What is Andropause?
Andropause is the result of low testosterone throughout your body.


ADAM Questionnaire

Symptoms of low testosterone (Androgen Deficiency in the Aging Male) This basic questionnaire can be very useful for men to describe the kind and severity of their low testosterone symptoms. If you Answer Yes to number 1 or 7 or if you answer Yes to more than 3 questions, you may have low Testosterone.

1. Do you have a decrease in libido (sex drive)? Yes No

2. Do you have a lack of energy? Yes No

3. Do you have a decrease in strength and/or endurance? Yes No

4. Have you lost height? Yes No

5. Have you noticed a decreased "enjoyment of life" Yes No

6. Are you sad and/or grumpy? Yes No

7. Are your erections less strong? Yes No

8. Have you noticed a recent deterioration in your ability to play sports? Yes No

9. Are you falling asleep after dinner? Yes No

10. Has there been a recent deterioration in your work performance? Yes No

Dr. Forrest Recommends

  1. To raise testosterone levels - Tribulus Synergy and Tonkat Ali 1:200
  2. To tonify the endocrine system - Revolution Pro Maca
  3. To block conversion - Endosterol Suppositories
  4. To increase nitric oxide - Neo40 Daily
  5. For comprehensive Libido Enhancement Bundles

Enhance Libidio by Increasing Free Testosterone
For information on Erectile Dysfunction click here)

Andropause is the result of low testosterone throughout your body.
Andropause or male menopause is a name that has been given to a supposed menopause-like condition in middle-aged men. This may relate to a reduction of the production of the hormones testosterone and dehydrogenate in middle-aged men, and the consequences of that reduction, which is associated with a decrease in Leydig cells.

Unlike women, middle-aged men do not experience a complete and permanent physiological shutting down of the reproductive system. A steady decline in testosterone levels with age (in both men and women) is well documented,[4]. There is on-going professional disagreement about whether or not "andropause" should be considered a normal "state" (the term used by MeSH), or a disorder.

Unlike "menopause", the word "andropause" is not currently recognized by the World Health Organization and its ICD-10 medical classification. Nevertheless, it is still sometimes used in peer-reviewed journal articles, both with and without scare quotes. Researchers who oppose the use of the word andropause do not always object to the more limited terms "SLOH" or "ADAM", as described below.

Andropause is usually caused by a very gradual testosterone deficiency and an increase in sex hormone-binding globulin (SHBG) that occurs from age 35 onwards. By contrast, women have a sudden onset of menopause around age 51. Testosterone declines 10% every decade after age 30 (1% per year).

Premature andropause can occur in males who experience excessive female hormone stimulation through workplace exposure to estrogen. Men who work in the pharmaceutical industry, plastics factories, near incinerators, and on farms that use pesticides are high risk for early andropause.

About 30% of men in their 50’s experience andropause. About 5 million American men do not produce adequate testosterone, which leads to early andropause. In Australia, about 1 in every 200 men under the age of 60 and about 1 in every 10 men over 60 have low testosterone. Regardless of where you live, the most likely males to develop early andropause are diabetics, hypertensives (those with high blood pressure), and men with genetic disorders that produce hypogonadism, including Klinefelter, Wilson-Turner, and Reifenstein syndromes.

Libido & Sexual Enhancement
Loss of libido is a common complaint of many especially as we age. Men go through  a gradual decrease in their androgenic hormones with age, a process called andropause. While this is normal, it does not mean that it cannot be successfully addressed.

