Hormonal Balance in Menopause and Andropause

Men and women experience hormonal declines from a certain age that diminish their quality of life and overall health. Menopause and andropause are often associated with problems in sexual function, but as sexual well-being is an important part of health, these hormonal imbalances also cause other significant health issues.

Hormones play a very important role in balancing the body, the nervous system, the mind, the skin, cardiometabolic health, and sexual well-being. From the age of 35 or 40, all hormones begin to decrease in men and women. What are the signs of this hormonal decline? We become more nervous, our hair and skin become more fragile; cholesterol begins to increase, and fat starts to accumulate in places it didn’t before. In men, there is a decrease in libido, and in women, vaginal dryness and also a lack of sexual desire.

Menopause, much more widely known and mentioned, involves the gradual decrease of sexual hormones in women. “Significant drops occur in the levels of testosterone, oestrogen, and progesterone, and from that moment, women are at greater risk of suffering from various diseases, including heart diseases, osteoporosis, Alzheimer’s disease, and dementia, compared to premenopausal women. On the other hand, the decline of these hormones also causes alterations in sleep patterns and associated symptoms, such as night sweats,” explains Dr. Rafael Navas, a hormone specialist at SHA.

The initial attempts to replace this hormonal decline with replacement therapy brought more problems than solutions. “That conventional hormone replacement therapy (derived from conjugated equine oestrogens and synthetic progestins) was shown to have serious adverse consequences.” Dr. Navas refers to a significant study conducted in the early 2000s, which associated conventional hormone replacement therapy with a higher risk of developing certain cancers.

“Twenty years later, it is known that the study on hormone replacement therapy with equine oestrogens taken orally was poorly designed; many of the women participating were obese, had cholesterol problems, and were very likely to develop certain cancers,” explains Dr. Navas, adding that “when that hormone is taken orally, it goes to the liver and generates secondary metabolites that are often proliferative, and care must be taken with the breast and endometrium.”

Fortunately, hormone replacement therapy options have advanced, and today, safer bioidentical hormones are used. “The synthesis of bioidentical hormones is done through vegetables and plants, the formula is analogous to human hormones, they are not equine oestrogens, and moreover, the administration is not oral, avoiding the hepatic passage,” explains Dr. Navas, who indicates that this therapy can be applied with subcutaneous pellets or in the form of creams. At SHA, other natural alternatives such as phytoestrogens are also chosen, offering women a safe and effective treatment to promote adequate hormone levels.

At SHA, we offer replacement therapy using hormones identical to those naturally produced by the body, which are not associated with the risks of conventional hormone therapy. They are obtained through FDA-approved preparations, available orally, transdermally, or vaginally. Alternatively, a compounding pharmacy makes these preparations individually once a proper clinical assessment has been done with the appropriate reviews and reports from the gynaecologist.

“In the case of men, a similar process occurs from the age of 40. Testosterone levels decrease, a hormone that men associate with sexual function but is crucial for cognitive function, body weight, insulin sensitivity, and glucose metabolism. In summary, testosterone is very important for heart health,” describes the SHA expert.

The symptoms may be less varied than those of menopause. According to Dr. Navas, they are more related to lack of libido, metabolic syndrome, and loss of muscle mass. “Mortality in men increases by almost 50% within seven years following these hormonal changes,” asserts Dr. Navas.

At SHA’s Sexual Well-being Unit, the aim is to balance the body at the orthomolecular level, stabilise digestive and immune health, and low-grade inflammation parameters, and after everything is balanced, the treatment is completed with hormones.

Also we optimise men’s testosterone levels through medical prescription, after analysis and check-up by specialists. Generally, we prescribe bioidentical testosterone creams (available in compounding pharmacies) with an integrative approach.