Every week I am posting about  everything you need to know about hormones. This weeks topic is about andropause

Did you know …

  • Is a condition associated with the decrease in the male hormones Testosterone and DHT Di-Hydro-Testosterone
  • Also called late-onset hypogonadism or age-related low Testosterone.
  • Testosterone was discovered in 1935
  • Testosterone (T) decline is on average approx. 1 – 2% per year, from the age of 30
  • Much more gradual than female menopause and easier to navigate as there is only 1 hormone to support and replace
  • By approx. age 70 the decrease can be 40 – 80%
  • Andropause awareness is very important as many men over the age of 40 experience symptoms of low T, but are unaware that their symptoms are due to andropause and that there are solutions.
  • Young men under 30 will have T levels exceeding 1000 ng/dl
  • Average levels for men in their 70s and 80s is 200 ng/dl
  • 30-40% of men in their 50s will experience symptoms of low T levels.
  • Most older men still have testosterone levels within the ‘normal age related range’
  • With only an estimated 10% to 25% having levels considered to be low
  • Because of this the medical community is not united on the topic of male menopause and the need to replace T
  • BUT just because you are within your ‘normal age related range’ doesn’t mean you have enough T to function optimally as a man physically, mentally and or emotionally
  • Levels vary during the day, with peak values in the early morning, which is why morning erections are a good sign of optimal production of T
  • T production is increased during REM sleep, especially between 2 – 6am
  • Heart studies show that TT levels corresponding to the upper level of the age related range for 50-59 year olds, ie 500-800 ng/dl to be beneficial
  • Andropause / low T may cause any number of physical and mental changes and can increase the risk of serious health conditions, such as CV problems
  • Other reasons for low T can be diabetes, thyroid problems, and medication side effects, such as finasteride for male pattern baldness
  • BTW – men with diabetes are twice as likely to have lower levels of T than men without diabetes.

Meet Sally and get to know all about andropause


The aging penis

Testosterone replacement therapy

Andropause 101

  • Is a condition associated with the ‘natural’ decline in the production of Testosterone and DHT / Di-Hydro-Testosterone
  • The decline start around the age of 30 and is more gradual than what occurs in female menopause
  • Andropause also clinically referred to as Testosterone deficiency syndrome, androgen deficiency, and hypogonadism
  • NB! – unlike the female menopause men don’t lose the ability to reproduce completely and not all men are conscious of the drop in T
  • Men in their 50s can have approx. 40% less testosterone than in their 30’s
  • Physical, sexual, and emotional changes occur as a result of a decline in T.

Symptoms Related to Andropause and or Low T

  • Low libido / sex drive
  • Erectile dysfunction:

– difficulties getting erections
– lack of spontaneous erections

  • erections not as strong as usual
  • Increased fat accumulation especially around the middle and / or hips and butt
  • Man boobs
  • Higher fat% in general
  • Poor muscle definition and strength
  • Increasing muscle mass doesn’t come easy
  • Low bone density – osteoporosis
  • Height loss
  • Loss of body hair
  • Low energy
  • Hot flushes / sweats
  • Depression
  • Mood swings
  • Lower self-esteem (than usual)
  • Low motivation
  • Poor decision-making and procrastination
  • More cautious than before
  • More ’grumpy’ than before
  • More irritable than before
  • Poor sleep.

Other Causes of Low T

While andropause is the natural cause of declining T related to aging, there are other causes that should be excluded

  • Diabetes
  • Hypothyroidism
  • Low iron levels
  • Testicular failure due to genetic errors
  • Mumps
  • Severe trauma
  • Alcoholism
  • Cancer chemotherapy and radiation
  • Medication side effects
  • Pituitary gland problems, such as tumours, head trauma, brain surgery
  • Severe malnutrition.

Testosterone Important for: 

Brain Health

  • Creates the male mood and character, by increasing
  • risk taking
  • problem solving
  • libido
  • competitiveness
  • dominance
  • aggression

Muscle and Bone Health

  • strength


  • increases fat burning
  • may increase Estrogen production

Skin and Hair Health

  • increases sebum production – oily skin and acne
  • increases hair growth on the face and body
  • increases hair loss on the head – male pattern baldness

Testicles and Prostate Health

  • sperm production
  • seminal fluid production
  • ejaculation

Ovarian Health

  • increases Estrogen production

Cardio-Vascular Health

  • increases red blood cell production in bone marrow
  • keeps the endothelial layer healthy, decreasing inflammation
  • dilates blood vessels
  • keeps heart muscle strong.