Symptoms of Testosterone Deficiency

  1. Apathy and Depression
  2. Anxiety
  3. Irritability
  4. Loss of sexual enjoyment
  5. Poor memory or concentration
  6. Weight gain
  7. Insomnia
  8. Inability to make clear and precise decisions
  9. Poor recovery from injuries or illness
  10. Decreased stamina and endurance

Factors that can lower testosterone
As we age many suffer from declining or lost libido. This can be from many reasons, both physical as well as psychological. Although lowering testosterone is common, there are factors which can accelerate this decline:

  1. Aging
  2. Over-training - too much exercise causes the release of cortisol. Cortisol lowers the body production of testosterone.
  3. Zinc Deficiency - needed for the pituitary. The pituitary releases the hormones LH and FSH. Zinc deficiency can lower testosterone as much as 75%. This can be caused by stress, alcoholism, over-training.
  4. Statin drugs can lower testosterone. Cholesterol is a building block for testosterone.
  5. SSRI's can lower testosterone.
  6. Opiate use for pain control can lower testosterone.
  7. Liver Issues

Raising Testosterone Levels Naturally
Nutrients function by increasing testosterone availability, often by affecting testosterone’s interaction with SHBG or by decreasing its aromatization (conversion) into estrogen. Natural supplements can complement hormone replacement therapy. For people who choose not to (or should not) use hormone replacement therapy, nutrients can be a vital part of a comprehensive program to reduce the impact of aging on the systems of sex hormone production, regulation, and metabolism. Nutritional therapy also has a role in preventing diseases of the male reproductive tract, such as prostate cancer and benign prostatic hyperplasia (BPH).

This can be a complex area but the information below can help you understand what the issues are, how to test and how to treat.
The hormones generally involved with libido are:

  • Testosterone - Produced in the testes, major contributor to libido and muscle development. Lowers with age.
  • Lutenizing Hormone (LH) - From the pituitary; induces the body to produce more testosterone.
  • FHS - From the pituitary; induces the body to produce more sperm.
  • Prolactin
  • Sex Hormone Binding Globulin (SHBG) - binds up free testosterone leading to a functional deficiency. Rises with age.
  • DHEA - a precursor to testosterone but can also convert to Estradiol through an aromatase enzyme.

Most commonly is a low or low normal testosterone and high SHBG. This causes there to be a low level of Free Testosterone. There can also be an increase in Estradiol.

Hormone Tests

We offer a variety of male hormone testing using either saliva or blood. The best test is a combo test from ZRT labs, Comprehenisve Male Panel. Another great test is the Male Hormone Test from Diagnos-techs.

Hormone Test Ranges:

  • Testosterone (Total) - optimum range is 500 - 700 ng/dl
  • SHBG: 20 - 30 nm
  • Estradiol:  30 - 50 pg/ml
  • Prolactin:  < 5
  • LH: 2-10
  • FSH: 2-10

Natural Products that raise Testosterone and Libido
There are a variety of products that can effect testosterone levels. Some work by raising levels, others work by lowering SHBG leading to more free testosterone. Another option, if all else fails is to take testosterone as a gel or patch. This method, while effective, can cause your body to produce less of its own testosterone and will cause your gonads to shrink.  This is considered to be a last resort.

