Gonadorelin Acetate
Gonadorelin is a synthetic form of the body’s natural gonadotropin releasing hormone (GnRH) that may stimulate the release of luteinizing hormone.
Andropause therapy is designed to support age-related symptoms that can be associated with a gradual decline in androgens, like testosterone or DHEA. Andropause and low testosterone have many similarities and it can be difficult to distinguish between the two without the help of a medical professional.
While low testosterone is a reflection of a low hormone level sometimes related to a definitive diagnosis of hypogonadism that can occur at any age. Andropause is tied to midlife, typically occurring between the ages of 40 and 55. Both are connected to testosterone levels with parallel symptoms like mood changes, low sex drive, and sleep disturbances. Patients can have overlap – men in andropause can also experience low testosterone or be formally diagnosed with hypogonadism and pursue bioidentical hormone replacement (BHRT) such as testosterone therapy.
For many men, andropause symptoms are warning signs that flag patients to make lifestyle changes, address underlying issues, and monitor testosterone levels more closely. While andropause treatment has many aspects, therapies that promote restorative sleep, sex drive, and metabolic health can make a difference early on.
Our Andropause Medication Offerings
Pregnenolone
Pregnenolone is a cholesterol-derived steroid precursor produced in the adrenal glands and brain that supports vital functions like hormone synthesis, nerve protection, and memory.
Enclomiphene Citrate
Enclomiphene citrate is a selective estrogen receptor modulator that blocks estrogen feedback in the pituitary, which may raise LH and FSH levels.
Clomiphene Citrate
Clomiphene is a selective estrogen receptor modulator (SERM) that increases the release of LH and FSH by blocking estrogen feedback in the brain.
Testosterone Cypionate / Anastrozole Grapeseed Oil
A testosterone cypionate/anastrozole in grapeseed oil may support hormone balance and limit excess conversion of testosterone into estradiol.
Testosterone Cypionate / DHEA Grapeseed Oil
A testosterone cypionate/DHEA grapeseed oil injection combines long‑acting testosterone with DHEA, a hormone that the body can naturally convert into other hormones.
Testosterone
Testosterone is a sex hormone that plays a number of important roles in reproductive health and general wellness in both women and men.
Anastrozole
Anastrozole is a nonsteroidal aromatase inhibitor that blocks the enzyme aromatase, limiting the conversion of testosterone to estrogen in peripheral tissues.
About Andropause in Men
Lifestyle
Lifestyle modifications can make a big impact during the earlier phases of andropause. These day to day changes may seem small, but their cumulative effect can directly improve symptoms related to gradual hormonal shifts and age. Maximizing the body’s ability to better utilize available testosterone will help, but andropause symptoms do not solely revolve around testosterone level alone – there are bigger systems at play. Focusing on health targets such as sleep, body composition, emotional wellbeing, and nutrition have clinical value and offer benefits before or after testosterone therapy is on the table:
- Quality sleep dictates energy limits and cognitive capacity. Addressing existing sleep disorders can improve circadian rhythm, stress resilience, and overall mood.
- Targeted weight management with a focus on body composition and metabolic health via exercise and resistance training can reduce visceral fat and preserve bioavailable testosterone.
- Dietary changes that reflect proper therapeutic nutrition with adequate protein are also an important step toward feeding daily vitality and motivation.
- Reducing chronic stress, and concentrating on restoration of the body and mind will have a meaningful impact on fatigue and depressed mood.
Therapies
Therapy targets will depend on what andropause symptoms are most prevalent.
To address sleep disorders and insomnia that may become more prevalent during andropause in men, sermorelin acetate may offer benefit. As a growth hormone releasing hormone, sermorelin has been shown to help with sleep quality and physiologic recovery. The drug can stimulate the release of endogenous growth hormone, which is also important for driving basal metabolic rate and overall body composition.
Low sex drive is a common complaint as men approach andropause age. Bremelanotide acetate can affect brain pathways involved in sexual response, improving sexual satisfaction during intimate moments with a partner. Additionally, oxytocin therapy can help men feel more open to connection and communication when taken prior to intimate moments.
Weight management medications that influence body composition can change how fat is distributed throughout the body and metabolized. Body composition not only affects how andropause in men looks on the outside, but how well their cardiovascular and metabolic systems are running on the inside.
Promoting wellness during andropause involves balancing physical health and mental wellbeing. It is not uncommon for inconsistent sleep, declining energy, or stress related conditions to take their toll on the body and mind. Goals of andropause therapy are to support daily functioning, reduce symptom burden associated with midlife, and improve quality of life in a meaningful way.
Nicotinamide adenine dinucleotide (NAD+) is a coenzyme critical for energy metabolism and cellular stress response. NAD+ generation declines over time. Aging bodies require more NAD+ to combat inflammation and the wear and tear on energy systems. NAD+ is often prescribed to aid mental clarity, boost energy, and help improve sleep quality – also common concerns for men as they age.
Methylcobalamin is a form of B-12 critical for red blood cell and energy production. Andropause often coincides with Vitamin B-12 deficiency. Restoring what is lost can improve fatigue, stamina, cognition, and mood for midlife men.
Monitoring
Closely monitoring how andropause symptoms and laboratory results progress over time will dictate next steps in care. There is a distinction between andropause, low testosterone, and hypogonadism and how they are clinically supported. Lab parameters such as free testosterone and sex hormone binding globulin (SHBG) can provide valuable information that may determine whether testosterone levels have dipped low enough to warrant consideration of bioidentical hormone replacement therapy (BHRT).
Andropause is marked by declining total and free testosterone, with the potential for rising SHBG. High SHBG generally indicates less free testosterone, because testosterone bound to SHBG is inactive. Less unbound/free testosterone translates to less usable testosterone that can elicit effects in the body. Symptomatic hypogonadism is related to low testosterone and considered a defined androgen deficiency that requires testosterone replacement therapy.
Commonly Asked Questions About Andropause Therapy
Andropause looks different for every man, but common symptoms include lower libido (loss of sex drive), fatigue, depression or anxiety, among others. Men go through andropause as an expected part of the aging process, but don’t have to accept these physical and emotional changes as their new normal. The severity and duration of symptoms of andropause are highly personal and unique. Therapies that promote restorative sleep, sex drive, and metabolic health can make a difference early on.
Andropause in men can last 15-20 years, or longer. Because testosterone declines gradually about 1.5% each year after age 40, symptoms can persist, as the hormone decline is permanent. During andropause and beyond, the body will no longer produce the amount of testosterone needed to help men feel their best physically, emotionally, and sexually. Over time, the gradual decline in testosterone may warrant further intervention with low testosterone therapy.
Andropause is an expected aging process associated with declining androgen levels, whereas low testosterone is a measurable hormone deficiency. During andropause, testosterone levels may stay within normal limits for an extended period and may not warrant immediate intervention. It is also true that andropausal patients can have low testosterone and seek symptom support from bioidentical hormone replacement therapy (BHRT).
