What
Is Testosterone?
Testosterone is the primary
sex hormone in men, and it is responsible for the development of many of the
physical characteristics that are considered typically male. Women also produce
the hormone in much smaller amounts. Testosterone, part of a hormone class
known as androgens, is produced by the testicles after stimulation by the pituitary gland, which is located near the base of the brain.
Among other functions, testosterone sends signals to a male’s testicles (or to
a woman’s ovaries) that spark feelings of sexual desire.
The
Role of Testosterone in Male Development and Health
In
males, testosterone plays an important role in puberty, the time when a young
man reaches sexual maturity and he can reproduce. The following changes
typically happen during this life stage:
- The penis and testicles grow
- Facial, pubic, and body hair
develop
- The voice deepens
- Muscles and bones become
stronger
- Height
increases
After puberty, testosterone
helps regulate the following bodily functions:
- Production of red blood cells
- Bone density
- Fat distribution
- Muscle strength and mass
- Growth of facial and body hair
- Sperm production
- Sex
drive
What Happens When Testosterone Levels Are Low?
Testosterone
levels gradually drop in men as a natural part of aging. By age 45, it starts
falling by about 1 percent a year, but it is widely accepted that levels may
start to decline when a man is in his thirties.
Lifestyle factors also
affect testosterone production, including exercising too much or not eating a
healthy diet.
How Can You Tell if
Testosterone Levels Are High, Low, or Normal?
Your
doctor can order a blood test to find out if your testosterone levels are in
the normal range.
What Is Low Testosterone or
“Low T”?
In
some cases, low testosterone (also known as low T) may be caused by a
medical condition known as hypogonadism, which occurs when the body does not
generate normal amounts of the hormone. It happens when there is a problem with
the testicles or the pituitary gland that creates an inability to produce
normal amounts of testosterone. Low T can also be caused by other issues,
including certain medications and being overweight.
What Is the Longevity Diet?
Symptoms of so-called low T vary depending on the cause of problem and the age when it happens.
In men who are middle-aged
and beyond, symptoms may include:
- Low energy and depressed mood
- Sleep disturbances
- Low sex drive
- Problems getting or maintaining
an erection
- Low sperm count
- Loss
of muscle and bone strength
Not all men with
age-related low testosterone will experience any symptoms, and others
aren’t bothered by them. Troubles with energy, sleeping, and mood can also be caused by other issues like
medication side effects or excessive alcohol use.
How Do Doctors Test for and
Diagnose Hypogonadism?
Hypogonadism
(as well as age-related low testosterone) is diagnosed with blood tests that
measure the level of testosterone in the body. The Endocrine Society recommends testing for suspected
low T with a total testosterone test. It should be performed on two separate
occasions, early in the morning and on an empty stomach. Testosterone levels
tend to be highest early in the morning in young men, although this isn’t
necessarily the case in older men.
What Are the Options if
Your Testosterone Levels Are Low?
Testosterone
replacement therapy is currently only FDA-approved for men who have been
diagnosed with hypogonadism. The use of testosterone therapy is increasingly
common in the United States, with more than two million men receiving the
therapy. Not every man benefits from taking testosterone replacements.
Testosterone is available in different forms, including topicals such as gels,
creams, and patches; injections; and pellets that are surgically placed directly
beneath the skin.
What Are the Side Effects
of Testosterone Replacement Therapy (TRT)?
Possible
long-term effects of TRT have not yet been established, but there is scientific
evidence to suggest it may have an impact on cardiovascular health, cancers of
the prostate and breast, and sleep disturbances such as sleep apnea.
There
is also a risk of polycythemia, which in turn increases risk for blood clots
and stroke.
People who take
testosterone should seek medical attention immediately if symptoms of a heart attack or stroke are present, such
as:
- Chest pain
- Shortness of breath or trouble breathing
- Weakness in one part or one
side of the body
- Slurred
speech
What About Testosterone in Women’s Health?
Women’s bodies don’t produce as much testosterone as men’s. The hormone is generated in the ovaries and adrenal glands. Women need small amounts of it as part of the mix of hormones that keep mood, energy levels, sex drive, and bodily functions running smoothly.
Women can have health
issues as a result of either low or high testosterone levels. Some
postmenopausal women experience dips in testosterone levels that can cause a
decrease in sex drive. Low testosterone levels can also cause other health
issues such as fatigue, and increased risk for bone loss, osteoporosis, and fractures.
High Testosterone Levels
Can Cause Problems in Women
But
when a premenopausal woman’s testosterone levels are too high, it can lead
to polycystic ovary
syndrome (PCOS), a condition that increases the risk of irregular or
absent menstrual cycles, infertility, excess hair growth, skin problems, and
miscarriage. High levels of testosterone in women, whether caused by PCOS
or by another condition, can cause serious health conditions such as insulin resistance, diabetes, high cholesterol, high blood pressure, and heart disease.
