Natural Testosterone Hormone Replacement

Bioidentical Hormone Replacement Therapy (BHRT) – Testosterone

In recent years, testosterone replacement therapy has gained in popularity amongst andropausal men to improve their sexual function, sense of well being, muscle and bone mass and strength.  In addition, it has also been found to be beneficial in preventing heart disease, diabetes, and Alzheimers Disease.  There is a growing trend over the last decade for both men and women opting for the use of bioidentical, natural hormones for the treatment of andropause and menopause, respectively.  The trend away from the use of conventional synthetic hormones towards bioidentical hormones has been driven by several factors including a global trend towards everything “natural” as seen in the increased interest in organic foods and complementary and alternative medicine (CAM).

 

The testosterone used in BHRT is identical to that produced in the male human body.  Although bioidentical hormones have long been utilized in other countries, the United States has predominantly used synthetic hormones for the past 40-50 years beginning with the introduction of oral contraceptives in the early 1960s. 

 

Before men start with BHRT, laboratory tests are necessary to determine if there is a physiological need for testosterone replacement.  Both free and total testosterone are measured, along with DHT and SHBG.  If free and total testosterone levels come back within normal limits, BHRT may not be necessary.  However, if a man is experiencing symptoms of andropause and has lowered levels of testosterone, it may be necessary to start on BHRT. 

 

A Prostate Specific Antigen (PSA) will also be run before beginning BHRT to determine if there is a risk for developing prostate cancer while supplementing with testosterone.  There are mixed opinions in the medical field regarding the use of BHRT and its relationship to developing prostate cancer.  Some experts believe that there is a stronger risk of developing prostate cancer while using testosterone, while others agree that testosterone does not cause prostate cancer.  Clinical trials have demonstrated the latter, showing that PSA, the laboratory value most indicative of a potential cancerous lesion of the prostate, does not rise over 3-5 years of use of testosterone replacement therapy.  These same researchers showed that prostate cancer seems to develop most commonly in older men when their testosterone levels are actually lowest versus highest.  Despite the evidence suggesting that testosterone replacement therapy does not increase the risk of developing prostate cancer, BHRT should not be started on men who have a personal history of prostate cancer.

 

The methods of administration of BHRT of testosterone include oral administration, application of a transdermal patch, intramuscular injections, and the implantation of pellets containing testosterone under the skin of the buttocks.  Oral testosterone is the most unfavorable method of administration, as it is poorly absorbed by the body.  Most of the oral testosterone is carried from the intestines to the liver by the portal vein where the liver inactivates a sizeable portion of the hormone.  An oral micronized form of testosterone suspended in oil can also be used which is slightly better than the non-micronized form, however it is still poorly absorbed when compared to the other routes of administration. 

 

Testosterone injections are usually given as a shot into the muscle of the buttocks and are usually given at 2-4 week intervals. This seems to be the most favorable method of application of testosterone as it relatively painless, of higher compliance on therapy and less messy than creams.  The number of injections is variable and depends on how depleted testosterone levels are in an andropausal man.  The side effects are minimal and usually include swelling at the injection site.  Blood tests are run at 3 month intervals to monitor patients on therapy. 

Testosterone cream or gels .  These work best if applied daily on a particular schedule and are applied to the thin skin of certain areas of the body, including the thighs or the back, where absorption is best.  Creams are absorbed directly into the bloodstream.  In addition, they seem to mimic the natural rhythm of testosterone secretion that occurs the human body throughout the day.  The male body produces the most testosterone during the nighttime during sleep, which is why men so often wake with erections in the morning.  By applying cream just before bedtime a similar effect can be achieved. 

 

Potential side effects can include those listed as above for the individual methods of administration.  Other side effects can include a rise in hematocrit, the proportion of blood volume that is occupied by red blood cells.  Therefore, BHRT is contraindicated in individuals with high hematocrit levels.  The rise in hematocrit is less commonly seen with the transdermal (cream/gel) form of administration.  It has also been shown that BHRT can cause sleep apnea in younger patients and less frequently in older patients.  This is due to the direct effect on laryngeal muscles.  Rarely, testosterone can cause breast enlargement in males, called gynecomastia.  This is due to the fact that testosterone can be converted into estrogen which leads to breast enlargement if in excess in males.  One of the main complications of BHRT is the possibility of sterility following treatment.  This is because sperm production and hormone production by the hypothalamus can be inhibited once starting on BHRT.  It should be discussed with your doctor if you plan on retaining the option of fatherhood because of this potential side effect.

