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Neolife has a unit exclusively dedicated to men, which focuses on treating people who are going through andropause approximately starting from the age of 40 to 45.

The term andropause is used in men to define a process similar to menopause in women, but with two fundamental differences:

  • While menopause occurs between the age of 45 and 55, the ‘transition’ in men is usually slow: it can last for decades and progresses differently in each individual.
  • Menopause means the absence of fertility; on the contrary, andropause is not necessarily related to the end of men’s fertile stage.

What is andropause? What are its symptoms?

Andropause, also called ‘midlife crisis', ,has been mainly attributed for some time now to a testosterone deficit which occurs starting from the age of 40, although recent investigations have demonstrated that it is not only due to this hormone. Andropause has a physiological basis in the fall of the plasmatic levels of hormones such as testosterone, DHEA or melatonin, and an increase in others such as cortisol or insulin.

In men, a decline in hormonal levels starts to show up from this age, increasing the chances of suffering diseases such metabolic syndrome, cardiovascular compromise, diabetes and hypertension. Some of them, like osteoporosis or cancer, are common in menopause.

The symptoms of andropause are characterised by the emergence of:

  • Physical disorders: like a decrease in sexual desire, erectile dysfunction and ejaculation disorders, increased waistline, loss of muscle mass, skin dryness, etc.
  • Emotional disorders: like mood changes, anxiety or irritability.
  • Sleep disorders and difficulty resting.

Progressive fatigue and hot flushes are some of the symptoms that andropause and menopause have in common.


Do you suffer from andropause? Learn about your diagnosis

The so-called ‘midlife crisis’ has a physiological basis in the fall of the plasmatic levels of hormones such as testosterone or melatonin. In men, hormonal level decline starts to appear at this age, increasing the possibility of suffering diseases (cardiovascular, neurocognitive, osteoporosis, cancer, etc.) and decreasing quality of life (a decrease in athletic and professional performance, a decrease in libido, muscle loss, fat gain,etc.).

The following questionnaire will help you to understand if your symptoms are due to a hormonal imbalance. Andropause can start insidiously even before the age of 40. Not all the symptoms described below are exclusively due to a hormonal imbalance, but their presence, together with low or sub-optimum hormonal analytic levels, may be the reason.



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Hormonal balance in men is the key to maintaining good health. Testosterone, thyroid hormones, estrogen, dehydroepiandrosterone, cortisol, insulin, melatonin, etc. Each one has its specific function and moreover many of them interact in a synergistic way.

As hormonal values decrease, our health deteriorates, increasing the chance of suffering diseases.

Hormones are chemical messengers secreted by different endocrine glands which intervene in our body’s metabolism. The incidence of age-related diseases is largely controlled by our immune and endocrine systems, partly responsible for our changes in the ageing process.

Hormones in Men

Over time, all the symptoms resulting from the hormonal imbalance happen more due to the decrease in levels of most of the hormones (estrogen, progesterone, testosterone, melatonin)and/or to the increase of others (insulin and cortisol).

But the body does not work nor react the same in all men, so it is essential to test yourself to find out the real causes of the imbalance and like this, achieve an accurate and precise diagnosis to be able to act accordingly.

Below is a brief overview of the main male hormones, their functions and the impact of their imbalance on the body.


Main hormonal functions in men
  • Testosterone
  • Estrogen
  • Thyroid Hormones
  • Melatonin
  • DHEA
  • Cortisol
  • Insulin

Testosterone

Testosterona is the main sex steroid hormone. It is produced in the Leydig cells in the testes by the stimulation of the pituitary luteinizing hormone (LH).

Testosterone has a powerful anabolic effect on muscle and bone tissue. It also has androgenic effects, such as libido or hair distribution through its immediate metabolite, DHT (Dihydrotestosterone).

It also affects mood and cognitive function.

Hormones VS Aging

Numerous studies confirm that in men, starting from the second half of the twenties, levels of total testosterone, and especially levels of free testosterone, decrease between 10% and 20% per decade.

Low testosterone levels are associated with decreased libido, sexual organ potency loss (hardness and duration), lack of morning erections, lowered mood, body fat gain, loss of muscle mass and strength, a decrease in bone mineral density and an increase in cardiovascular risk, among others.

Estrogen

Although it is a typically a female hormone, it is also crucial in men’s health. Estrogen in men is produced in the testes and in small quantities in the adrenal glands. The quantities produced in the male body are significantly lower than in women.

Estradiol in men is responsible for regulating the nervous system, stimulating metabolism, increasing the calcium deposit in bone tissues, participating in sperm production processes and regulating the cardiovascular system reducing the bad cholesterol.

Low estradiol levels are associated with negative effects on the cardiovascular system, bones, sex life, skin smoothness, emotional well-being, sleep, cognitive capacity, mood and the immune system.

Thyroid Hormones

Thyroid Hormones are produced in the thyroid and regulate the metabolic rates of all cells. There are receptors for the thyroid hormones in most of the tissues and, therefore, they affect the functioning of almost all organs and systems, especially the heart, bones and subcutaneous fat.