The FDA has not approved
the use of testosterone therapy in women, and in their most recent guidelines, the Endocrine Society recommends
against the general use of testosterone therapy in healthy women for the
treatment of the following conditions:
- Infertility
- Sexual dysfunction other
than hypoactive sexual desire disorder (HSDD)
- Cognitive function
- Cardiovascular health
- Metabolic syndromes
- Bone health
- General
well-being
Is
There a Natural Way to Enhance Testosterone Levels?
While the testosterone
supplementation industry is somewhat controversial in the United States, there
are many well-established drug-free ways to maintain healthy testosterone
levels.
Is
Your Libido Healthy and Normal? Is Your Sexual Desire Lacking?
Sex
drive is a nonclinical term that means enthusiasm or interest in
sexual activity. The presence of it (or lack thereof) can indicate the state of
your mental and physical functioning.
What controls the sex drive
is a very complex intertwining of biological, psychological, and
social-cultural influences. Libido levels can be affected by factors such as
medication, relationship quality, fatigue, and disease, as well as issues such
as anxiety, stress, and depression.
While a change in interest
and desire for sex may signal a medical problem or side effect, it’s not
considered a red flag. If you consider your libido levels too low, or too high,
treatments are available.
Resources
We Love
This
is a selective list of online resources to provide information, support, and
searchable databases on testosterone health and testosterone disorders.
Favorite Orgs and Pages for
Essential Testosterone Facts and Stats
Hormone Health Network From the Endocrine Society
The Endocrine Society is
the world’s largest and most influential organization of endocrinologists
(doctors who treat hormone disorders). The Hormone Health Network provides
online resources for patients, including information on men’s health and low
testosterone. The site also contains an up-to-date physician referral directory
with more than 6,500 Endocrine Society member doctors.
American Society for Reproductive Medicine
This society of fertility specialists
maintains a patient-focused website with easy-to-read educational pages on
reproductive health topics, including testosterone use and male infertility.
The site also contains resources for finding a reproductive health
professional.
American Urological Association (AUA)
The AUA, which represents
urologists and urologic health professionals, publishes guidelines on the
diagnosis and treatment of testosterone deficiency.
Choosing Wisely
Choosing Wisely is an
initiative of the American Board of Internal Medicine that aims to promote
conversations between patients and their doctors about unnecessary medical
tests, treatments, and procedures. Along with the AUA, they’ve compiled a list
of 15 things physicians and patients should question, including the
prescription of testosterone to men with erectile dysfunction but normal testosterone
levels.
Favorite Resources for
Becoming an Advocate
Partnership for the Accurate Testing of Hormones (PATH)
PATH was formed in 2010 to help
the clinical, medical, and public health communities improve patient care
through more accurate and reliable hormone tests. PATH supports research that
improves the diagnosis and treatment of hormone disorders, including a landmark
2017 study that defines the “normal” range of testosterone in young adult men.
National Center
for Transgender Equality
This nonprofit was founded
by transgender activists in 2003 to advocate for transgender equality,
including the rights of people seeking hormone therapy and other transition-related
medical procedures and treatments.
Trans athlete
This site, founded by U.S.
duathlete Chris Mosier — the first openly trans man to make a U.S. Men’s
National Team in 2015 and the first transgender athlete to feature in a Nike
commercial and ESPN The Magazine The Body Issue — offers
a list of policy resources for transgender athletes of all ages and abilities
undergoing hormonal treatment with testosterone or testosterone suppression
therapy.
Favorite Blogs
Talking About Men’s Health
This blog was one of the
top 10 men’s health blogs in 2018. Topics vary from natural remedies to help
fight hair loss to what you need to know about testosterone replacement therapy.
Jed Diamond, author
of Male Menopause and Surviving Male Menopause,
blogs about critical aspects of health and well-being for men over 40.
Dr. Turek’s Blog, The Turek Clinic
Paul Turek, MD, a urologist
in San Francisco, is an international leader in male fertility research. He blogs about men’s health
topics, including steroids, testosterone, and male infertility, on the Turek
Clinic’s website.
Where to Find Testosterone
Clinical Trials
Clinical trials are
medical studies aimed at preventing, diagnosing, and treating diseases. Check
here for clinical trials on male infertility, andropause, low T, and other
testosterone-related disorders:
·
Antidote
·
CenterWatch
·
ClinicalTrials.gov
·
Program for Healthy Volunteers
·
Research Match
·
Science 37