 

Botanical Medicine

There are many herbs and plants that have been researched and documented clinically that show beneficial effects in improving symptoms associated with andropause.  The following is a list of some of the herbs that have been shown to be effective:

 

·         Yohimbe (Pausinystalia yohimbe) – This herb is a well documented remedy for male impotence and lack of libido.  Yohimbe works by increasing the amount of blood that flows into the penis and prevents blood from flowing out of the penis, thereby causing and helping to maintain an erection.  It may also stimulate areas of the brain involved in sexual desire.  It has also been indicated for depression, although at very high doses, which has been found to be unsafe.  Because yohimbe works on blood vessels and the brain, it can cause dizziness, nausea, insomnia, anxiety, rapid heartbeat and increased blood pressure as potential side effects.  It is good to be monitored while taking this herb, so talk to you doctor before starting to take this herb.

 

·         Tribulus terrestris – Tribulus is an herb that has been used for thousands of years by Chinese herbalists and in Aruvedic medicine to increase testosterone levels through the stimulation of precursor hormones in the brain.  It has been used to boost libido and raise fertility in men with low testosterone.  Potential side effects are minimal but can include upset stomach and gynecomastia, or the enlargement of breasts in men.

 

·         Saw Palmetto (Serenoa repens) – This herb is the most effective and well-researched natural remedy for BPH.  It has been shown that saw palmetto is just as effective as Proscar in men with both mildly and severely enlarged prostate glands with mild to severe symptoms of BPH.  This herb also has many less side effects than medications used to treat BPH and has a wide array of mechanisms of action.  It helps to relieve urinary urgency, inhibits binding of DHT to androgen receptors in the prostate gland and exhibits mild 5 alpha-reductase activity.   A study by Carraro JC et al (1996) concluded that saw palmetto does not have an effect on the actual size of the prostate, nor does it change serum PSA levels.

 

·         Stinging Nettles Root (Urtica dioica) – Androgens such as testosterone and estrogen bind to sex hormone binding globulin (SHBG) and cause cell proliferation, leading to BPH and potentially prostate cancer.  Andropause causes men’s SHBG levels to increase making him more susceptible to abnormal cell growth.  The chemical constituents of Nettles root are able to bind to SHBG limiting the amount of testosterone and estrogen that can bind to it and influence cell proliferation.  It has been shown that Nettles improves urinary flow, the amount of urine left in the bladder after urination, and decreases SHBG levels in blood.

 

·         Pygeum (Pygeum africanum) – Pygeum is a plant that has been used frequently for both its affinity for the genito-urinary tract and for its role in boosting a man’s libido.  By reducing the abnormally high levels of prostaglandins found in men with BPH, this herb helps to reduce frequency of urination, especially at night, dribbling and decreased stream of urine flow, and feelings of bladder fullness. 

 

Nutrition

A healthy diet with a concentration on whole foods is key to achieving good hormone balance and vitality.  A large proportion of the diet should be comprised of lots of leafy greens and other fruits and vegetables along with adequate protein sources, healthy oils and whole grains.  Foods that impair hormone balance include harmful fats found in margarines and refined vegetable oils, packaged foods containing hydrogenated or partially hydrogenated fats and refined sugars found in most foods like bread and pasta.  Organic foods, especially vegetables, fruits, beef, poultry and fish, should be eaten as frequently as possible as non-organic food sources often contain pesticides and herbicides that can have estrogen-like effects on the body and disrupt hormone balance.  Milk and dairy products should be consumed in moderation as they also have been found to contain hormonal residues that disrupt normal hormonal biochemistry as well. 

 

Although there are many vitamins and nutrients that are very important for adequate hormonal functioning, specific nutrients have been researched and found to be beneficial for men’s health and for counteracting the effects of andropause.  A few of these nutrients are listed below, although this list is not all-inclusive.  Your naturopathic doctor can discuss what other vitamins, minerals and co-factors are important for you to take to assist you with your andropausal symptoms

 

·         Essential Fatty Acids – There is a group of fats that the body is incapable of synthesizing on its own known as “essential fatty acids” (EFAs).  They include omega 3 (linolenic) and omega 6 (linoleic) fatty acids.  EFAs are required constituents of every cell membrane in the body and are required to maintain the fluidity of these membranes, aid in producing and balancing hormones and play an essential role in managing inflammation.  Classic signs of deficiency include depression, mood disorders, memory loss, hyperactivity, anxiety, dry flaking skin, inflammation, arthritis, decreased bone density, muscle spasm, food allergies, fatigue, increased body fat and most important to our discussion, hormonal imbalance.  Prostate health is also directly tied to adequate essential fatty acid intake and levels in the body.  A group of researchers recently found that men with Benign Prostatic Hyperplasia (BPH) have less omega 3 fatty acids in their serum and prostate cancer patients have substantially less omega 3 fatty acids compared to men without BPH or prostate cancer. 

