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Hormonal Balance: a Brighter Life in Your Middle-Age

The endocrine system is an amazing thing. It’s the extensive network of glands that produce the hormones we need to regulate metabolism, sexual function, growth, mood, and more.

As we move through the stages of life, our hormone levels fluctuate. Aging means that we produce more of some hormones and less of others (mostly they are less).

These are some of the hormonal changes people can experience as they get older:

For Men: Andropause

It’s not “male menopause,” exactly — for one thing, it doesn’t happen to all men — but about 30 percent of men over 55 will experience andropause, a significant decline in testosterone production.

The symptoms might include the following:

  • the decrease in muscle mass and overall strength;
  • a decrease in bone mineral density and a corresponding increased risk of osteoporosis;
  • low libido and erectile dysfunction;
  • decreased energy and depression;
  • cognitive impairment.

Men experiencing any of these symptoms should ask a primary care physician or geriatrician about having testosterone levels tested.

Help with symptoms: If testosterone levels are low and symptoms are present, testosterone replacement might be an option but the therapy should be customized for every patient individually to select the proper dosage and term of the treatment cycle.

People disposed toward blood clots should consult the doctor before starting the replacement therapy because testosterone increases the production of red blood cells, and their overproduction could be unnecessary for such patients. Men with prostate cancer and cardiovascular disorders should refuse from taking the therapy.

Being treated with testosterone means that you need regular prostate exams as well as frequent monitoring of your prostate-specific antigen (PSA) levels and hematocrit.

A healthy lifestyle with regular exercise and a balanced diet will be also helpful in fighting symptoms of andropause as they are for menopause.

Hormone replacement therapy works better if you hold to a healthy lifestyle. You have to work a little, and there’s no magic bullet but simple changes can help with almost every symptom.

For Women: Menopause

The most common consequence of aging-related hormonal changes is menopause. Around age 50, women’s ovaries begin producing decreased amounts of estrogen and progesterone; the pituitary gland tries to compensate by producing more follicle-stimulating hormone (FSH).

While menopause is normal and happens to all women, some of the symptoms can be irritating or even dangerous. Symptoms might include the following:

  • hot flashes;
  • vaginal dryness and atrophy leading to painful intercourse;
  • decreased libido;
  • insomnia;
  • irritability/depression;
  • osteoporosis can increase the risk of bone fractures.

Help with symptoms: For many years, physicians prescribed long-term use of an oral estrogen/progesterone combination to alleviate these symptoms.

Current guidelines indicate that it’s okay to take estrogen and progesterone for a short time to help with the transition to menopause — and there are ongoing studies investigating the efficacy and safety of different estrogen and progesterone formulations that could potentially be used for longer periods of time.

Alternative therapies, such as bioidentical hormones made from plant or animal sources, haven’t yet been thoroughly evaluated for safety and effectiveness.

So for now, try the following:

  1. Non-hormonal medications can treat hot flashes
  2. Topical estrogen cream used vaginally can help with painful intercourse.
  3. Leading a healthy lifestyle that incorporates a balanced diet, regular physical activity, and stress management help alleviate many symptoms of menopause.
  4. It’s also important for all women of middle age to have regular bone-density screenings to catch osteoporosis early.
  5. Current guidelines indicate that it’s okay to take estrogen and progesterone for a short time to help with the transition to menopause.

For Everyone: Thyroid Hormones

It can be easy to chalk up changes in mood, weight, and menstrual patterns to the normal hormonal fluctuations of aging, but they can also be the result of thyroid disease, which affects 30 million Americans of all ages.

The thyroid, a small, butterfly-shaped gland located at the front of the neck, produces hormones that control the rate of processes like metabolism, body temperature, and muscle strength.

Learn which symptoms may indicate a thyroid condition.

Physicians differ on the age at which physical exams should begin including checks of thyroid-stimulating hormone (TSH), but they recommend a simple blood test for everyone over 60 or anyone with symptoms of thyroid disease. If needed, treatments for underactive or overactive thyroid are generally very well tolerated.

Prevention is the Best Medicine

At this point, doctors don’t really know whether the physiologic decline in hormones with aging is normal and healthy, or whether it should be treated. With a number of ongoing large-scale studies underway, there’s new data emerging all the time about whether and how to supplement hormones.

In the meantime, it’s essential to talk with a primary care doctor about treating any symptoms you experience — and just as important to prevent or manage symptoms by taking good care of yourself.

If you are unsure about your symptoms or you’ve got any other questions concerning hormonal balance, please get in touch with us to get a free consultation.

21 February 2021 Hormones
About Dr. Nil Hoppins

Dr. Nil Hoppins is a consultant dermatologist and professor of medical dermatology specializing in the diagnosis and treatment of skin disorders, treatment of severe scarring, and photodermatology. He has a strong background in translational research, and expertise in genetic skin disorders.

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