If you are a male over the age of 40 and are suffering from weakness, impotence, pain, stiffness, drooping muscles, depression, anxiety, or heat intolerance, you may be experiencing “andropause”. Andropause is a syndrome resulting from the deficiency of hormones, especially testosterone. It’s onset and symptoms may not be as dramatic as female “menopause”, but its effects can be just as serious. It is interesting that hormone replacement is quite routine in women but barely even addressed in men. The decline in hormone levels in both sexes has an adverse impact on one’s state of health. Starting around age 25, DHEA and testosterone levels begin a progressive downward trend. With falling hormones, it is much harder to maintain muscle mass. Things begin to sag and fat begins to form increasingly thick layers around the lower back and abdomen. Stamina is affected and exercise intolerance occurs. Osteoporosis is well-documented in women and occurs in men as well. This can result in hip and vertebral compression fractures. Wrinkles that carve deep crevices in the face are partially due to testosterone deficiency. Libido is reduced and even impotence may develop. These changes are all a result of male “menopause”. Hormone replacement has been available for women for decades and the positive results continue to multiply. In Anti-Aging medicine, it is expected that maintenance of hormone levels in the youthful range (that of a 25-30 year old) will provide substantial health benefit. Proper monitoring of hormone replacement is a relatively recent innovation that makes this therapy much safer. We can now insure proper dosages in the accepted normal physiologic range. Cancer risk is greatly reduced by this refined approach to replacement therapy. The decline in testosterone occurs as a result of multiple causes and treatment should be directed accordingly. Aromatase (an enzyme that converts Testosterone into Estradiol) increases as we gain years. This increases raises the free estrogens and lowers the free Testosterone. Prostate cancer is correlated with high circulating estrogens. Aromatase inhibitors, such as chrysin, nettle extract, and Arimidex can inhibit aromatse. Testicular atrophy leads to decreased testosterone production. A course of treatment with HCG stimulates testicular development and can boost Testosterone production. A complete vitamin, mineral, and antioxidant supplement plus a proper diet help to correct nutritional deficiencies. DHEA and possible melatonin replacement also serve as alternatives and as adjuncts to testosterone therapy. A diet that includes a large amount of legumes, especially soy, is helpful in providing the necessary building blocks for our bodies to manufacture hormones. Maintaining cholesterol in the normal range (not to high or to low) is also critical for hormone synthesis. Testosterone replacement can be accomplished by the use of creams, pills or even injection. It is best if the physiologic patterns natural to the body are mimicked, which makes injection less favorable. Creams containing natural testosterone are well absorbed through the skin, bypass metabolism by the liver, and are easy to apply, thus making them superior to pills. The potential risks of testosterone administration include increases in red cell mass, worsening of sleep apnea, changes in plasma lipid levels, and fluid retention. There is some concern that testosterone replacement might exacerbate benign prostatic hypertrophy (BPH). There is no change in PSA with testosterone therapy. You are not a candidate for this replacement therapy if you have an active testicular or prostate cancer. Finally, testosterone supplementation may produce adverse side effects if administered to men with normal levels, hence the importance of monitoring. With proper replacement, you can expect to regain muscle mass, increase bone density, increase stamina, increase libido, reduce your risk for a variety of cancers and Alzheimer’s disease, and live an improved quality of life.