 

·         Zinc – The prostate gland has a unique characteristic of storing high levels of zinc.  Healthy prostate tissue contains higher concentrations of zinc than all other tissue in the human body.  Therefore, it is no coincidence that the level of zinc in the prostate gland declines dramatically in patients with BPH and even more so in patients with prostate cancer.

 

·         L-Arginine – L-Arginine is an essential amino acid that can be very effective for erectile dysfunction that can help to produce harder and longer-lasting erections and increasing libido.  Supplementation with arginine has also been shown to improve low sperm counts and male infertility.  Arginine promote the production of nitric oxide, a substance that opens up blood vessels in the penis much like the drug Viagra.  But unlike Viagra, arginine is free of side effects like Viagra and is relatively inexpensive.  Arginine also helps to stimulate the release of growth hormone which also acts to stimulate sex drive.  For men, losing muscle mass and gaining more fat mass during andropause can be very frustrating.  Arginine, along with a healthy exercise regimen can help to increase muscle mass and decrease fat mass. 

 

Acupuncture

Acupuncture is the oldest form of medicine, dating back thousands of years. It is an energy-based medicine which acknowledges the existence of unseen electrical energy in the body which flows in documented patterns and pathways. Disease occurs when there is an imbalance or blockage of energy.  Acupuncture is used to treat many conditions ranging from pain relief to chronic disease, to addictions (e.g. smoking cessation).  More importantly acupuncture is a great treatment modality to use in conjunction with the aforementioned therapies to treat hormonal imbalances and fertility problems in men, combat aging and stress and assist with insomnia, depression and pain.

Sexual health is a very important function to most men.  Erectile Dysfunction (ED) is the inability for a man to attain or maintain an erection sufficient enough for intercourse.  ED and decreased libido is a trend increasing amongst aging men in the United States which tends to causes embarrassment, sexual frustration and leads men who experience this condition to feel less “manly” than those who do not.  Often times, ED occurs as part of the normal aging process in men, however it may occur in younger men as well due to either lowered hormone levels or psychological causes.

The majority of men who experience ED also exhibit other signs of Andropause as well.  Andropause, also termed “Male Menopause,” typically results from a drop in the primary sex hormone, testosterone, just as women experience menopause from a resultant change in their hormones as they age.  The loss of testosterone, which can happen to men as young as 35, is gradual, with testosterone levels dropping just 1 percent to 1.5 percent annually.  Unlike the precipitous loss of estrogen which menopausal women face, the gradual loss of testosterone may take years to exact its mark on men.

The most common signs and symptoms of Andropause include:

• Erectile Dysfunction – difficulty attaining/maintaining erections
• Lowered Libido
• Mental decline – irritability, depression and anxiety
• Fatigue
• Enlarged Prostate causing urinary difficulties
• Weight gain
• Loss of muscle mass/muscle weakness

Naturopathic physicians take a full individualized history from you to determine if you are experiencing symptoms of andropause.  They most often spend up to an hour and half with you on your first visit to really get to know you as a person and to know your full history before starting with any laboratory tests or with any treatments.  Andropause seems to be a multi-factorial process but most often occurs when testosterone levels in men decline with age.  Symptoms of andropause may also be caused by or be mimicked by other conditions like adrenal fatigue, hypothyroidism and environmental toxicity.  With lowered testosterone levels, not only can men have the unwanted symptoms of andropause like lack of libido, erectile dysfunction and a decrease in energy but they can also be predisposed to developing other more serious conditions like cardiovascular disease, obesity, insulin resistance and diabetes, osteoporosis, and Benign Prostatic Hyperplasia (BPH).

