Menopause and Andropause – Hormonal Changes As We Age

 Dr. Lisa Polinsky, ND

We don’t stop playing because we grow old; we grow old because we stop playing.

George Bernard Shaw

Symptoms of peri-menopause and menopause for women can be similar to what men experience during their own hormonal changes of andropause (colloquially known as ‘male menopause’).  Nightsweats, fatigue, insomnia, depression and reduced libido can be experienced by both sexes during midlife and while they may have different hormone profiles they have similar health systems that contribute to the imbalances. Hormonal transitions in life simply amplify preexisting deficits be they of digestive, thyroid, liver or adrenal (stress) origin or some combination of these systems. From a naturopathic medical perspective by identifying the underlying systems that may be out of balance as one moves through these hormonal transitions helps us understand how to treat holistically thereby alleviating symptoms. Occasionally we do need to rely on hormone replacement yet often when we treat the deeper causal system we experience better health, enhanced quality of life and a reduction of distressing symptoms.

Andropause

Not all men experience ‘andropause’ which is defined as a significant reduction in the androgen hormone testosterone beyond the normal 1% per year that occurs after age 30.   Approximately 30% of men experience a more severe drop in testosterone that then leads to a relatively higher experience of estrogen in the body, often coupled by lower relative progesterone. Testing hormones by either saliva or serum are used to diagnose andropause as well as identify what other hormones may be out of balance. The underlying systems that influence hormones for women also impact hormones for men and dictate how this transition is experienced – smooth and balanced or rocky and disturbing – liver, thyroid, adrenal, nutrition and digestive function. Naturopathic doctors in BC are restricted from prescribing testosterone hormone as a treatment yet have many other tools available to support increasing the body’s production of innate testosterone.

Symptoms of Andropause:

Insomnia, night sweats, depression, fatigue, low libido, low self-esteem, hair loss, weight gain around the abdomen and chest, weakness, erectile dysfunction.

Treatment of andropause may include:

Increasing testosterone through strength training, far infrared saunas, increased dietary protein, reduced alcohol and saturated fats, and the addition of herbal agent Tribulus terrestris.

Peri-Menopause and Menopause

Women age naturally through a phase of transition called perimenopause (approximately ages 35 – 50) cheekily called ‘reverse puberty’. Menstrual cycles become unpredictable and irregular, often heavy, more frequent or sporadic. Once cycles stop for greater than 1 year a women technically enters the phase of menopause. Serum testing of elevated FSH (follicle stimulating hormone) confirms the diagnosis.

Transitions through either perimenopause or menopause vary significantly for a woman based on how her lifestyle and general health was prior to this time. The state of her liver, thyroid, overall nutrition and digestive function, as well as mental and emotional stress (adrenal function) all contribute to either stabilize or destabilize the symptom picture. The more she is in balance the smoother this transition will be. Not all cultures have the same experience of menopausal symptoms with Japan being the most notable at a mere 7% of women noting hot flashes compared to 55% of women in the United States*. This points to a significant influence of dietary nutrients being supportive of hormonal equilibrium. Soy products (ideally organic rather than GMO) bind to estrogen receptors and help balance out what the body needs.

Symptoms of Menopause can include the following:

Insomnia, hot flashes, vaginal dryness, decreased libido, depression, fatigue, dry skin, reduced tolerance to stress, increased facial hair, heart palpitations, hair loss, memory problems, brain fog, painful intercourse, joint pain and muscle aches.

The unique experience of menopause points to the fact that underlying hormonal changes are not the same for every woman. Ideally, serum or salivary testing is undertaken to pinpoint the individualized imbalances. There is no ‘one size fits all’ treatment. Common hormone fluctuations can be reduced or elevated testosterone, reduced or elevated estrogen, lowered progesterone, lowered DHEA, reduced or elevated cortisol as well as thyroid imbalances. Given the liver breaks down and excretes hormones from the body any congestion here will worsen other imbalances. Naturopathic doctors are skilled at navigating through the confusion by determining underlying issues and personalizing treatment.

Treatment of menopause may include:

Dietary inclusion of non-GMO soy products, seaweed for iodine, reducing stress and adrenal support, enhanced thyroid function, liver herbs, optimizing gut microbiome bacteria, botanical herbs such as Cimicifuga racemosa, Wild Yam, and bioidentical plant-based hormone therapy.

Similarity for Women and Men

The Endocrine Triangle (an equilateral triangle of the adrenals, thyroid and ovaries/testes) in both men and women assists in hormone balance throughout life and is aided by liver and digestive function. As a woman’s ovaries reduce function during menopause, and men’s production of testosterone from the testes reduces during andropause both rely more on their adrenal and thyroid function for support. Women and men are perhaps more similar than we realize as we age hormonally.

*Hormone Deception Berkson, Dr. Lindsey. McGraw-Hill. 2000 Pg 321

NO MORE HRT: Menopause Treat the Cause 2002 Jensen, Dr. Karen, Vanderhaeghe, Lorna

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