Measuring Testosterone

Serum Testosterone levels are measured in various ways

  • TT – Total Testosterone
    – the total amount of Testosterone found in the blood
  • SHBG – Sex Hormone Binding Globulin
    – a protein that binds free testosterone
  • Free Testosterone
    – usually a calculation of Total Testosterone minus SHBG = free testosterone, which is the bioavailable hormone and only Testosterone that can be used by the cells

TT levels are measured in ng/dl and vary depending on age

Age 17-20

Age 21-29

Age 30-39

Age 40-49

Age 50-59
215-878 – a good range when using TRT for optimal CV health

Age 60-69

Age 70-79

Replacing Testosterone

TRT – Testosterone Replacement Therapy

  • Patches – every day
  • Gels – every day
  • Injections – 2 – 4 weeks
  • Capsules – 2 x daily

NB! – Always test before and after starting TRT – aim for am. serum levels of TT (total testosterone) of 500 – 800 ng/dl

Aromatase Inhibitors

  • Aromatase is the enzyme that converts T to Estrogen
  • Aromatase inhibitors block this conversion
  • Can be used in combination with or instead of TRT
  • DIM – increases the excretion of all Estrogens and is a mild aromatase blocker – BUY HERE
  • Grape Seed Extract – blocks aromatase –BUY HERE
  • Prescription aromatase inhibitors – such as letrozole are very effective in increasing testosterone. Careful with the amount – <2.5mg once a week is more than enough for most men. Work with a professional.


  • TRT is a lifetime commitment.
  • TRT is not a silver bullet, lifestyle is equally important.
  • TRT can be harmful if taken by men with normal levels – think misuse of anabolic steroids
  • TRT is contraindicated for any man with prostate cancer.

Lifestyle Choices to Maintain and or Increase T

  • Blood sugar control and fat burning with TRE – Time Restricted Eating and low carb regimes – READ MORE IN THIS BLOG
  • I. strength exercise to increase muscle mass – 50 minutes sessions daily can be enough
  • Reduce stress – Cortisol increases blood sugar and breaks down muscle tissue, not a good cocktail if you want to burn fat
  • Block the conversion to Estrogen with natural aromatase inhibitors, such as DIM and or Grape Seed Extract DIM – BUY HERE or HERE
  • Stop smoking
  • Reduce alcohol
  • Get some sun – vitamin D increases testosterone – BTW that’s why we get horny when sunbathing.

Disease States and Conditions Related to Low T

  • Cardiovascular problems
  • Insulin resistance and Type 2 Diabetes
  • Osteoporosis (brittle bones)
  • Sarcopenia (muscle loss)
  • Low blood percent
  • Depression.

Testosterone and Heart Disease

  • In a 2014 study, researchers found that men who increased their levels of testosterone through TRT (testosterone replacement therapy) had a 55 % reduced risk of heart attack and stroke
  • Also in men with pre-existing heart disease BUT – Higher-than-normal testosterone levels can increase the risk for heart attack and or stroke.
  • Men under 55, the risk of heart attack and stroke was reduced by 25%, men over 60, the risk was reduced by 15%
  • Blood testing before and after TRT is imperative
  • TT (total testosterone) serum levels between 500-800ng/dl is best for optimal affect
  • This review states – states:

– There is no credible evidence at this time that TRT increases cardiovascular risk, BUT there is substantial evidence that it does not.

– Many studies have indicated that low serum T concentrations are associated with increased cardiovascular risk and mortality and that TRT may have clinically relevant cardiovascular benefits.

– Studies have reported:

  1. reduced CV risk with higher endogenous testosterone concentration
  2. improvement of known CV risk factors with TRT
  3. reduced mortality in testosterone-deficient men who underwent TRT versus untreated men.

The Aging Penis

  • Age leaves its mark on every part of the body, including the penis
  • Testosterone helps the penis grow during puberty and fuels sex drive
  • The decline in testosterone can change the size, shape, and function of this all-important organ
  • It Shrinks – a penis may downsize due to low T, but also problems with reduced blood flow due to clogged blood vessels, which will also increase blood pressure. Plus putting on weight creates the illusion of lost length as belly fat hides the penis, making it look smaller than it really is
  • It Curves – injuries from rough sex, sports, or an accident can create scar tissue and by your 50s or 60s, you can have enough scar tissue build-up to make your penis bend or curve during an erection. The condition is called Peyronie’s disease. It’s often painful, and it can make sex uncomfortable, even impossible. Treatments ranging from injections to surgery can lessen the curve and make sex more comfortable / possible again
  • Testicles Shrink – for the same reason the penis shrinks, such as, low T, injuries, less blood flow, and anabolic steroid misuse. A shrinking testicle can sometimes be a symptom of testicular cancer – check in with your doctor
  • The Scrotum Sags – skin naturally becomes less elastic as we age, so just as the skin of the face and neck wrinkle and sag, so can the skin that covers the testicles. Scrotal rejuvenation surgery can give the sac a lift
  • Less Sensitive – the penis naturally loses sensation as it ages, so maybe more time, and or more stimulation is necessary for arousal, erection and orgasm
  • It Loses Its Spontaneity – erections at the drop of a hat are a delight of the past, ‘getting it up’ may become harder to accomplish. In fact by age 70, approx. 70% of men have trouble getting an erection – talk to your doctor
  • It Changes Colour – blood makes the penis pink and as blood flow slows, the penis may turns a lighter shade, especially its head and poor blood flow can cause erectile dysfunction
  • Cosmetics:

– It Goes Grey – as in the pubes lose colour, just like the hairs on your head

– It Goes Bald – hair thins just as the hair on your head, a hair transplant is always an option if you are sensitive about baldness down below.

Questions? Please don't hesitate to contact me

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