Hi Dr. Blanscet,

Thank you for the great information on the hormonal changes that women go through as we age. I was wondering if guys go through something similar. I always tease my husband that he is going through “Man-o-pause.” Is there such a thing?
-Heather V.

Indeed there is! Andropause is the medical term for the decline in hormones that occurs as men age. Testosterone is the main hormone that declines in men, although I also look at other hormones. Testosterone has many roles in the body. Not only is it key for drive and stamina, it is essential for many other functions in the body. Testosterone plays a role in bone density, muscle mass, and red blood cell levels, among other things.

Couple Holding each Other

Men make up a large percentage of the patients who seek out hormone therapy. They are often referred by their wives or have heard about hormone treatment from some of their guy friends. The symptoms men may experience include: decreased energy, more aches and pains, changes in mood, trouble concentrating, issues with erections and/or libido, increased body fat, poor muscle tone, slower recovery after workouts, sleep issues, and they may generally feel like they’ve passed their peak. You may hear him complain that he’s “getting old.” A man with low testosterone may not necessarily experience any change to his sex drive, but other symptoms will be evident.

Men’s hormones drop more gradually than ours do so it can often be overlooked. Generally testosterone will decline slowly starting in the thirties. Our toxic environment seems to be accelerating this decline. Remember that testing in a “normal” range for testosterone is not the same as testing at an “optimal” level, so doctors without special training in hormones may not recognize a problem. The trouble is that “normal” is based on a population that is overweight, fatigued, and stressed; basically a population that is not feeling optimal. Often everyone gets caught up in the facade of staying within the arbitrary “normal values” that the whole person is forgotten. Before you assume that the man in your life is doomed to suffer because his lab work is “normal”, trust your gut feelings that something is not right and have his hormones evaluated by a physician who is trained to get him to optimal lab values and functioning.

The great news it that when done correctly it is perfectly safe for men to have Hormone Replacement Therapy (HRT). Men on optimal HRT report feeling at their prime again. Improvements in motivation, mood, memory, energy, sleep, libido, and even their physical appearance have many men loving life again! There are several ways to restore hormone balance in men including bioidentical pellets, creams, or injections. Each man is different and needs a personalized HRT program that addresses his unique needs.

Do not rely on your insurance to pay for optimal wellness–if you want to feel balanced it is in your hands. For the men and women out there: if you are experiencing the decline in your health and the drop in vitality that comes with a decrease in hormones, act now and stop suffering. Schedule a consultation with a hormone specialist!

Staying Balanced

Many people seek my guidance on how to help them balance their hormones. This is a complex subject that has many parts. Balancing your hormones properly is like putting a puzzle together–it takes some time, patience, and requires multiple pieces.

Organic Foods

Taking bio-identical hormones such as Estrogen, Testosterone, and Progesterone is definitely an important piece of that puzzle that will help you to feel better and live a more vital life. In addition, it is also important to minimize the hormone disruptors that you are exposed to on a regular basis.
Stress is something that can disrupt your hormones, thus it is critical to learn how to properly manage stress. Yoga, meditation, epsom salt baths, deep breathing exercises, regular exercise, etc can all help you with this. Avoid watching news and turn off your electronic “toys” and TV on a regular basis. Practice just being in the moment.

Chemicals are all around us and many are a cause of disrupting your hormones. Do not put anything on your skin that you woul d not safely be able to eat—what you put on skin absorbs into your body in about 30 seconds. Also, be mindful of your cleaning products as they can be a source of harmful chemicals.
It is a good rule of thumb to eat a diet of organic non GMO foods— focusing on whole foods and not processed foods. A hormonally balanced diet is one that is full of organic vegetables, some organic fruits, and a wide variety of organic protein sources. Avoid meat from animals given hormones and other artificial substances. You don’t have to eat perfectly, simply be aware and realize that every little thing does add up so choose wisely whenever possible.

Balancing your hormones means being able to live a full, active, and vital life. Taking bio-identical hormones is an important piece of this. Your daily choices are also important. Be aware and make positive healthy choices whenever you can. Do your best and focus on progree, not perfection.

Low Sex Drive

A low sex drive is a common complaint. This is heard from both women and men, but men are more likely to be concerned about it and women sadly tend to accept it more easily. A healthy sex life is important for both men and women–a couple needs intimacy to truly thrive in their relationship.

Happy Couple

There are many reasons for a low sex drive. Stress definitely lowers anyone’s sex drive so it is important that you take time to relax and spend quiet time alone as a couple. If you are having communication problems or other issues with your partner these need to be addressed. Seek the help of a counselor or communication expert if needed. Make your relationship a priority.

