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Andropause Protocol:
Addressing Androgen Deficiency in Men – Age Related and Premature Andropause
The physical symptoms associated with low testosterone levels and low testosterone function include; decline in sexual activity, poor or no erections, loss of muscle mass and strength, increased risk of cardiovascular disease, chest pain, insulin resistance (with increased risk of diabetes), loss of bone mass that can lead to osteoporosis, fatigue and loss of energy, reduction in body hair and skin thickness, development of hair in ears and nose, increase in upper and central body fat, increase in heart and artery disease, problems with circulation and sleep disturbances.
The mental and emotional symptoms include decreased intellectual ability, trouble with memory, decreased interest in sex, difficulty focusing attention, depression, anxiety, agitation, irritability and a decreased sense of well-being.
Initial effects of improved testosterone function are usually noted within 2 months after beginning this program to improve testosterone function, including healthy lifestyle choices such as optimal diet, regular exercise, stress-management and the reduced tobacco and alcohol use. Continued improvement will be seen as these changes become a routine part maintaining hormone health.
For more information on andropause and premature andropause, see the article: Andropause: Androgen Deficiency in Men – Age Related and Premature Andropause.

Determination of andropause is made through the use of questionnaire, and/or lab tests. The Hormone Health Guidelines provide a detailed description on how the get the best results from protocols. A brief summary on using this protocol is at the bottom of this page.
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Secondary Hormone Health Formulations

     DIM
     ThyroMend
     Glucobrium
Shop for Secondary Andropause Hormone Formulations
Primary Hormone Health Formulations

      TestoGain
      AdrenoMend
Hormone Precursors

       DHEA (50 mg)
       7-Keto (100 mg)
 
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Shop for Andropause Hormone Precursors
Foundations of Health
Foundations of hormone health include lifestyle and dietary choices that support optimal hormone function, a high grade multiple vitamin-mineral formulation, essential fatty acids rich in docosahexaenoic acid and eicosapentaenoic acid, and a high grade multiple species probiotic to support optimal health of digestive system and immune system. To learn more about the foundations of hormone health, please see the  Hormone Health Guidelines series of articles.

Primary Hormone Health Formulations
The Hormone Specific Formulation most important for men experiencing Andropause is TestoGain. But if a man is also experiencing a significant amount of stress – or an inability to handle the routine demands of life – then the support of the adrenal glands is critical. TestoGain is primarily a testosterone supporting formulation that also provides some support of the adrenal glands. AdrenoMend may be considered as a secondary formulation for andropause if more adrenal support is needed, as discussed below.
  • TestoGain, which improves testosterone function in men, has a significant effect on libido, including desire, arousal, response, orgasm & satiety, including herbals which increase nitric oxide synthase, interact directly with androgen receptors, and enhance dopamine and GABA function – all important for optimal sexual function.
Significant clinical improvement should occur within the first two months of using formulations when foundational therapies are used concurrently. Please review Customized Dosing Guidelines for the protocols on increasing dosages, weaning, and  determining maintenance dosage. The Primary Hormone Health Formulations should be taken at least three months after symptoms are under control before attempting to wean down to maintenance dosage.

Secondary Hormone Health Formulations
The secondary hormone imbalances commonly seen in andropause include excessive estrogens, adrenal fatigue, decreased thyroid function, and insulin resistance. While mild cases of each of these imbalanced may be improved by increasing the function of testosterone, additional support may be required in many cases. TestoGain is compatible with each of these formulations, and they can all be used together if need be. Please review  Customized Dosing Guidelines to learn the best way to wean off of secondary formulations once you make progress in these additional hormone imbalances. 
Estrogen excess is more likely to be present in men as they age or if they have gained more than 20 pounds of excess body fat. Liver disease is also associated with increased estrogen production in men. One of the best ways to decrease excessive estrogen is to increase the activity of pathways that detoxify estrogens. I have found the DIM formulation from Douglas Labs to be effective.
  • DIM, a formulation that promotes detoxification and removal of excessive estrogens, especially the toxic estrogen by metabolites. Keeping estrogen under control is as important as increasing testosterone function.
Adrenal fatigue is a common occurrence in men as they age and go through andropause. This is most likely due to the fact that the adrenal glands are trying to help the body recover from stress caused by the drop of testosterone. On the other hand, if adrenal fatigue is caused by excessive stress, then andropause will happen sooner.
  • AdrenoMend is the only adaptogen formulation designed to restore normal adrenal function and support the normal function of multiple homeostasis regulatory systems that become imbalanced with adrenal fatigue. This formulation was designed to synergistically increase the specific actions of AdrenoMend adaptogens
Thyroid hypofunction occurs in men, though to a lesser extent than in women. None-the-less, when it does occur is can dramatically interfere with normal function of the testes – and bring andropause on sooner. Hypofunction of the thyroid also is more likely to cause weight gain and  insulin resistance. Low thyroid function is also associated with increased production of toxic estrogen metabolites and less of the non-toxic estrogen metabolites.
  • ThyroMend is a synergistic combination of iodine containing seaweeds, and herbs which contain phytothyroidogenic, phyto-thyroid-receptor agonists, and other herbs designed to promote optimal function of thyroid hormones by maintaining the health of thyroid hormone producing tissues and by supporting the healthy function of tissues that respond to thyroid hormones. This formulation supports the function of the thyroid gland and the liver (which converts T4 to T3) and also supports the function and response of tissues that respond to thyroid hormones. It should be used use if there are persistence signs and symptoms of decreased thyroid function.
Insulin resistance is more likely to occur in men as their testosterone levels drop, as their estrogens increase, as they age, and as they gain weight. If increasing testosterone function with TestoGain™, and lowering estrogen with DIM, and increasing thyroid function with ThyroMend™ are unsuccessful in restoring healthy blood sugar function, then Glucobrium™ may be appropriate.
  • Glucobrium,  a synergistic formulation of phytotherapeutic extracts which mimic and potentiate the actions of insulin and support healthy blood glucose function. Excessive body weight also increases the risk for decreased blood glucose function, so this formulation may be needed if there is a need to lose weight.

