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Originally posted October 2017 / Updated June 2024
Many of the changes men experience with aging result from hormonal changes. The terms “andropause, “male menopause,” or "man-opause" have been used to suggest that men experience a similar physiological event to what women experience during menopause. However, while all women go through menopause, not all men go through andropause.
Male menopause or andropause reflects the appearance of signs and symptoms related to the slow but steady reduction in the hormones testosterone and dehydroepiandrosterone in middle-aged men.
Common symptoms of hormonal changes in men:
Decreased testosterone naturally occurs as men age, but in andropause, or its more technically correct term of “hypogonadism,” levels drop below the normal range for a given age.
In case you have not seen the ads for “Low T,” there is a big push by suppliers of prescription testosterone preparations to get men hooked on the quick fix of testosterone therapy. Suffice it to say that this whole area of andropause and Low T is fraught with controversy.1
Testosterone levels naturally decline 10% every decade after age 30, or roughly 1% yearly. That is normal; what is not normal is when testosterone levels drop faster than this rate.
Several factors can lead to low testosterone, including:
The best approach to boosting testosterone levels in men with low T is addressing underlying issues by improving the action of insulin, achieving ideal body weight, and improving blood sugar control. Weight loss alone can increase testosterone levels by 50%.2
Beyond these basic measures, several natural products may be helpful:
Zinc is perhaps the most critical trace mineral for male sexual function and is found in high concentrations within the prostate testes. Particularly high amounts are also found in the semen (approximately 2.5 mg of zinc is lost per ejaculation).
Zinc is involved in virtually every aspect of male reproduction, including testosterone metabolism. Several studies support the use of zinc supplementation in the treatment of low sperm counts, especially in the presence of low testosterone levels. In these studies, zinc has shown an ability to raise both sperm counts and testosterone levels.3
Many men may be suffering from infertility, low sperm counts, and low T simply because they lack sufficient zinc.4,5 Daily supplementation of 30 to 45 mg daily is recommended to ensure adequate zinc levels.
Fenugreek contains a number of active plant steroids, most notably fenuside and protodioscin. Fenugreek extracts have shown promising results in improving libido and testosterone levels in several human clinical studies.6,7 In one double-blind study, the group taking 600 mg of special fenugreek extract daily reported improved libido (81.5%), recovery time (66.7%), and quality of sexual performance (63%) as well as a mild effect in boosting testosterone levels. In another study, 50 male subjects between the ages of 35 and 65 years took 500 mg per day of a 20% protodioscin content fenugreek extract. Free testosterone levels were improved in 90% of the study population, as much as 46%.
Tokgkjat Ali (also known as eurycoma ongifolia or longjack) is a flowering plant native to Indonesia and Malaysia that is heavily promoted as a testosterone booster and sexual performance enhancer. There is evidence to support these claims, along with concerns over fake products on the market.8 In one study in men with Low T, a daily dosage of 200 mg of a standardized water-soluble extract of longjack produced a 46% increase in total testosterone levels, with 90% of the subjects achieving testosterone levels within the reference range for their age.9 Positive results have also been noted for improving sperm counts, sexual well-being, and erectile dysfunction.9,10
Tribulus terrestris (Tribulus) has been used traditionally in Ayurvedic medicine as a tonic and aphrodisiac and in European folk medicine to increase sexual potency. While studies in healthy males with normal testosterone levels have not shown Tribulus to raise testosterone levels, there is some clinical evidence that it may be effective in raising testosterone levels in men with low T.11 A 2019 study in men with low T showed that consuming taking tribulus extract for 60 days raised testosterone levels and improved erectile function. The typical dosage for tribulus extracts is 100 to 250 mg per day.