Hormonal imbalances in both men and women can drastically affect a sex drive (your desire for sexual relations with your partner). In addition, a hormonal imbalance can affect function– in men it can affect your erection abilities and for women it can affect your vaginal lubrication. Both men and women require optimal Testosterone, Estrogen, and Progesterone for healthy sexual functioning and desire–obviously the levels of each of these hormones differ in men and women but both sexes need all of these hormones to be optimal.

If you are a man or woman in your late 30′s to 50′s who has noticed a decline in sex drive and/or sexual functioning it is smart to get your hormones properly evaluated by a bio-identical hormone specialist. Regular doctors simply look at normal values and normal values will mistakenly show that you are fine when you are not. Optimal hormone levels are where you function at your best and this is what a hormone specialist is trained to help you achieve.

Andropause: Male Menopause

Men go through a hormonal change but unfortunately it is largely ignored or treated incorrectly. Men’s Testosterone starts to decline around age 30. It is a slow, gradual decline over the next few decades. Stress and chemical hormone disrupters expedite this decline.

Hormone Pellets and Their Benifits

As a man’s Testosterone decreases he may have fatigue, loss of muscle mass, poor recover from workouts, emotional changes, sleep disturbances, a decrease in morning erections, a lowered sex drive, and other diverse symptoms. Long term potential risks of low Testosterone are osteoporosis, dementia, and an increased risk of heart disease. Replacing your Testosterone can potentially mitigate these long term problems and can definitely help to bring back your vitality and performance.

When replacing Testosterone you want to use bio-identical (biologically identical) Testosterone. The best form is directly absorbable into your blood stream and gives you hormones when you need them, just as your testes would do if the functioned properly. Bio-identical pellets are the only way to this. This is given to you through an easy office procedure ever 3-6 months. As a result of this treatment you can expect to have an improved energy level, increased sense of well being, increased cognition, and overall function.

Dear Dr. Blanscet,

I’m a 45-year old woman and for the last year I have not really been feeling all that great. I don’t feel sick or anything, I just don’t feel right. I have gained about 15 pounds in 12 months. I often have trouble sleeping now, which was never a problem before. I’m tired a lot lately and get headaches more than what I think is normal. I’m not really interested in intimacy with my husband and we seem to be arguing a lot. I just feel like things are off. When I told my primary doctor this, he did some tests and said everything is fine. Is this just a normal part of aging?

-Sarah H.


picture of Dr Laurie Blanscet
After going through some of those symptoms myself, I decided to get further education on bioidentical hormones and healthy aging. Helping men and women achieve optimal health is something I’m very passionate about.

When a primary doctor looks at your blood tests, they are often only checking to see whether your results are “normal.” The problem is, in our society “normal” is based on people who are overweight, fatigued and in general not feeling that great. You don’t necessarily want to be normal; you want optimal health.

Trust your intuition. If you are feeling like your body is “off,” then it probably is. If you’re doctor isn’t trained in bio identical hormones, you should really find someone who is. Bio identical hormones are usually plant based and are made to be biologically equivalent to the natural hormones your body produces. It just makes sense that a product with the exact chemical structure as your body makes will be safer and more effective.

Problems that are associated with hormonal changes in women include a decrease in energy, lack of sleep, night sweats, low libido, weight gain, migraines, hot flashes, vaginal dryness, mood swings, a general feeling of malaise, and more. Men also experience many of these symptoms and feel like they have passed their peak even though they are only in their 40′s or 50′s.

Experts in bio-identical hormone replacement therapy strive to achieve optimal results by working with each individual’s unique biochemistry. Every person is different and will receive a plan customized to their needs. It takes time to properly evaluate your symptoms, interpret your lab work, and be educated on treatments. There are several ways to restore hormone balance in men and women: creams, oral capsules, implanted pellets, etc.

It is unfortunate, but current medical insurances do not cover the expense of a proper hormone consultation and treatment. This may change in the future, but you if you are experiencing hormonal imbalance, it’s best not to wait.

Aging Well

Aging is inevitable but aging well is not. The good news is that you have more control over that than your genetics does. It is also never too late to do something about how you age. Living full of vitality until the end of your life is much more preferable than lingering for 10-20 years—getting sick and frail. There are some fairly simple things that you can do in order to enhance the quality of your life.

