Andropause: Beyond testosterone decline

Dr Leah Hechtman, one of Australia’s most respected naturopathic educators, joins fx Medicine by BioCeuticals ambassador Emma Sutherland to discuss the often-overlooked stage of men’s health: andropause. More than simply “low testosterone,” andropause reflects age-related changes including Leydig cell decline, metabolic changes, vascular shifts, and neurological alterations that shape male wellbeing across the lifespan. 

Leah outlines how andropause may present in practice, from body composition changes and hair greying, to mood shifts, sleep disruption, prostate dysfunction and reduced cognitive performance. She highlights the importance of comprehensive testing — extending beyond testosterone — to include oestrogen, progesterone, follicular stimulating hormones (FSH), luteinising hormone (LH), insulin, leptin, insulin-like growth factor-1  (IGF-1), and DUTCH hormone analysis. These insights allow clinicians to identify early signs and develop a more complete picture of male ageing. 

The discussion also explores strategies that may support resilience, including optimising sleep, managing stress, and addressing metabolic health. Useful complementary medicines to support include nutritional considerations such as nicotinamide riboside, bioflavonoids and zinc, herbal medicines including gingko, grape seed extract, Ashwagandha, tribulus.