Maca is becoming increasingly popular. Maca is the common name for Lepidium meyenii, a plant in the broccoli family that is grown exclusively in Peru. It looks a lot like a turnip. One of maca’s most renowned benefits is the enhancement of sexual desire and function for both men and women. Clinical trials confirm these properties, including maca’s benefits in erectile function. Maca does not affect the testosterone level directly but acts on the entire endocrine system to reduce the harmful effects of stress while improving mood, energy, and endurance. There are many forms and types of maca. For general health, raw maca powder is a great option. When stronger effects are desired, extracts made from the whole tubers that have been gelatinized (removal of the starch) are often recommended. The typical daily dosage for maca is 3 to 6 grams.13,14
Erectile dysfunction (ED) is the term used to signify the inability of a man to attain or maintain erection of the penis sufficient to permit satisfactory sexual intercourse. ED may be due to physical or psychological reasons. In men over the age of 50, the most common cause is atherosclerosis of the main arteries of the penis. Hence, factors that prevent atherosclerosis (hardening of the arteries) also prevent ED.
Dietary factors important to support blood flow are important considerations, including the Mediterranean diet, omega-3 fatty acids, beets, dark chocolate, and other sources of polyphenols and flavonoids, including pomegranate, green tea, pine bark, and grape seed extracts.15,16
The amino acids arginine and citrulline, as well as beets, can improve blood flow by increasing the formation of nitric oxide within blood vessels.17 Several double-blind studies have shown the ability of arginine to improve the hardness of an erection and satisfaction with sexual intercourse.18 Studies have also shown results are better if arginine or citrulline is combined with either pine bark extract (or grape seed extract).19
One of the most important health concerns for men is prostate health. The same dietary factors helpful in erectile dysfunction are important in prostate health. Namely the Mediterranean and other heart-healthy dietary factors.20,21 In particular, raw nuts and seeds provide a rich source of nutrients and plant compounds that support prostate health. Pumpkin seeds are an especially rich source of zinc, vitamin E, and phytosterols that provide nutritional support for prostate health.
One of the most common issues with prostate function is benign prostate enlargement (BPH). This condition affects roughly 1 out of 2 men at age 50 and increases steadily to affect 90% of men at age 85. The major symptoms of BPH are improved, especially increased nighttime urination (nocturia).
The most popular dietary supplement for BPH is saw palmetto extract (85-95% fatty acids and sterols). The mechanism of action of saw palmetto extract is related to improving the hormonal metabolism within the prostate gland. In studies using high-quality extracts, saw palmetto has been to help roughly 90% of men with mild to moderate BPH experience some improvement in symptoms during the first 4 to 6 weeks of therapy.22 However, there is a major problem with adulteration of saw palmetto products in the marketplace, highlighting the need for high-quality extracts identical to those used in positive clinical trials.23
Prostate cancer is another major health concern for men. There is a strong correlation between heart health and prostate health.21 Basically, what is good for the heart is also good for the prostate. For example, the Mediterranean diet and its components protect against heart disease and prostate cancer.24,25 Key dietary factors linked to prostate cancer include diets rich in animal foods, particularly grilled and broiled meats,26 saturated animal fat, and dairy,27 and low fruits, vegetables, and nuts and seeds, as well as low in protective nutrients such as lycopene; selenium; vitamin E; long-chain omega-3 fatty acids from fish, and anticancer nutrients from cabbage family vegetables. These dietary factors are known to affect sex hormone levels, detoxification mechanisms, and antioxidant status. Here are some of the key findings from scientific studies:
Lycopene, a carotene that provides the red color to tomato products and watermelon, is an important dietary factor in prostate health. In a study conducted by Harvard researchers, men who had the highest amounts of lycopene in their diet showed a 21% decreased risk of prostate cancer compared with those eating the least.28
Selenium is also important as it works closely with lycopene in protecting prostate cells. Human double-blind clinical trials with high-selenium yeast have confirmed this supportive effect of selenium on prostate health.29
There are a lot of options in natural medicine for men to improve their declining testosterone, libido, sexual performance, and prostate health. However, realistic expectations are required, along with some common sense. If a man is overweight, does not exercise, and causes significant stress on his system because of other dietary and lifestyle factors, none of these natural products will likely produce the real magic he is looking for.
References:
By Dr. Michael Murray, N.D. 