Happy Couple

Everyone knows that they need to exercise in order to lose weight but you may not think about it as helping you to age more gracefully. When you get regular exercise it helps your heart and lungs while also helping your musculoskeletal system. When you strengthen your bones and muscles this helps to prevent falls and fractures plus it enhances your overall mobility. You are able to get up and move around much easier. Regular exercise also helps your brain to stay younger and your cardiovascular system to stay in shape. Many people give up on exercise if they don’t lose weight fast enough. Refocus your goal of exercise as a way to live a vital life not just as a means to lose weight. Get at least 150 minutes of exercise a week–that is easy for the majority of people.

A healthy diet is another thing people thing about as a means to lose weight. A healthy diet gives your body the nutrients that it needs in order to build healthy bones and muscles, to keep your heart functioning well, to improve your mental clarity, and to give you energy; among other things. A healthy diet is one that focuses on protein and vegetables. Fruit is ok but limit your intake to one or two per day. Live by the 90/10 rule: 90% of what you eat should be for your health and it is ok to have 10% of what you eat be a little more “fun”. Whole foods that are organic are the best source of nutrition in your 90%.

Getting adequate sleep is critical to feeling energetic and rejuvenating your body. You should get enough sleep that you wake up refreshed. Keep your bedroom dark, quiet and cool. Turn off the TV and computer at least an hour before your bedtime. If you have trouble falling asleep melatonin, yoga stretches, and Epsom salt baths are wonderful natural things you can do to help you sleep better. Better sleep means better aging.

Organic Foods

There are people who say that your hormones should decline as you age but there is also a school of thought that believes you age because your hormones decline. Both men and women can benefit from bio-identical hormone balancing to help them live optimally and age more gracefully. Balancing your hormones (this includes Progesterone, Estrogen, Testosterone, and Thyroid) helps you to feel stronger and more vital, think clearer, and prevents overall deterioration of your health. Bio-identical hlormone balancing is not just for women with hot flashes–it is for men and women who want to age well.

Take control of your aging process and control the things that you can. There are other things that you can do but the four things I mentioned above are often overlooked and yet fairly easy to do. The little things you do each day do add up. If you want to live a full and vital life it starts with a decision to make some changes towards that goal.

Mood and hormones

Anxiety, depression, and irritability is something that can affect both men and women. There are different causes of mood disorders and they sometimes do require an anti-depressant or anti-anxiety medication. However, hormonal imbalances are an often overlooked cause of feeling “off”.

Andropause - Menopause For Men

Progesterone, Estrogen, and Testosterone are produced in every man’s body and every woman’s body. Obviously men and women have different amounts of each hormone but all three are important to both sexes. If these hormones get out of balance they can affect how you think and how you feel. It can be a gradual onset over many years or a more abrupt onset. It can be difficult for a traditional physician to pinpoint hormones as the cause of your mood disturbance.

Balancing your hormones involves the use of bio-identical hormones that are customized to your specific needs-this is done by a physician specializing in hormone balancing and can never be done correctly within the constraints of health insurance. Once your hormones are balanced you feel happier, more energetic, and overall you feel mentally balanced. Now you are able to sleep better and you have the focus and energy to eat a healthier whole food diet and to exercise more—all factors that help you to optimize your hormones which in turn, optimizes how you feel, think, and move.

Is It Menopause Or Am I Just Wacky?

Sylvia (name has been changed for privacy) sat down in front of me and said “I am whacked”. “I feel like I am crazy–I fly off the handle at little things-it is so easy to get irritated. Also, I am not depressed but I just don’t have any joy or energy anymore. And I worry about little things. My regular doctor thinks I need an anti-depressant but I don’t think that is the answer. I never had these issues until I turned 46.”

What Are Hormones?

I actually hear stories like this quite often from women age 35-55. This is the time in a woman’s life when her hormones really start to change. It is so sad that women are made to feel like they are in need of an anti depressant automatically. Many health care providers, and patients, fail to look at the possibility that a hormonal imbalance can be the cause of feeling “wacky”.

It is a common misconception that hormonal changes are only felt as hot flashes or night sweats. Your hormones (specifically Progesterone, Estrogen, and Testosterone) have so many more functions in your body than just preventing hot flashes or giving you a sex drive. These hormones perform hundreds of different functions in your body. One of those things is helping you to feel emotionally balanced and to have better energy and vitality.

In Sylvia’s case I found that she lacked Testosterone, Progesterone, and B-12. I gave her a bio-identical Progesterone capsule at night which helped to calm her and enhance her sleep quality. I also inserted a bio-identical Testosterone pellet which also helped her to balance her mood and gave her back her vitality. She was counseled to eat an organic whole food based diet and to eliminate gluten (gluten has been found to be a hormonal disrupter and she was found to be sensitive to it). She was also given methyl-B12 injections (B-12 is important for the proper functioning of hormones) and this also helped her energy.

