Life Clinic

Male Menopause – Does it exist?

By Dr Stephen Chan, Medical Director in Life Clinic

Like women, a man’s hormones decline as he gets older. Although less dramatic than female menopause, this drop in sex hormone still has a profound impact on a man’s health.

As s men approach their forties, subtle changes may begin to take place. They may start putting on weight, lose stamina (both in the bedroom and out) or find themselves losing interest in things that previously excited them. Some may appear less decisive or sure of themselves, which may herald a full-blown mid-life crisis where they try to recoup their dwindling youth (often with disastrous effects). A few will become moody or suffer depression.

Whereas most men accept these changes and losing their edge as “just getting older”, few will know the reasons for it happening – a phenomenon known as andropause, or “male menopause”. Likewise, they may not know that something very simple can be done about it.

Compared to women, whose main sex hormone, oestrogen, declines precipitously around the age of 50, Men’s main sex hormone, testosterone, declines more gradually after their peak in their twenties. This is the time when a man is physically his strongest and most sexually virile. After that peak, testosterone gradually begins to fall most noticeably after the age of 40. By the time men have reached 70, the hormone levels may only be 20 percent of what they were at their peak.

In addition to playing a major role in male fertility and sex drive, testosterone also has many other functions, explains Dr. Stephen Chan, director of Life Clinic. “Testosterone keeps the muscles strong, and there’s one muscle that’s especially important – the heart. Testosterone not only keeps the heart strong, but also helps also keep the blood vessels dilated, lowers bad cholesterol, and helps the blood from getting too sticky, in effect protecting men from heart disease. As they get older, men will lose this protective effect as testosterone levels fall, explaining the rise in heart attacks after the age of forty."

As testosterone levels continues to fall in a man's forties and fifties, psychological changes can occur like loss of confidence,low self esteem, and a general loss of the focus and ambition they had in their younger years.

Men’s initial reaction to feeling older is often to exercise more and eat healthier. “While that is admirable, there is usually only so far they can go with these lifestyle changes,” Dr. Chan says. “When they reach a plateau, that is when they often seek help.”

“We do a full assessment and will check their hormone levels on saliva and blood tests. We will check not just testosterone, but also oestrogen, DHEA, stress hormone, sleep hormone, thyroid hormones and sleep hormones,” Dr. Chan says.

The reason for this, he explains, is because hormones like to play together - if you change one, it will often affect another. So when we balance the hormones, he says, it is important to look across the board at all the hormones.

“If hormone testing confirms the patient has low testosterone, we help him boost them with bioidentical hormone creams or injections,” Dr. Chan says. “I prefer creams because they mimic our own natural production of testosterone much more.”

“Our testes will produce 7-12 mg of testosterone per day. Applying a little bit of cream each day is simulating that process,” he says. However, for those who find apply a cream every day too much a hassle, an injection every one to three months can be a very convenient alternative.

Life Clinic prefers to use bio-identical hormones over artificial hormones to balance a patient’s hormone levels. Many originate from plant source, but are upgraded so that they are exactly identical to our own hormones. They fit our cell receptors exactly as our own hormones do, and are metabolised (or removed from the body) in exactly the same way. This, Dr. Chan says, vastly reduces the risk of side effects, since any potential side effect would be no different than having too much or too little of our own natural hormone in our body.

This is in stark contrast to conventional hormone replacement therapy (HRT), which has been linked to potentially harmful side effects. According to Dr. Chan, the problem with traditional HRT is that it uses high doses of an artificial hormone in a one-size-fits- all approach that takes no account of each person’s individuality or unique needs. The chemical is entirely different to our own hormones, and may partially fit in our cells receptors, and not be removed so easily, much like how the wrong key can sometimes open a door but then get jammed in the lock. This continued stimulation of the receptor is why traditional HRT has been linked to a variety of conditions including heart attacks, strokes and thrombosis.

In contrast, bio-identical hormones are exactly identical to our own hormones, are given in the small doses found naturally in our bodies, and tailored to each person’s needs. Each person is then regularly monitored to make sure they’re not overtreated or undertreated.

We like to use the lowest effective dose that’s possible to achieve the maximum effect,” Dr. Chan says. “Patients are reviewed once a month after starting, and then every few months after that. We typically repeat a saliva test six months later, but usually when clients report they are feeling much better, and back to their former selves, we pretty much know we are on the right track. Done in a very gentle way, we find there are almost no side effects.” 

Although treatment with bioidentical hormones can be stopped at any time, Dr. Chan says that once patients begin to feel the benefits of treatment –sharper, quicker, more energetic, and more virile – most choose to stay on the treatment. After all, Dr. Chan says, all the treatment is doing is restoring a man’s hormones to more youthful levels.

Men with existing conditions such as high blood pressure and cardiovascular disease also have no problem using bioidentical hormone therapy, Dr. Chan says. “If anything, it’s likely to help with these conditions,” he says, “because of all the beneficial effects it has on the heart and blood vessels.”

“Most people think of testosterone as working just on the genitals and sex drive. But actually there are hormone receptors everywhere in the body – the brain, the heart, the liver, and the bones. The benefits are everywhere.”

As men are genetically and anthropologically programmed to be providers, many are reluctant to seek help with symptoms associated with getting older. But men who consult an anti-ageing specialist to find out how to make the right changes in their lifestyle and take the right supplements to get their body back on track, find that they can see dramatic improvements in their well-being after only one or two months without a huge amount of effort, Dr. Chan says.

“Our aim, with anti-ageing medicine, is not for people to live to be 150 – although that would be nice,” Dr. Chan says, “it’s really to help people to be as fully-functioning as they can be.”

This means being full of vitality, mentally sharp and engaged, and sexually virile – to be a fully-contributing member of society well into old age, Dr. Chan says. “That’s very much our focus – to empower people to live the best lives that they can.”

If you have any further queries about bio-identical hormones, please contact us by email This email address is being protected from spambots. You need JavaScript enabled to view it. or call reception on 2881 8131.