Both simple blood tests, like a male hormone panel, and other specialized tests like a thyroid function test, an adrenal function test, or an IgG Food Allergy test can determine the underlying cause of your andropausal symptoms.  Other specialized tests like a Cardiovascular Risk Assessment can determine your risk of developing other conditions like cardiovascular disease and even insulin resistance or diabetes.   Although medications are not a naturopathic physician’s first choice for treating the symptoms of andropause, naturopathic physicians do have prescription rights in the state of Arizona and may decide to prescribe you a medication if they feel it necessary.

With the use of natural Bioidentical Hormone Replacement Therapy (BHRT) in conjunction with many other natural treatment options, like botanicals, nutritional supplementation, and acupuncture, andropause can be managed effectively and help men regain and attain optimal health as they age.

Contact Dr. Matthew Cavaiola at East Valley Naturopathic Doctors to schedule your FREE 15 minute consultation TODAY.  (480) 985-0000.

All of us have experienced some sort of physical pain at one point in our lives. How we choose to deal with the pain varies from person to person, yet for most of us, despite what we do to help our pain, it inevitably returns. Naturopathic Physicians work with you and take a natural approach to treating and preventing future occurrences of pain. Naturopathic Physicians use therapies like clinical nutrition, acupuncture, and prolotherapy and run specialized laboratory tests like an IgG Food Intolerance Test or a Neurotransmitter test to treat and determine why your pain may be occurring.

Naturopathic Physicians are trained in treating and curing pain as result of a whole host of both acute and chronic conditions. Acute conditions like motor vehicle accidents, sprained ligaments and strained muscles and chronic conditions like Osteoarthritis, Rheumatoid Arthritis, low back or knee pain respond favorably to naturopathic treatments. These naturopathic treatments have been shown to be superior when compared to the treatment of pain with standard medications, steroid injections, or surgery.

Arthritis and many chronic pain syndromes are a result of widespread uncontrolled inflammation in the body. Inflammation can occur due to a variety of reasons, however the largest percentage of inflammatory type reactions in the body are due to an inflammatory type diet. Arthritis and a whole host of other conditions stem from poor diet and nutritional imbalances. Naturopathic physicians can help you to find out what foods are causing an inflammatory reaction in your body and gain control of pain and other symptoms of inflammation. The most reliable approach to determining inflammatory dietary foods in the diet is by performing an IgG Food Intolerance Test. Naturopathic physicians recognize the individual variability in everyone and realize that everybody has different foods that cause inflammation so an IgG Food Intolerance Test shows what foods in particular are toxic for YOUR system.

Acupuncture dates back over 2500 years and is great for helping people deal with and cure both chronic and acute pain syndromes. Acupuncture is based on the concept of energetic balance. Energy is thought to run smoothly through channels or meridians in a healthy individual. When there is an energetic imbalance, illness often ensues. Treatments are based on assessing the flow and distribution of this vital energy within its pathways, and influencing health and sickness by stimulating certain areas along these meridians. Naturopathic Physicians are trained in acupuncture and commonly use this form of medicine in conjunction with other therapies to bring a person to wellness. Often patients feel great after the first treatment, but it usually takes 5 treatments to see the maximum benefit.

Prolotherapy is another wonderful treatment modality that Naturopathic Physicians can use to help treat both acute and chronic pain. Prolotherapy is a leading anti-aging treatment for painful joints characterized by diminished function and pain due to stretched or strained ligaments and tendons. Once stretched or weakened, ligaments are not able to return to there original strength or length without outside assistance. Nutritive injections strengthen ligament and tendon attachments in the ankle, knee, hip, shoulders and even along the spine. The injections stimulate the growth of new collagen and ligament fibers resulting in stronger ligaments, more stable or tighter joints, improved joint function and reduction in pain. Prolotherapy solutions do not contain cortisone, which may end up weakening the strength of the joint. For pain in your feet, ankles, knees, hips, back, shoulders, or hands, Prolotherapy is the best anti-aging treatment for your joints.

To schedule a FREE 15 minute consultation to have a Naturopathic Physician help you with your pain, contact Dr. Matthew Cavaiola at East Valley Naturopathic Doctors at (480) 985-0000.

Conceiving a child can often be a challenging and stressful event in the lives of a couple. Despite the fact that most of the pressure seems to reside on a woman’s shoulders to get pregnant, factors related to a man’s fertility are equally important and just as much emphasis should be placed on men’s infertility as women’s.

Infertility is defined as the inability to achieve a pregnancy after one year of unprotected intercourse. Conception is normally achieved within 12 months in 80-85% of couples using no contraceptive measures. Therefore an estimated 15% of couples attempting their first pregnancy will have difficulty conceiving.