Hormone Precursors & Bioidentical Hormone Replacement Therapy
Hormone precursors such as DHEA and 7-KETO may be used to support hormone production pathways that create testosterone. DHEA dosages for men may start at 50 mg to 100 mg each AM. It is very important that estrogen and testosterone levels both be monitored before and after starting DHEA, to make sure the estrogens do not become elevated.
While DHEA may help increase testosterone, it may also increase estrogens - especially in men with excessive body weight or liver disease. So, it is really a good idea to be on DIM for three months before adding precursors. Hormone precursors can be tried after three months of Foundations of Health and Hormone Health Formulations as indicated, so that hormone metabolism pathways are at their best health.
7-Keto (3-acetyl-7-oxo-dehydroepiandrosterone) dosage of 100 mg is commonly used.
Again, even though they are commonly referred to as “hormone precursors”, these supplements (1) may or may not be converted to more potent hormones such as testosterone or estradiol, and (2) even if they are not converted, they still have actions of their own. Sometimes these supplements are used with BHRT to get better results. If hormone precursors are going to be used, please see the guidelines for Proper Use of Hormone Precursors.
Bioidentical Testosterone Replacement Therapy (BTRT), may be indicated based on lab tests. If they are used, hormone levels should be monitored. Hormone Health Formulations and Foundations of Health should still be used with bioidentical testosterone replacement therapies (BTRT) to improve the function of the testosterone and the response of tissues to the prescribed testosterone. By using the formulations with BTRT healthcare professionals prescribing the testosterone notice that they are able to prescribe lower dosages of testosterone, and men are having a much better response to the testosterone prescriptions.
Keep this point in mind: If the dosage of testosterone has to be increased because the previous dosage no longer works, then the problem is androgen receptor resistance &/or increasing estrogens.
If BTRT is used, please see the guidelines for Safe and Effective Use of Bio-identical Hormone Replacement Therapy.
It is also important to stay on TestoGain while taking testosterone therapy to prevent the atrophy of testes because TestoGain™ has some gonadotrophic properties, which help maintain testes size in men.
This is important because testosterone replacement therapy does not fully support the hormone production pathways, but instead provides “replacement”, which may further diminish endogenous hormone production, (the hormones made in your own body). Hormone Health Formulations also maintain proper tissue response to the BHRT and decrease the development of hormone resistance.


Using this Protocol
1. This is a brief summary on how to use this protocol. Please become familiar with the Hormone Health Guidelines to learn how the get the best results from protocols.
2. Remember, the position of Your Hormones, Inc. is to connect healthcare professionals, nutritionists, health advisors, health teachers, personal trainers, fitness trainers, life coaches, health coaches or other persons acting in any other advisory role (collectively called Associates) with patients, clients, consumers, customers, etc. (collectively called Clients) who are looking for guidance, direction and support in achieving optimal Hormone Health. So we encourage patients, clients, consumers, customers, etc. to work with Associates.
3. The Foundations of Health and Primary Hormone Health Formulations should be followed for at least two months, up to three months, before going to the next step.
4. If need be, modify dosages using the Customized Dosing Guidelines. This may especially be required if premature andropause is due to use of anabolic steroids.
5. If there is evidence of increased estrogens (such as through lab tests) or increased risk for excessive estrogen (such as 20 pounds or more excess body weight), then the Secondary Hormone Health Formulations should be considered.
6. The Hormone Precursors, if they are indicated and appropriate may then be considered, based on the unique needs of each person.
7. Bio-identical Testosterone Replacement Therapy (BTRT) may be appropriate if the prescribing physician feels they are indicated. In patients already taking BTRT, but experiencing inadequate relief even at higher dosage, Foundations of Health and Hormone Health Formulations should be started to improve tissue and cellular response to the testosterone prescription.

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