As you may know, testosterone, also known as ”the hormone of desire”, is the primary sex hormone in men. Thanks to it, boys develop their sexual characteristics during puberty, and adult men maintain their muscle mass, produce sperm and have sexual desire, so its nickname suits it well. But what happens when it starts to fall?
Yet, contrary to popular belief, this hormone is responsible for numerous physiological functions and not just the main sex driver, including bone maintenance, blood cell stimulation and blood lipid enhancement, so low blood T levels can lead to significant health outcomes for any man. But before going into details, you must first know what testosterone is and how it works.
What Is Testosterone?
Testosterone is an androgen, a hormone produced by male and female sex organs and the adrenal cortex (mainly dehydroepiandrosterone), the outer region of the adrenal gland. Men, in particular, have more testosterone than women, and in them, it is primarily produced in the testes by the Leydig cells. Also, the brain and the pituitary gland (a small gland at the base of the brain) control the amount of testosterone produced by the testes through another hormone called luteinizing hormone (LH). Testosterone levels increase dramatically during puberty, so as an androgen, it causes the typical body and facial hair growth, muscle development, and deepening of the voice in boys.
Benefits of Testosterone
Testosterone is also responsible for:
• Promoting testes development.
• Promoting bone growth.
• Healthy red cell maintenance.
• Improving high-density lipoproteins (HDL) and lowering low-density lipids, the so-called “bad cholesterol” (LDL).
• Supporting health heart.
• Erectile response.
• Improved cognitive function and vitality in men.
Normal Testosterone Levels
Specialists suggest that normal serum testosterone levels range from 300 to 1,000 ng/dL. This amount is made primarily from Leydig cell cholesterol under the influence of LH. Thus, a man’s testicle produces approximately 5 to 7 mg of testosterone per day in normal conditions.
However, a healthy man does not produce testosterone constantly throughout the day; on the contrary, T secretion is conditioned by the time of day, or in short, by the circadian rhythm.
The circadian rhythm is nothing more than the set of physiological changes in response to light and dark. Just as your body slows down and blood pressure drops at night, the testes also respond to the time of day. In this way, T blood secretion increases from late evening to early morning and decreases to a minimum in the late afternoon. This explains why blood tests must be done in the early morning.
What Happens If a Man Is Low On Testosterone?
Low levels of testosterone, also known as male hypogonadism, is common in most men, especially as they age. Men lose up to 0.4-2% of testosterone levels annually after their 30s; the main reason? The testes are less and less capable of producing testosterone as the years go by. Low testosterone is linked to several health problems, such as loss of libido, erectile dysfunction, depression, decreased cognitive ability, trouble focusing, lethargy, osteoporosis, and muscle mass and strength loss. As you get older, you will likely feel less vigorous, gain a few pounds, your sex drive will decrease, and you will have a harder time getting an erection.
Can Low Testosterone Affect My Sex Life?
Low testosterone can also affect a man’s sex life. You may experience:
• Ejaculation with less semen quantity.
• Reduced ejaculation warning.
• Orgasm without ejaculation.
• Your penis may become flaccid quickly after an orgasm.
• After an orgasm, a longer time may elapse before getting an erection.
Why Do Testosterone Levels Drop?
Testosterone can drop for many reasons and not just because of aging. Trauma, medications, diseases, genetic disorders, or a history of steroid use are some of the causes of its decline.
Causes of Low Testosterone:
• Testicular damage.
• Genetic diseases such as Klinefelter’s syndrome.
• Some medications such as opioid painkillers.
• Hormonal disorders (pituitary gland tumors or diseases, high prolactin level).
• Liver and kidney disease, obesity, type 2 diabetes, or HIV/AIDS.
• Chronic and heavy drinking.
Long-Term Effects of Low Testosterone
As testosterone decreases over the years, health problems also occur due to the lack of its action in the male body.
Increased risk of injury
The lack of optimal T levels can cause bones to become thinner, leading to osteoporosis and increased risk of falls, fractures, and death in the long run.
Low T also causes men to gain weight, especially in the belly, which predisposes them to an increased risk of type 2 diabetes. Lifestyle and dietary changes are decisive in preventing this disease.