Their effects are to control body temperature and to boost the metabolism of fatty tissue which helps with fat weight loss and lowering cholesterol levels. They are cardio and neuroprotectors.

Low levels of thyroid hormones are related to uncontrolled weight gain, feeling blue, chronic fatigue, depression, thin and weak hair, dry skin, brittle nails, feeling cold, etc.

Melatonin

Melatonin is a molecule related to neuroendocrine physiology. It is involved in the regulation of circadian rhythms and the sleep/wake rhythm, also a hormonal modulator of immune system activity.

It is also a crucial hormone in the regulation of the mitochondrial function, for ATP production, which is the form of energy a cell uses for all its functions. Additionally, melatonin is a powerful antioxidant and anti-inflammatory.

Hormones VS Ageing

Lack of melatonin produces a loss in the capacity to regulate circadian rhythms, producing problems in the quantity and quality of sleep and rest.

A decrease in melatonin produces oxidative and nitrosative stress,which will intensify the bigger this hormone deficit is. This causes cell inflammation, weakening the immune system, and therefore causes disease.

Moreover, as melatonin synchronises the rhythms of brain neurotransmitters, its decrease directly affects cognitive capacities.

DHEA (Dehydroepiandrosterone)

DHEA is a weak androgen produced by the adrenal glands, which is secreted in the liver and circulates in the blood in its sulfated form (DHEA-S).

It is a precursor of numerous sexual hormones, such as testosterone, estradiol and estrone. Moreover, it has effects alone in arteries, bones and the immune system.

DHEA-S plasma levels are a good biomarker of ageing because they decrease between 10-20% per decade from the age of 20.

Hormones VS Aging

A proper DHEA level promotes tissue reconstruction (stimulating protein metabolism), helps to control stress (countering the cortisol effect) and has positive effects on cardiovascular, bone, immune, sexual and mood levels.

Cortisol

Cortisol is produced in the outer layer of the adrenal gland, like aldosterone, DHEA and other hormones. It intervenes in the metabolism of protein, fats and glucose, and plays an important role in the immune system.

Like insulin, it is a hormone which increases with age and with bad lifestyle habits, producing medium and long-term problems.

It is known as the ‘stress hormone’ because it increases in situations of severe physical and/or psychological stress , in response to the hyperstimulation of adrenal glands in phase 1 or the Hans Seyle alarm, suppressing the immune system.

However, a chronic stressful situation produces a decline in this hormone and can reflect adrenal fatigue syndrome.

Insulin

Insulin is the hormone that is secreted by the pancreas when glucose levels increase after eating and allows it to enter inside the cells (especially in the liver, brain and muscle) to be used as energy.

The amount of insulin needed to maintain a certain level of glucose in the blood is an indicator of resistance and sensitivity of the cells receptors to insulin.

Insulin, together with the rest of the indicators of the hydrocarbon profile, is correlated with the risk of developing type 2 diabetes and its related cardiovascular, renal, neurological complications and complications of the retina, as well as a lower life expectancy and quality of life.

Type 2 diabetes is a disease that corresponds to 95% of diabetes cases. It appears in adults and increases with age, sedentary lifestyle, overweight and obesity. It is characterised by a resistance of the cells receptors to insulin, hyperinsulinism at first and an exhaustion of the pancreas to release insulin in the most advanced stages.

Prediabetes can be detected years before the development of type 2 diabetes by monitoring the metabolism of hydrocarbon biomarkers.

Bioidentical Hormones. The Key.

Correct and safe hormone replacement therapy always must be done with bioidentical hormones.That is to say, synthetic hormones have to be avoided.

Bioidentical hormones have the same molecular structure as our own hormones and, therefore, are metabolised exactly the same as the hormones produced by our endocrine system, in a natural way, and without the possible side effects of synthetic hormones whose chemical structure differs from natural hormones to boost or inhibit certain effects or improve their storage.

These hormones are handmade and custom-compounded, with the aim of ensuring they are biologically identical. Hormones that are sold in the pharmacy are all synthetic.

Moreover, properly used bioidentical hormones are directly absorbed and do not require the involvement of the liver so they do not interfere with medicines for heart diseases, hypertension, nephropathy or thyroid diseases, nor do they increase the risk of developing breast or ovarian cancer.

Routes of Administration

At Neolife bioidentical hormone replacement therapy is done for women through different routes of administration -subcutaneous or delayed-release (pellets) implants, creams, gels or patches on the skin, oral capsules, sublingual tablets, etc.

The method of application is determined according to the type of hormone and each patient’s specific characteristics:

  • Testosterone in men can be applied through an intramuscular injection once or twice a week, in small doses of subcutaneous injections or in creams.
  • Melatonin and DHEA are always administered in oral tablet form.

Bioidentical Hormonal Replacement Therapy (TRHB) is a key pillar in anti-ageing preventive medicine and aims to restore hormonal levels which decrease with age towards their levels of excellence. The objective is to reach an optimal metabolic and hormonal balance in order to prevent related to age diseases and improve all the symptoms related to this phase.

