‘Manopuase’ is a term mainly perpetuated by the media as a buzzword to explain how men’s physical and mental performance declines in middle age, but although manopause seems like a derogatory label, it does make sense – and let’s face it, that sounds a heck of a lot better than “hypogonadism”; the medical term for those who suffer with little or no production of sex hormones. ‘Muscle & Fitness’ spoke with Dr Jeff Foster, Men’s Health Specialist and Medical Director of H3 Health in the UK to find out what we need to know about manopause on the way and beyond. 40s, and what are the last treatments in 2021, so that we can # befitover40 with our body and mind.

What is “manopause”?

Testosterone gradually rises in men until they reach about age 30, and then it begins to decline at a rate of about 1% per year. Your testosterone levels will be affected by lifestyle factors like diet, stress levels, and genetic predisposition, but once your levels start to drop you may lose more than just your sex drive.

For women, menopause means low estrogen, and for men, manopause, or hypogonadism, basically means a decrease in testosterone production. Whether you prefer “manopause”, “hypogonadism”, “andropause” or any other term, it is essential to be aware of what they all basically mean. Due to lack of awareness, many men suffer from easily treatable symptoms due to low testosterone levels as they simply attribute them to the aging process when in reality there is a lot we can do to improve our quality. of life. Testosterone provides metabolic benefits such as muscle mass, bone density, cognitive abilities and many aspects of our personality, it also lowers the risk of heart disease and type 2 diabetes, so it makes sense to have a optimal level of “T”!

What are the signs of manopause and low testosterone?

Signs that you may be low on testosterone include low sex drive, difficulty getting or maintaining an erection, low semen volume, hair loss, fatigue, loss of muscle mass, increased blood pressure, body fat, mood swings, memory problems and “brain fog”.

In the United States, low T is diagnosed when levels drop below 300 nanograms per deciliter (ng / DL). In England, where Dr Foster is a practitioner, the British Society of Sexual Medicine uses a different scale where a target of 15 to 30 nanomoles per liter (nmol / L) is the ideal range for the test. In theory, low testosterone can be diagnosed with a simple blood test, but treating the problem is more complex because there may be a highlighted medical condition such as asthma or depression that is lowering your level. This is where the advice of a male health practitioner becomes very beneficial.

“What we really want to know is the level of free testosterone; real or ‘bioavailable’ testosterone in our blood, ”explains Foster. “A fit, healthy man has only about 3% usable testosterone at any given time and the rest is bound to other proteins, primarily sex hormone binding globulin and albumin. This means that for some men they have what looks like normal testosterone levels, but in reality the amount they can actually use is less than it should be. This is why it is so important to see a specialist for men’s health and not to rely solely on an online test, or even seeing a regular doctor, as you may be told your levels are normal when they are not.

Know this before you start testosterone replacement therapy (TRT)

Foster shares this: “Maybe less scrupulous clinics will just give men with low testosterone replacement therapy (TRT), but in fact there are two things we should always do before we start. therapy.

1. Find out why the levels are low. Other medical problems can cause low testosterone, for example thyroid disease, type 2 diabetes, anemia, problems with our pituitary gland in the brain, as well as certain drugs or factors related to mood. of life.
2. Decide if the levels can be restored by treating the cause. For some men, a poor diet, no exercise, little or no sexual activity, being overweight, poor sleep, high stress levels, and certain medications (such as asthma, blood pressure, and antifungal drugs) can affect our testosterone. .

“We shouldn’t ignore these things,” says Foster. “We must always treat patients holistically by addressing the underlying cause. Investigate their lifestyle, then you can add TRT if needed. Interestingly, while this is true, some guys find that they are in such a downward spiral of negativity that changing these bad habits can be nearly impossible. For these men, we actually give them testosterone early in the process because it gives them the energy and motivation they need to lose weight, eat better, sleep better, and improve their mental health. For these men, they may be able to stop testosterone altogether when their lifestyle or other medical issues have been resolved.

The Latest Advances in Low Testosterone Treatments

Advances in technology mean that TRT can be administered as a topical preparation or as an injection. For some, daily application of a cream or gel is the way to go, while others prefer to inject as it can then mean several weeks between treatments. It’s already understood that maintaining a healthy weight, staying active, reducing stress, getting better quality sleep, and reducing alcohol consumption will have a positive effect on test levels, but there are other advancements seen by experts such as Dr Foster in his clinic at Leamington Spa, Warwickshire.

“We are now using a combination of testosterone replacement and daily tadalafil (a drug similar to Viagra but which has a longer half-life),” says Foster. “It seems to produce better results for many patients than using testosterone replacement alone. Tadalafil is inexpensive and very effective and may have other benefits besides better sexual function, in terms of benefits for your heart.

Despite our propensity to advertise ourselves as “over the hill” by the time we turn 40, the existence of a weak test can affect any age group. “My clinic has over 150 men on treatment and my youngest patient is 26, my oldest is 92,” says Foster. “It can affect any man, and we already have almost a million men diagnosed with low T in the UK (at least one in four men over the age of 30 is thought to have low testosterone in the United States, and that number is increasing due to our longer life expectancy and other environmental factors.) The key is to listen to your body and look for symptoms and don’t just accept them as being “normal for my age”.