Since testosterone plays a key role in maintaining a normal red blood cell count, low levels can lead to anemia both in women and men. As you may know, hemoglobin levels are similar in boys and girls but increase in boys after 13 years, coinciding with the increase of serum testosterone during puberty, leading to the classical 1 to 2 g/dL difference in hemoglobin readings between adult females and males.
In addition, testosterone regulates body iron availability, an essential component of hemoglobin. In this way, low levels of this hormone predispose to an increased risk of anemia and a higher risk of developing it over a 3-year follow-up period.
Similarly, low testosterone influences brain chemistry and predisposes to depression, cognitive and memory impairment, and Alzheimer’s disease.
Testosterone plays a protective role in male arteries, and a decrease leads to plaque build-up in the wall of the arteries that supply blood to the heart and a consequent risk of coronary disease. It can also lead to high blood pressure and dyslipidemias.
How Do I Know If I Have Low Testosterone?
A blood test is necessary to measure the testosterone in your body. There are two main tests: total testosterone and free testosterone. But what does this mean? Well, 98% of the testosterone in your body circulates bound to proteins in your blood, and only the remaining 2% travels freely. Thus, the free T-test measures 2% while the total T-test measures 100%.
Because testosterone fluctuates during the day, you will probably require several measurements, mainly in the early morning. Whether you have symptoms of low testosterone or because your doctor has requested it, measure your current testosterone levels with step 1 of our program at HRT doctors. Our professionals will help you know exactly how your hormones are doing.
How Can I Normalize My Testosterone?
Here’s the question you were probably waiting for throughout the article. First of all, before opting for medical treatment, you must look at your lifestyle. Believe it or not, lifestyle is a determining factor in how much testosterone your body produces. According to science, diet and exercise have been key in preventing aging and maintaining optimal testosterone levels. So, you must keep fit and eat healthy for your testicles not to be damaged by aging so soon, and your testosterone doesn’t drop so early.
Why should you exercise?
It is no secret that doing some physical activity from time to time is a powerful tool to prevent many diseases and keep you active. The same applies to your blood testosterone levels. Recent studies have shown that blood T levels can rise with as little as twelve weeks of exercise for at least fifteen minutes a day, especially aerobic exercise, such as cycling or running.
Plant-based diet: a way to improve your quality of life
The plant-based diet was not a real suggestion until its health benefits in many ways were recently discovered, including sexual and male health. Studies have shown that a plant-rich diet decreases the likelihood of erectile dysfunction, obesity, diabetes and heart disease, which are the main chronic conditions that impact the hormonal balance of any man.
If you want to stay healthy and prevent chronic diseases as you age, try adding more plants to your diet and fewer carbohydrates. This will slow down the aging process of your testicles and improve all of your body’s systems, including your metabolism. Make sure you get a good night’s sleep every night. Sleep restrictions have been shown to decrease blood levels of testosterone, either due to stress, sleep disorders or sleep schedule changes. To promote rest, make sure your room has a proper temperature, not too cold or warm, the lighting dim, and be as quiet as possible. If you are going to start the fitness world or if you already belong to it, try to exercise not too close to your usual sleep time and no less than three hours before bedtime.
Hormone Replacement Therapy (HRT) or Testosterone Replacement Therapy (TRT): A Medical Option for Some Men
Although lifestyle changes are crucial to improving your hormone levels and keeping you healthy, you should know that they are often not enough to raise your testosterone enough to make your symptoms disappear. Lifestyle improvements are often effective, especially in young, healthy men whose bodies are not damaged by aging and still respond efficiently. It may be an option for men over 30 years to start testosterone replacement therapy (TRT) guided by specialists.
But what is testosterone replacement therapy?
It is the treatment of choice for men diagnosed with low testosterone. It consists of receiving external testosterone to rebalance your blood T levels to disappear the symptoms, improve your sexual life and reverse the detrimental health effects that its low levels cause.
TRT brings many benefits to those who really require it, including:
• Better erections.
• Improved sexual performance.
• Improved general mood.