Proper hormonal replacement therapy has to be:

  • Personalised – each individual needs a treatment adapted to his body.
  • Safe - with bioidentical hormones. Or in other words, the use of synthetic hormones must be avoided.
  • Monitoring key biomarkers over time – this way the necessary prescription will be made at each moment.
  • Monitored – under strict medical supervision.

The protocol for carrying out the programme has two clearly distinct parts, the start of the treatment and the programme monitoring and stabilisation.

Start of the Treatment

The steps to be taken at the beginning of the treatment are the following:

  • Initial analytical profile - can be done at Neolife or someplace else.
  • Health and lifestyle questionnaire.
  • Cardiac imaging tests (optional) – although advisable, they are not necessary in all cases.
  • Rest and oxidative stress tests (optional) - if opting to start melatonin treatment.
  • Consultation to deliver results - the medical team will jointly review all clinical aspects of the tests carried out, providing a report with the diagnosis and personalised treatment.

Monitoring and Stabilisation of the Programme

Hormone replacement therapy treatment will always be done under strict medical supervision. Consequently, it requires a protocol that has been reviewed and measured, always adapted to the needs of each man.

  • Analytic profile to monitor - during the first year, at least once every three months. From the second year on, according to the advice from the medical team.
  • Consultations for monitoring - Every three months during the first year, with an appointment. From the stabilisation of the treatment (second year onwards), when advised by the doctor.
Multiple medical and scientific articles confirm the positive effects bioidentical hormone replacement therapy for men -correctly prescribed by a specialist–have on the ageing stage.
  • Prevention of diseases like cardiovascular disease, diabetes, cancer, Alzheimer’s or osteoporosis.
  • Improvement in the sexual area - libido increase, quality and erection duration improvement, erectile dysfunction improvement…
  • Neurocognitive improvements - increase in performance and ability to concentrate and more mental agility.
  • Improvement in sleep and rest, emotional state and levels of energy and wellbeing.
  • Immune system optimisation.
  • Lipid profile improvement - a decrease in cholesterol and triglyceride levels.
  • Functional improvements - increase in energy and exercise capacity, strength, endurance and muscle tone.
  • Improved body composition - increase in the breakdown of fat, weight loss and a decrease in body fat reduction, mainly in the abdominal area.
  • Improvement of the hair, skin and nailsincreasing collagen and elastin.
The benefits provided by comprehensive bioidentical hormonal replacement therapy significantly improve if complemented by the rest of the antiaging preventive medicine pillars (exercise, nutrition, rest, nutritional supplementation,etc.).

Hormone replacement therapy is already supported by the scientific associations related to menopause and andropause, both in Spain and internationally.


Bioidentical Hormone Replacement Therapy Risks and Safety

Questions arise about if hormone replacement therapy (HRT) is safe, if it causes cancer, if it really prevents the emergence of diseases and if people will feel better.

If the peak in hormonal levels happens between the age of 20 and 30, a time when young people are fully functional with lots of vitality and without diseases, wouldn’t it be good to maintain these hormonal levels in an adult, replacing his deficit with hormones that are identical to those which our body produces?

The answer is yes. Hormones have extremely important physiologic functions for the normal functioning of our bodies.

But the word hormone has a negative connotation in our environment, especially in our country: cattle with hormones, hormone doping in athletes, cancer caused by hormones, etc.

Even the non-qualified medical professionals in this area of medicine (and not familiar with the recent scientific literature and medical practices) voice their concerns. So, it is reasonable that many people have certain misgivings when thinking about starting HRT.

The strictest scientific literature and medical practice of leaders in this field ensure that proper bioidentical hormone replacement therapy with strict medical supervision does result in risks for men but the contrary: in most cases, it brings huge benefits to our health and quality of life.


Testosterone and cardiovascular risk

Scientific evidence collected over the last 30 years correlates the highest levels of testosterone with better cardiovascular health.

The alleged connection of testosterone with cardiovascular risk is controversial nowadays. An article published at the end of 2013 in JAMA attributed an increase in the cardiovascular risk to in men treated with testosterone.

  • The article has been harshly criticised for (including several women who were snuck in with the subjects being studied) and a key group of experts in the subject have strongly refuted the conclusions of this study in different articles and have called it ‘malpractice in medical literature’.
  • An article published in 2015 in the magazine by the Mayo Clinic, Mayo Clinic Proceedings, ensures that hormone replacement therapy with testosterone does not produce an increase in cardiovascular risk. Quite the opposite, the low levels of plasmatic testosterone are correlated with an increase in cardiovascular risk.

Testosterone and prostate cancer

If we focus on another possible risk, prostate cancer, a study published by Charles B. Huggins in 1941 about only three clinic cases ensured the link between hormone replacement therapy for men and prostate cancer.

But over 10 years ago, Abraham Morgenthaler (Professor of Urology at Harvard Medical School) published his research demystifying testosterone as a prostate cancer inducer in the NEJM. .

Moreover, the association between low plasmatic levels of testosterone with a higher incidence of prostate cancer incidence is proven.

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