  1. Tongkat Ali - Pasak Bumi - (Eurycoma Longifolia Jack)
    Scientifically shown to raise testosterone levels. In laboratory tests on human testicular tissue, Tongkat Ali extract increased the formation of testosterone fourfold. Even with its other serious medical applications, what excites most people about Tongkat Ali is that the root significantly boosts sex drive and function in both men and women, by building testosterone
  2. Tribulus terrestris - works by stimulating LH and FSH.
    A botanical used to raise testosterone levels. Used as a natural aphodisiac, Tribulus is a traditional use for sexual potency and libido. Traditionally, a tonic is something that produces physical, mental, or emotional vigor. Tribulus has a tonic reputation that has been verified in the lab by increased endurance in rats. In humans, Tribulus has been shown to be a general stimulator, enhancing activity across a wide spectrum. In addition to improving motor activity and muscle tone, it helps restore vigor, vitality, and stamina. It has also been shown to intensify protein synthesis, particularly in the liver, kidney, and heart tissue of animals, while it enhances energy metabolism.
  3. Maca - works by normalizing hormones.
    Maca works primarily through its adaptogenic properties. Stimulation of the hypothalamus (through your pituitary and adrenal glands and your nervous system), induces your body to create a healthy balanced state that promotes optimal health.
  4. Chrysin. A bioflavonoid called chrysin has shown potential as a natural aromatase inhibitor (Kellis JT Jr et al 1984). Chrysin can be extracted from various plants and is found in high concentrations in honey. Bodybuilders have used it as a testosterone-boosting supplement because, by inhibiting the aromatase enzyme, less testosterone is converted into estrogen. Although chrysin is a known inhibitor of aromatase, in one study it did not result in the expected increase in testosterone levels (Gambelunghe C et al 2003). This may be because of poor intestinal absorption of chrysin (Walle UK et al 1999).
  5. Zinc - can raise testosterone as much as 35%. 30 mg daily.
    Zinc is related to testosterone levels. In one animal study, rats subjected to an acute swimming test were either supplemented with zinc or placebo. The study showed that zinc supplementation led to significant increases in testosterone levels and may help in athletic performance (Kaya O et al 2006).
  6. DHEA - a precursor to testosterone. Raises testosterone levels.
    DHEA has been the subject of over 4,000 studies, that have shown that this Adrenal Hormone has life rejuvenating properties for all people above forty years of age
  7. Pregnenolone - a hormonal precursor to testosterone.
    Pregnenolone, another Master Hormone, has shown dramatic memory enhancement properties in recent medical studies. Pregnenolone converts not only into the DHEA branch of hormones, but because the DHEA pathway is already filled, is forced into another hormone pathway that converts to Progesterone and several other needed hormones that DHEA cannot be converted too.
  8. Carnitine. Carnitine is an amino acid derivative that may be more active than testosterone in aging men who have sexual dysfunction and depression caused by an androgen deficiency (Cavallini G et al 2004). Both testosterone and carnitine improve sexual desire, sexual satisfaction, and nocturnal penile tumescence, but carnitine is more effective than testosterone in improving erectile function, nocturnal penile tumescence, orgasm, and general sexual well-being. Carnitine was better than testosterone at treating depression (Cavallini G et al 2004).
  9. Muira puama. Muira puama is a South American folk medicine derived from a shrub, Ptychopetalum olacoides, which grows in the Amazon region of Brazil. Also called marapuama and “potency wood,” it is considered an aphrodisiac and an effective treatment of impotence. Because of its purported libido-enhancing properties, muira puama has been the subject of two published clinical studies by Dr Jacques Waynberg, an eminent medical sexologist and author of 10 books on the subject.

Natural Products to Lower Estrogen or DHT Levels
The enzyme aromatase converts testosterone to estradiol thus lowering testosterone levels.

To block this we use aromatase inhibitors. By blocking aromatase the estradiol levels can decline which leads to a decrease in SHBG. The end result is an increase in Free Testosterone.

Our favorite product in this category is DIM Palmetto Prostate Formula.

  1. DIM - blocks conversion of testosterone to estrogen.
  2. Chrysin - blocks conversion of testosterone to estrogen
  3. Saw Palmetto - blocks the conversion of testosterone to DHT.
  4. Nettles - Nettle root extract has also shown an affinity for SHBG (Hryb DJ et al 1995). SHBG is closely related to levels of free testosterone and estrogen; most of these hormones travel through the bloodstream “bound” to SHBG. Any testosterone that is unbound to SHBG is referred to as free testosterone. Studies have shown that men with BPH have elevated levels of SHBG in their prostate gland (Jiang H et al 2004); thus, any nutrient that reduces SHBG levels may also be able to reduce BPH.



Not Certain What To Do Next?
If you are uncertain as to which products or programs to use or which tests to take; or, if you would like additional help:

  • Contact us with a brief question.
  • Arrange a phone consultation with Dr. Forrest.
    Call ( 408) 354-4262
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