• Increased energy and greater vitality.
• Your bones become stronger again (improved bone density).
• After a workout routine, it becomes easier to gain muscle (improved muscle mass).
• Improvement of anemia and return of red blood cell count to normal.
How Do I Know If I Am a Candidate for TRT?
Many men think they have low testosterone, but not all men are candidates, even if they show symptoms. To determine if you really are a candidate, you should see a health care professional who will measure your T blood levels and confirm if they are below the average, considering that normal readings range between 300 to 1,000 ng/dL per day. If you are a candidate for TRT, you will probably get testosterone in creams or gels, muscle injections, daily tablets, skin patches or implants, depending on the specialist suggestion. Dosages also vary depending on your testosterone readings, and you may also experience adjustments during treatment tailored to your body’s needs.
The Hormonal Program That Meets Your Needs
Either because you think you have low testosterone, match several symptoms after reading them, or you just want to make sure your blood readings are normal, the HRT doctors team guides you through the whole process, from taking the sample for blood reading to the right T dosage according to your body demand.
Our program consists of five steps:
1. Initial review of your medical record and baseline lab testing.
2. Continuation of your medical record with new data.
3. Consultation with our physicians without leaving the comfort of your home or office.
4. Get treatment tailored to your needs and your body’s hormonal demands.
5. Continuous and supervised care during the entire course of therapy.
Once the therapy has started, we’ll provide necessary follow-up check-ups to see if everything is going well or if, on the contrary, you need changes to your respective medication protocol.
Click for more information about HRT Doctors Group Low T Centers.
1. Carto, C., Pagalavan, M., Nackeeran, S., Blachman-Braun, R., Kresch, E., Kuchakulla, M., & Ramasamy, R. (2022). Consumption of a healthy plant-based diet is associated with a decreased risk of erectile dysfunction: A cross-sectional study of the National Health and Nutrition Examination Survey. Urology, 161, 76–82. https://doi.org/10.1016/j.urology.2021.12.021
2. Cunningham, G. R., Matsumoto, A. M., & Swerdloff, R. (2004). Low testosterone and men’s health. The Journal of Clinical Endocrinology and Metabolism, 89(5), E2–E2. https://doi.org/10.1210/jcem.89.5.9997
3. Devi, S., Saxena, J., Rastogi, D., Goel, A., & Saha, S. (2014). Effect of short-term physical exercise on serum total testosterone levels in young adults. Indian Journal of Physiology and Pharmacology, 58(2), 178–181.
4. Duca, Y., Calogero, A. E., Cannarella, R., Giacone, F., Mongioi, L. M., Condorelli, R. A., & La Vignera, S. (2019). Erectile dysfunction, physical activity and physical exercise: Recommendations for clinical practice. Andrologia, 51(5), e13264. https://doi.org/10.1111/and.13264
5. Laughlin, G. A., Barrett-Connor, E., & Bergstrom, J. (2008). Low serum testosterone and mortality in older men. The Journal of Clinical Endocrinology and Metabolism, 93(1), 68–75. https://doi.org/10.1210/jc.2007-1792
6. McBride, J. A., Carson, C. C., 3rd, & Coward, R. M. (2016). Testosterone deficiency in the aging male. Therapeutic Advances in Urology, 8(1), 47–60. https://doi.org/10.1177/1756287215612961
7. O’Byrne, N. A., Yuen, F., Niaz, W., & Liu, P. Y. (2021). Sleep and the testis. Current Opinion in Endocrine and Metabolic Research, 18, 83–93. https://doi.org/10.1016/j.coemr.2021.03.002
8. Shores, M. M., Sloan, K. L., Matsumoto, A. M., Moceri, V. M., Felker, B., & Kivlahan, D. R. (2004). Increased incidence of diagnosed depressive illness in hypogonadal older men. Archives of General Psychiatry, 61(2), 162–167. https://doi.org/10.1001/archpsyc.61.2.162
9. Tenover, J. S. (2003). Declining testicular function in aging men. International Journal of Impotence Research, 15 Suppl 4(S4), S3-8. https://doi.org/10.1038/sj.ijir.3901029