Feeling emotionally out of balance can be caused by hormonal imbalances and Sylvia’s case shows this perfectly. Feeling “whacked” is a thing of the past and without the use of an antidepressant.

Testosterone and Fatigue

“Mark” a 48 year old gentleman came to my office complaining of fatigue, an increase in aches/pains, an increase in irritability, and a decreased ability to build muscle. He still ha a good libido but had noticed a decrease in morning erections. He had seen his regular doctor who told him his labs were normal and that he needed to exercise more but he was too tired to do that. Mark knew there was something else going on.
When I reviewed his symptoms and his lab results we both agreed that he suffered from low Testosterone. At first he was concerned about the risks associated with replacing Testosterone based on recent news releases. We went over the study that the news was citing. The news reports were telling men that Testosterone replacement increased heart disease risk.

Andropause - Menopause For Men

However, the study being cited had tested older, high heart disease risk men whose Testosterone level was never in an optimal range and they were treated for too short a time to even show a benefit. Optimal Testosterone levels are around 600-1400 depending on the male, men in this study were averaging levels in the 300 range. This was a poorly done study and it is a shame that it was used to scare men away from seeking help.

In fact, there are many studies showing that when Testosterone levels are optimized and given enough time to work, that Testosterone actually is protective for the heart as well as the brain.
Remember that the normal Testosterone lab values are not optimal–they are simply the expected values based on testing the male population—both ill and healthy. You want optimal levels if you want a life of vitality.

Hormone Pellets

Optimizing a man’s Testosterone level involves replacing his Testosterone along with starting healthy lifestyle changes. Testosterone is best replaced with bio-identical Testosterone–biologically identical to what your body is designed to respond to. Mark was given the choices on replacing his Testosterone. Creams which are applied twice a day. There are synthetic gels and patches on the market but they are not bio-identical-using them can cause unforeseen complications since they are chemically different from what your body is designed to work with. A compounding pharmacy makes the bio-identical Testosterone. You can not buy it at a regular pharmacy. A quality compounding pharmacy offers safe and effective bio-identical creams.

Creams are painless but you do need to remember to apply them daily and there can be a pulse like absorption after application. In addition you do need to be careful about getting the Testosterone cream on others.
Testosterone injections are another possible form of Testosterone replacement and they tend to be more effective than creams but your liver has to process it into a bio-identical Testosterone. There is also a pulse like absorption and you need an injection once to twice a week. This mode of replacement requires the most monitoring by lab work.

Testosterone pellets are bio-identical and are absorbed on a more constant level with a natural increase when your cardiac input increases–similar to your natural physiology. They work very effectively. Testosterone pellets have been well documented to protect the heart, bones, and brain as well as resolve symptoms. It does involve an in office procedure where the pellets are inserted in the fatty tissue of your buttocks and it is the more costly of the three choices.
Which form of Testosterone replacement a man chooses depends on the individual.

Mark chose Testosterone pellets and after about 2-3 weeks he felt better-he has energy, is able to build muscle, feels mentally balanced and can pole vault out of bed again. He also has the focus to get back into the gym and fine tune his diet to include more vegetables (organic) and less processed foods.

Male Menopause?

Even though there is more public talk about women and menopause, men also encounter a hormonal imbalance as they age (andropause). Because women tend to have a more abrupt hormonal change they are more likely than men to realize that their symptoms are from a hormonal imbalance. Men tend to have a more gradual change–with symptoms slowly appearing over 20 year period. Often the symptoms are not seen as a hormonal decline.

Andropause - Menopause For Men

Male menopause (called andropause) has many different symptoms. These symptoms come from a drop in Testosterone. These symptoms include depression, irritability, decreased morning erections, longer recovery time from workouts, stiffness and pain in joints and muscles, decreased concentration, decreased ability to build muscle, lowered mental acuity, loss of the competitive edge, overall loss of vitality, fatigue, sleep disturbances, etc. A man may still have a good libido (sex drive) but be suffering from a decrease in his Testosterone levels because he does not realize that Testosterone perfor.s many functions in the body. Testosterone is not just a “sex” hormone.

There are also strong associations between low Testosterone and bone loss (osteoporosis), dementia, type 2 diabetes, elevated LDL cholesterol, and arthritis. There is a lot of incorrect information about the negative side effects of Testosterone and when you research the studies you will find that when bio-identical Testosterone is prescribed and monitored by a hormone specialist, Testosterone is a benefit to the overall health and vitality of men and has not been shown to cause cancer or heart disease. Proper hormone balancing for men results in a man who feels great, thinks clearly, moves easier, and enjoys life better.