much can also cause the prostate to enlarge (a condition known as benign prostate hyperplasia) and trigger hair loss in hereditary male pattern baldness. Unfortunately, this activity of DHT is largely determined by genetics.
  2. Nutritional deficiencies can also inhibit the production of testosterone.

    Adequate intake of protein, essential fatty acids, zinc and selenium is crucial to provide the necessary building blocks for testosterone production.

  3. Chronic stress can also reduce testosterone production in a number of ways.
    • The ‘ingredients’ (or structural components) required for testosterone production are also used to produce the stress hormone cortisol. Excess production of stress hormones on a long-term basis reduces the amount of ingredients available for testosterone production.
    • Cortisol levels can also directly inhibit testosterone production in the testes, as well as the production of the testosterone signalling hormones in the brain.

While there may be complex processes reducing testosterone production, the good news is that many of these can be addressed by simple diet and lifestyle interventions:

  • Eat a balanced diet rich in antioxidants, minerals and essential fatty acids to provide all of the building blocks for healthy testosterone production.
  • Maintain a healthy body composition, keeping body fat levels down to reduce the conversion of testosterone to oestrogen by aromatase.
  • Tackle inflammation by addressing lifestyle factors such as sugar and alcohol consumption, further reducing aromatase activity.
  • Learn to manage stress effectively, and ensure good quality sleep to regulate cortisol production, which is crucial for maintaining healthy testosterone levels as you age.

Lastly, there are a number of herbs that have been shown to support testosterone levels and male reproductive health. For example, Tribulus terrestris or ‘tribulus’ has been shown to enhance testosterone in animal studies, and has a long history of use in traditional Ayurvedic medicine to support virility and sexual desire. Similarly, the intriguingly named ‘horny goat weed’ (whose correct Latin name is Epimedium sagittatum) is a traditional male tonic indicated for impotence, as an aphrodisiac, and to enhance sperm production. For optimal results, these herbs should be combined with supplementary zinc (if required), along with the diet and lifestyle strategies above.

Even if the more superficial aspects of testosterone deficiency are not of concern, the role that testosterone plays in wellness and ageing means that all men who wish to live a long and healthy life should be looking to support their testosterone levels in a natural, holistic manner. So if you are feeling fatigued or cranky, your mojo isn’t wasn’t it used to be or you notice that you are losing muscle mass, it could mean that you have low testosterone. If so, work with a qualified healthcare Practitioner to uncover and address the underlying causes, such as those discussed above, to ensure your quality of life now and into old age.

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