If you’re in your late 30s or 40-something and not feeling your best, there’s a good chance that changes in your hormone levels are to blame. As we age, both men and women face an increased risk of hormone imbalance, along with the symptoms that result when hormone levels drop, increase or fluctuate erratically.
For men, low testosterone (hypogonadism) becomes more prevalent around age 40 and above, with many men experiencing issues with libido, mood disorders, decline in muscle mass and fatigue. At the same time, women nearing the end of their childbearing years and approaching perimenopause often have wide fluctuations in hormone levels, primarily estrogen. Many of the symptoms commonly associated with perimenopause—insomnia, irregular periods, vaginal dryness, hot flashes and more—can arise years before perimenopause officially occurs.
Hormone imbalance is common for people in their late 30s through 40s, so it’s important to be proactive about your hormonal health. Fortunately, there are many steps you can take to optimize hormones at any age, and a practitioner experienced in hormone health can explain how lifestyle changes and treatments like hormone replacement therapy (HRT), nutraceuticals and other integrative therapies can help.
At what age should men get concerned about Low T?
While low testosterone can occur at any age, the risk for Low T, also known as hypogonadism, gradually increases with age. For most men, testosterone levels peak in their 20s, then gradually drop 1-2 percent per year after age 30. That being said, it isn’t unusual for some men in their 40s, 50s and above to have testosterone levels register in a normal, healthy range.
According to the American Urological Association (AUA), a normal male testosterone level is 300 nanograms per deciliter (ng/dl) or above. Men with levels below 300 ng/dl have the condition known as hypogonadism or Low T.
Along with natural declines in testosterone that occur with age, some men unwittingly increase their risk of getting Low T. According to the International Journal of Clinical Practice, hypogonadism is “significantly associated with various comorbidities such as obesity, type 2 diabetes, hypertension, osteoporosis and metabolic syndrome.” Unhealthy lifestyle, poor diet, lack of exercise and using steroids, drugs and alcohol, also increase the risk of Low T.
Consequently, men should be concerned about low testosterone if they have any of the above comorbidities for Low T, live an unhealthy lifestyle, use steroids or struggle with substance abuse.
How do I know if I have Low T in my 40s? What are the symptoms?
The best way to find out if you have low testosterone is to visit a healthcare practitioner and ask to have your testosterone levels checked. You shouldn’t assume your practitioner will automatically test for Low T because many mainstream physicians simply do not.
Your practitioner will also want to find out what symptoms or health issues you have concerns about. The most common symptoms of Low T include:
- Reduced libido/erectile dysfunction
- Reduced muscle mass and strength
- Increased adiposity (body fat)
- Osteoporosis/low bone mass
- Depressed mood
- Fatigue, low energy
Based on your blood tests and symptoms, your practitioner can prescribe treatment, which may include hormone replacement therapy (HRT), nutritional support and other integrative therapies. According to the International Journal of Clinical Practice, restoration of testosterone levels to the normal range with testosterone therapy (including subcutaneous pellets), “improves libido, sexual function, and mood; reduces fat body mass; increases lean body mass; and improves bone mineral density.”
Women: What is perimenopause and when does it start?
Menopause gets a lot of press, not to mention blame, for a host of annoying symptoms including vaginal dryness, hot flashes, night sweats, low sex drive, sleep disturbances, weight gain and more. In reality, menopause occurs 12 months after a woman’s last menstrual period, and most women experience menopause around 51-52 years of age.
If you’re in your late 30s or 40s and reading this—and those irritating symptoms sound way to familiar to you—guess what? That’s not unusual, whether you’ve entered the years of perimenopause or not. Again, hormone imbalance can occur at any age and it commonly occurs in women in their late 30s and 40s.
For the record, perimenopause refers to a woman’s final reproductive years leading up to menopause. Perimenopause generally lasts between four to eight years, and the average starting age for perimenopause is 47 years.
You can experience wide fluctuations in hormones like estrogen at any age but the likelihood of experiencing the symptoms of hormone imbalance tends to increase as we approach age 40 and beyond. That means you don’t have to be in the heat of perimenopause to experience symptoms of hormone imbalance.
Women of childbearing age are also at risk for polycystic ovary syndrome (PCOS), one of the leading causes of infertility. One of the underlying causes of PCOS is high levels of testosterone, so along with keeping tabs on estrogen and progesterone (the primary female sex hormones), women should also have their testosterone levels checked, especially if infertility is a concern.
What are the commons symptoms of perimenopause?
As we mentioned above, women can experience fluctuations in their hormone levels at any age. Hormone imbalance can result in symptoms commonly associated with perimenopause and can afflict women in their 30s and 40s, whether they have officially entered perimenopause or not.
Women of any age can experience IRREGULAR PERIODS, but women in their 40s tend to have irregular periods for a couple of reasons. Egg quality declines, resulting in missed periods, and missed periods lead to heavier periods, when they do occur, because the uterus lining continues to grow even when ovulation is missed.
Hormone imbalance can also cause MOOD DISORDERS, including anxiety, irritability and depression. According to JAMA’s Archives of General Psychiatry, changes in reproductive hormones, like estrogen, have been linked with an increase in depressive symptoms in premenopausal women (including those without a history of depression).
HOT FLASHES AND NIGHT SWEATS are also common symptoms of hormone imbalance and perimenopause (not to mention postmenopause). Estrogen plays a role here, and research suggests that declining estrogen levels cause the body’s thermostat (AKA, the hypothalamus) to become more sensitive to fluctuations in body temperature.
Other common symptoms of perimenopause and hormone imbalance include:
- Sleep disorders
- Brain fog
- Vaginal dryness
- Bladder infections
- Hair loss
- Decreased libido (often due to a decline in testosterone levels)
- Sexual dysfunction
- Decreased bone density and more
Could I have early perimenopause? How do I get relief?
While most women don’t enter perimenopause until their late 40s, some women do experience perimenopause and menopause earlier in life. If your perimenopause (or what some people refer to as menopausal) symptoms have been going on for some time, you don’t need to suffer in silence. Some women are at higher risk for early menopause.
According to the Office on Women’s Health at the U.S. Department of Health and Human Services, risk factors for early menopause include:
- Family history
- Chemotherapy or pelvic radiation treatments
- Surgery to remove the ovaries and/or uterus
- Certain health conditions, like:
- Autoimmune diseases, like thyroid disease or rheumatoid arthritis
- HIV and AIDS
- Missing chromosomes
- Myalgic encephalomyelitis / chronic fatigue syndrome (ME/CFS)
So, how do you get relief for the symptoms of perimenopause and female hormone imbalance in general? Contact a healthcare practitioner who specializes in treating hormone imbalance. They can discuss your health concerns, run lab tests to check hormone levels and other vital health markers, then recommend treatment.
As with men, women in their late 30s through 40s (and beyond) who are experiencing symptoms of hormone imbalance, may benefit from hormone replacement therapy (HRT), nutraceuticals (we need certain nutrients to support hormone function) and other integrative therapies, like peptides. Diet, exercise and a healthy lifestyle are also key to maintaining hormone balance and overall health.
Keeping hormones in balance is more complex than you think
Testosterone, estrogen and progesterone are but a few of the many vital hormones the body needs to function optimally. Your practitioner should also evaluate thyroid, cortisol, insulin and growth hormone function (among others) when evaluating hormone balance and total body health. If you have questions about hormone imbalance, hormone replacement therapy and other integrative medicine therapies, contact an EvexiPEL provider near you to discuss next steps.