An estimated 6% of adult males are thought to be infertile. While certain cases of male infertility are due to anatomical abnormalities such as varicoceles, ductal obstructions, or ejaculatory disorders, an estimated 40-90% of cases are due to deficient sperm production. Factors that may affect sperm production or motility include tobacco use, excessive alcohol or marijuana usage, excess body weight, certain medications, environmental toxins, restrictive underwear and temperature extremes. Chronic underlying infections, diet and endocrine abnormalities can also play a crucial role in male fertility.

Naturopathic doctors take a holistic and individualized approach to male infertility. They take a thorough history from a patient to determine all of the underlying factors that may be contributing to the inability to conceive and are able to run both simple and specialized laboratory tests. One such specialized laboratory test is a blood Hormone Profile test. If certain hormones like testosterone or estrogen are abnormal, this could potentially contribute to male infertility. Other potential tests to determine the nature of male infertility include Heavy Metal Toxicity testing, Environmental Toxicity Testing, and Adrenal Function Testing.

Naturopathic doctors can tailor personalized treatments to a patient to improve the likelihood of a couple conceiving a child. Nutritional supplementation of vitamins, amino acids, minerals and antioxidants help to correct any nutritional imbalances that may be present and reverse the deleterious effects of environmental toxins that both may play a role in male infertility. Certain botanical medicines and acupuncture have also shown to be powerful naturopathic treatment options to benefit male fertility.

To schedule an appointment with Dr. Matthew Cavaiola to discuss improving male fertility, please call East Valley Naturopathic Doctors at (480) 985-0000 today.

With aging it is almost universal in men to have an enlarged prostate gland. It is most commonly seen in men over the age of 40, and 50% of men over the age of 50 have enlarged prostates. Although an enlarged prostate, or benign prostatic hypertrophy (BPH), may not cause men any difficulties in everyday functioning, often it can lead to problems with urination such as decrease in force of urination, sensation of incomplete voiding, increased frequency in urination, and dribbling of urine. As men age, testosterone in the body is converted more into dihydrotestosterone (DHT) in the prostate which has a direct relation to increasing prostate size. Simple blood tests and physical examination of the prostate can help naturopathic physicians determine if men have BPH or a more serious condition like prostate cancer. Naturopathic modalities like botanical medicine, nutritional supplementation and acupuncture can all help men with this condition.

Although BPH is a rather benign condition, it has similar signs and symptoms to prostate cancer which may be a more serious diagnosis in men. Like BPH, prostate cancer can be asymptomatic and it may not cause any problems in men until it is advanced in its progression. However, it may also lead men to have urinary urgency, hesitancy, need to urinate during sleep, poor urinary stream, and dribbling. Prostate cancer accounts for 70% of all male cancers and only lung cancer has a higher mortality rate. Incidence also increases with age, with 80% of new cases occurring after 65 years of age. It is important for men to begin screening for prostate cancer at age 50 and at 40 years in African-Americans or in men who have a family history of prostate cancer. To help naturopathic physicians screen for prostate cancer and other illness they may perform simple blood tests, a physical examination of the prostate, along with a Men's Wellness Exam.

Prostatic intraepithelial neoplasia, or PIN, is a condition in which the cells on the prostate gland's surface divide more rapidly than the rest of the prostate cells. Research shows that men diagnosed with PIN have a sharply increased risk of developing prostate cancer. It has been postulated that there seems to be an inflammatory component to this condition that typically respond favorably to naturopathic treatments. Recent literature has shown that natural cyclooxygenase (COX) inhibitors, like Zyflamend, have been linked to decreasing the amount of inflammation in not only the body, but specifically the prostate gland itself, and thus helping to reverse PIN. Naturopathic physcians use tests like IgG Food Intolerance Testing and other tests designed to measure the amount of inflammation in your body and doing so can help them tailor individual anti-inflammatory diets and natural protocols to decrease this inflammatory process taking place.

