Andropause

Have you ever heard of it? 

"Concerning the interprocreation of men, how, and of whom it shall be, in a perfect manner, and according to the laws of modesty and sanctity, conjointly, this is what I think right. First to lay it down that we do not commix for the sake of pleasure, but of the procreation of children. For the powers, the organs and desires for coition have not been given by god to man for the sake of pleasure, but for the procreation of the race. For as it were incongruous for a mortal born to partake of divine life, the immortality of the race being taken away, god fulfilled the purpose by making the generations uninterrupted and continuous. This therefore we are especially to lay down as a principle, that coition is not for the sake of pleasure." - Pythagoras

Andropause aka manopause is simply the symptoms associated with less than optimal testosterone levels in men. These symptoms include erectile dysfunction, poor mood, fatigue, low libido, muscle atrophy, increases in body fat and poor concentration. A relatively subtle drop in testosterone is a part of aging; yet it is much less extreme than most think. A 1% decrease in your testosterone year over year starting in your late twenties is considered normal, however, nowadays we see men in their early twenties with the testosterone levels of a middle aged or elderly man. What causes this drastic decline in testosterone? What can be done to reverse this trend? This post will walk you through the common pathways to low testosterone, the causes of low testosterone, and simple solutions to improve your testosterone levels. 

Male sex hormones

To provide further understanding pertaining to testosterone and male sex hormones lets first look at the basic male hormone physiology. Though it’s often thought to be incredibly complex, the male sex hormone pathway is actually relatively simple. The process starts in the hypothalamus where gonadotropin-releasing hormone (GnRH) is produced. (GnRH) stimulates the release of luteinizing hormone (LH) from the pituitary gland. Luteinizing hormone acts on the Leydig cells in the testicles, which produce testosterone. Testosterone can then be converted into dihydrotestosterone (DHT). DHT is said to be ten times more metabolically active than testosterone. DHT is what can lead to male pattern baldness, excessive body hair and an enlarged prostate.

Our bodies are set up to self-regulate hormones through a negative feedback loop. This means that in men when testosterone is low or high the body will signal the pituitary gland to either produce more or less luteinizing hormone. There are a multitude of things that could potentially influence this balance. Of which we will discuss in the next section of this article. Therefore, it is essential not only to understand what your levels are but also what could be negatively influencing them. If you can remove the negative influencers it will allow you to have optimal testosterone production. 

Pathways to low testosterone

There are several pathways that lead to lower than optimal testosterone. The first of these pathways is over conversion of testosterone into estrogen. This is done through a process called aromatization where the enzyme aromatase acts on testosterone and converts it into estrogen. The second pathway is an increase in the production of sex hormone binding globulin. This protein binds to testosterone lowering the amount of free or bioavailable testosterone. Often times when male hormones are assessed they simply look at the total amount of testosterone and not the free testosterone. Endomath's testosterone saliva test measures free testosterone levels. The third pathway is inflammation to the Leydig cells. This causes resistance to luteinizing hormone and decreases the production of testosterone. The fourth pathway is conversion of testosterone into DHT. The final and most common pathway is chronic stress. Chronic stress depresses pituitary function leading to lower LH levels. It can also lead to the body favoring the production of cortisol over testosterone. 

Causes of low testosterone

The first and most prevalent cause of low testosterone is insulin resistance. Insulin resistance up regulates the enzyme that creates aromatase. This enzyme is responsible for the conversion of testosterone into estrogen via aromatization. With the increase in estrogen you will get an increase in sex hormone binding globulin, which lowers your free testosterone. 

The second cause of low testosterone is inflammation. Excessive inflammation can alter the growth and function of the Leydig cells in your testicles. This creates resistance to LH, which ultimately negatively influences your pituitary function. The most common causes of inflammation are your nutrition, gut health, infections, overtraining, and blood sugar deregulation. 

The third cause is stress. The body’s natural response to stress is to increase the hormone cortisol. Cortisol has many actions, one of which being an increase in blood sugar and insulin resistance. Insulin can negatively influence luteinizing hormones effect on the Leydig cells. Cortisol also diverts precursor hormones away from the androgen pathway in favor of the stress pathway. To better understand how your stress hormones are influencing your testosterone levels consider Endomath’s adrenal stress profile.

What can I do to improve my levels?

The steps to optimal testosterone levels are often times relatively simple. Below are the steps to take to improve your testosterone levels. 

  • Minimize consumption of refined carbohydrates

  • Eliminate soy, dairy and gluten from your diet

  • Limit intake of caffeine 

  • Perform strength training 3+ days per week

  • Complete 3-6 sprint intervals ranging from 30-90 seconds 3x per week

  • Get 7-9 hours of uninterrupted sleep per night

  • Focus on getting 10,000 steps in per day

  • Take cold showers

Remember, knowing where you’re going is the first step to getting there. Sounds like something Yogi Berra would say… In reality one needs to understand what is going on within their body so that one can achieve optimal health. For many this is difficult, but since you are here reading this you are on the path. Test your levels to establish your baselines train hard to increase fitness, eat clean to provide yourself with the right fuel because health is wealth.