What Is Testosterone?
Testosterone is a male hormone that’s produced in the testicles in men. It operates as an anabolic steroid and primary sex hormone, with crucial roles in developing sex characteristics and reproductive tissues. This hormone thus helps to develop the prostate, penis and testes, as well as to develop characteristics oft seen in men, such as greater body hair, bone and muscle mass, deeper voice, sperm production and sex drive. Testosterone may additionally help to regulate mood.
Testosterone (T, for use here) is also produced in the adrenal gland and ovaries in women, with roles in ovary function and libido. A healthy balance between oestrogen and androgens like testosterone is vital for normal function of the ovaries.
For men, the brain sends signals to the pituitary gland, which then relays those signals to the testes to produce the T. A feedback loop regulates the amount of testosterone, with signals to produce more or less sent by the brain in order to maintain this hormone level in the blood.
What Happens With Too Much Testosterone?
Despite the social connotations between “too much testosterone” and high sex drive, violence and rage, it’s actually uncommon for men to have too much testosterone naturally occurring. This is thanks to that feedback loop of signals from the brain.
However, measuring T isn’t that straightforward. Firstly, levels can vary throughout the day and over time. Secondly, “normal” levels are not objective and it’s not easy to define “normal” behaviour either.
High testosterone is typically a result of artificially elevated levels, and it’s through such elevation where scientists have learned about the effects of too much of this hormone. High levels can be seen in individuals using hormone supplements, testosterone replacement therapy or anabolic steroids to increase their strength and muscle mass. The symptoms can vary from the more nuisance symptoms of acne and weight gain, to potentially vary serious and dangerous problems. Heightened risk of blood clots, high cholesterol, headaches and insomnia, liver disease, enlarged prostate and related urination difficulties, low sperm count, aggressive behaviour and mood abnormalities, fluid retention and swelling, high blood pressure, damage of the heart muscle, and heightened risk of heart attack.
How Does Testosterone Get Reduced?
As we age, certain chemicals and hormones can reduce at differing speeds. For women, oestrogen can drop quite rapidly and lead to the menopause. For men, testosterone drops far more slowly, with a gradual decline each year of around 1% to 2%. A third of men or more over the age of 45 are likely to have reduced hormone levels that are lower than “normal”.
The reduction is a result of less signals from the pituitary, less production by the testes and an increase in SHBG (sex hormone binding globulin).
Lower levels can also be due to certain medications, tumours, injury to the testes, chemotherapy, particular infections, and genetic diseases.
What Are The Symptoms Of Low Testosterone?
Lower levels of testosterone are normal with age but there’s a chance that the levels become deficient and provoke noticeable symptoms before one may expect them to occur naturally.
Symptoms of testosterone deficiency can include:
- Mood dysfunction, including depression and irritability
- Poor concentration
- Lower bone density, with increased risk of fractures
- Lower libido
- Night sweats
- Larger breast size
- Less muscle mass
- Erectile dysfunction
- Reduced facial and body hair
- Hot flushes
- Smaller testicles and reduced sperm count that can affect fertility
Some research is also suggesting that men with low T could be more likely to suffer dementia, developed type 2 diabetes and even be five times more likely to die prematurely.
In the case of early death, an older study has hinted at such a risk and further investigation is clearly warranted. In 2006, the University of Washington conducted a four year observation of 850 male veterans over the age of 40. The findings were eye-opening: men with lower testosterone had an 88% higher chance of prematurely dying. This was supported by further unrelated research in 2013 that found deficiency was associated with a greater risk of mortality, while T replacement was associated with greater survival in type 2 diabetic men.
Lower levels can, oddly enough, be beneficial in some cases. For instance, testosterone can trigger the prostate gland and thus stimulate the growth of prostate cancer. This is why prostate cancer treatment can include testosterone-lowering medications as a result. It doesn’t mean that testosterone supplementation causes prostate cancer, but it might lead to the growth of it.
Can Testosterone Therapy Reverse Symptoms Of Deficiency?
In some cases, testosterone replacement therapy (TRT) to boost levels can reverse symptoms of deficiency. If a person has low levels of this active hormone, symptoms like fatigue, depression, thinning bones, lowered libido, etc could see an improvement. Unfortunately, not all men necessarily see improvement with TRT, and symptoms could be mistaken for another condition.
Some men can experience such testosterone deficiency symptoms despite having “normal” levels. In 2003, Harvard Medical School found that even those with normal testosterone levels experienced improved mood, loss of fat, enhanced muscle mass and reduced anxiety after receiving testosterone therapy.
This further muddies the water of diagnosis and resulting treatment. It’s not always a straightforward case of measuring levels in the blood and as such, many men may miss out on TRT that could potentially help with their symptoms.
There are, however, potential side-effects and risks that come with such therapy, much like with most medications or supplements. Use of patches and injections could cause some itching, irritation or a rash. T supplementation use may also increase the risk of heart attack or stroke, but large scale clinical trials have not been done to assess the risks versus benefits.
Male Hormone Deficiency Has Been Overlooked For Too Long
The British Society for Sexual Medicine have stated that testosterone deficiency “has been long neglected”. The lack of definitive links between symptoms and deficiency has led to the problem being under-addressed, and research is only now shining a more educated light on the potential problems caused by low levels.
The 2006 and 2013 studies of premature death surely deserves a deeper investigation. From more nuisance symptoms to being a debilitating or even life-limiting condition, low testosterone does appear to be a serious problem and it rarely gets a mention by media, in social conversation or by medical professionals.
Low testosterone by itself may not need treatment, but if it is causing symptoms and interfering with life then replacement therapy could be helpful. However, if a medical professional considers the symptoms could be general ageing or anxiety, then patients may miss out on the right treatment for them.
Some Men Can’t Access Therapy
Given the aforementioned problems with defining a “normal” level and with testosterone levels varying throughout the day, it’s not always easy to interpret results. The hormone can be measured with a simple blood test, but if reliant on just the one sample, and at a time where testosterone is higher, the chance to identify deficiency at a different time of the day may be missed.
There’s not enough research on the links between testosterone and symptoms of deficiency to categorically state the two are linked and to give credence to funding treatment that may or may not be useful.
What You Can Do If You’re Concerned About Low Testosterone
If you have concerns about testosterone levels for yourself or a loved one, speak to your GP. You should be able to ask for a testosterone blood test. Be aware of the potential problem with fluctuating levels during the day and over time, because more than one test may be required. If you have problems getting adequately tested, you could also do an at-home test yourself. In the UK, you can buy a testosterone test from Medichecks. There’s a basic testosterone check for simplicity and value, or a more in-depth check with the male hormone test.
You can save 10% on your blood test order by using this link & the code INVISME10 @ checkout.
Do you have symptoms of low testosterone? Try writing down the issues that bother you, but be mindful that you may not be aware of everything like bone density. Speak to your doctor and present the symptoms you’re aware of. Explain the impact they have on your life and your concern about current and future health as a result, and perhaps broach the potential for TRT if your doctor doesn’t.
Testosterone Replacement Therapy
Testosterone replacement therapy can come in various formats. These include transdermal patches that apply to the skin usually once a day, a mouth patch that adheres to the upper gums or a tooth next to the front teeth, injections, implants, and gels.
Replacement therapy is not the same as synthetically increasing testosterone in the way some use anabolic steroids for bodybuilding. TRT doses will allow for natural levels of T in the blood. In contrast, illegally used testosterone or steroids are usually far higher doses and mixed with other substances.
Is this low testosterone male menopause crisis something you’ve heard about before?