Prostatitis is an inflammation of the prostate gland that can often lead to pain in the low back, abdomen or the pelvic region. It can also lead to urinary difficulties like difficulty urinating, frequency and urgency of urination, and the need to urinate during sleep. Prostatitis can be classified as either bacterial or non-bacterial prostatitis, often presenting with similar signs and symptoms. Most conventional physicians believe that cases of prostatitis are of the bacterial form and treat prostatitis with broad spectrum antibiotics, like Ciprofloxacin. What often occurs is that the symptoms of prostatitis and the general inflammation of the prostate are not made better by this treatment. As most naturopathic physicians would agree, prostatitis is not caused by bacteria in the prostate but most frequently due to fungus, like Candida, in the prostate – hence why prostatitis is not alleviated by antibiotics. In fact, it is estimated that prostatitis is of the non-bacterial form 95% of the time. Naturopathic physicians use treatments like both natural and, if necessary, prescription anti-fungals, botanical medicine, and omega fatty acids to treat both the underlying infection and inflammation of the prostate causing the prostatitis. Often times, food allergies over time can lead to the inflammation seen in prostatitis and can often exacerbate the underlying fungal infection occurring. Therefore, naturopathic physicians can also perform a specialized IgG Food Intolerance Test to determine what foods you are sensitive to. The reduction in consumption of these foods in conjunction with the aforementioned natural treatments can help to reduce the severity and the incidence of prostatitis.

Prostate Specific Antigen (PSA) is a controversial, but informative blood laboratory test that is used to determine the degree of underlying inflammation occurring in the prostate gland. While most conventional physicians would agree that only PSA values over 4.0 up to a level of 10.0 are indicative of serious prostate conditions, naturopathic physicians take a more cautious approach. Naturopathic physicians believe that a PSA level of 1.0 or greater indicates some degree of chronic prostatitis and that even PSA levels from 0-4, what is considered “normal” amongst conventional doctors, could still potentially be prostate cancer. As PSA levels climb, the underlying inflammation and/or chronic infection becomes worse in the prostate and predisposes a man to developing prostate cancer later in life. It is estimated that men with a PSA between 2 and 4 have a five to nine times greater incidence of developing prostate cancer within the next subsequent 10 years. Therefore, naturopathic physicians work with you to not only screen for this underlying chronic inflammation that is occurring in the prostate but also to treat the underlying inflammation/infection using natural therapies described above.

To schedule an appointment with Men's Health Specialist, Dr. Matthew Cavaiola, NMD, please call East Valley Naturopathic Doctors at (480) 985-0000!

It is estimated that today there are over 78 million Baby Boomers currently living in the United States. The Baby Boomers are the generation that was born between the years 1946 and 1964. As the Baby Boomers age, so comes with it a subsequent decline in their health and well-being.

Just as women experience declining estrogen levels in menopause from their 40’s through their 60’s, men experience a similar decline in levels of their primary hormone, testosterone, as they age. This decline in testosterone in aging men has been termed “andropause.” The loss of testosterone, which can happen to men as young as 35, is gradual, with testosterone levels dropping just 1 percent to 1.5 percent annually. Unlike the precipitous loss of estrogen which menopausal women face, the gradual loss of testosterone may take years to exact its mark on men. Declining testosterone levels in men can impact men’s health in a variety of ways – from declining energy levels to increased risk for cardiovascular disease.

Naturopathic physicians take a full individualized history to determine if men are experiencing symptoms of andropause. They most often spend up to an hour and half with patients on their first visit to really get to know them as a person and to know a full history before starting with any laboratory tests or with any treatments. Andropause seems to be a multi-factorial process but most often occurs when testosterone levels in men decline with age. Symptoms of andropause may also be caused by or be mimicked by other conditions like adrenal fatigue, hypothyroidism and environmental toxicity. With lowered testosterone levels, not only can men have the unwanted symptoms of andropause like lack of libido, erectile dysfunction and a decrease in energy but they can also be predisposed to developing other more serious conditions like cardiovascular disease, obesity, insulin resistance and diabetes, osteoporosis, and Benign Prostatic Hyperplasia (BPH).

Both simple blood tests, like a male hormone panel, and other specialized tests like a thyroid function test, an adrenal function test, or an IgG Food Allergy test can determine the underlying cause of andropausal symptoms. Other specialized tests like a Cardiovascular Risk Assessment can determine the risk of developing other conditions like cardiovascular disease and even insulin resistance or diabetes. Although medications are not a naturopathic physician’s first choice for treating the symptoms of andropause, naturopathic physicians do have prescription rights in the state of Arizona and may decide to prescribe a medication if they feel it necessary. With the use of natural Bioidentical Hormone Replacement Therapy (BHRT) in conjunction with many other natural treatment options, like botanicals, nutritional supplementation, and acupuncture, andropause can be managed effectively and help men regain and attain optimal health as they age.