Other Topics in Patient Care & Health Info

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.

The influence of testosterone in men

Testosterone is considered a male sex hormone, and it is primarily produced in the testicles (although a very small amount comes from the adrenal glands). Women also have testosterone in their bodies but at much lower levels than men. Testosterone is responsible for the development of primary sexual characteristics: male genitalia. It is also responsible for secondary sexual characteristics including muscle bulk, deep voice, and hair pattern. Testosterone helps regulate other physical factors that impact mood and energy levels and protect heart health. It is also responsible for maintaining a normal sex drive. Testosterone helps to influence or provides: cardiovascular protection obesity.

Nieschlag e, nieschlag s: endocrine history: the history of discovery, synthesis and development of testosterone for clinical use. Eur j endocrinol. 2019 jun 1;180(6):r201-r212. Doi: 10. 1530/eje-19-0071. [ article ] white cm, ferraro-borgida mj, moyna nm, mcgill cc, ahlberg aw, thompson pd, chow ms, heller gv: the pharmacokinetics of intravenous testosterone in elderly men with coronary artery disease. J clin pharmacol. 1998 sep;38(9):792-7. [ article ] wang c, catlin dh, starcevic b, leung a, distefano e, lucas g, hull l, swerdloff rs: testosterone metabolic clearance and production rates determined by stable isotope dilution/tandem mass spectrometry in normal men: influence of ethnicity and age.

This story is part of our annual fit at any age series—a guide to the innovations and breakthroughs in aging to help you live a stronger, longer life. For a long time, we accepted certain changes as the price (and privilege) of getting older. Your hair turns gray. Your hearing starts to…wait, what was that you said? and, of course, your testosterone level drops. But with a boom in testosterone-replacement clinics—by this point, who hasn’t gotten an ad for a service offer ing to test your t for under $100?—and podcasts and influencers preaching the powers of hormone optimization, should guys over 40 think about winding back their t clocks? and by how much? here’s what to know.

Testosterone is the major androgenic hormone. It is responsible for the development of the male external genitalia and secondary sexual characteristics. In female patients, its main role is as an estrogen precursor. In both sexes, it exerts anabolic effects and influences behavior. In men, testosterone is secreted by the testicular leydig cells and, to a minor extent, by the adrenal cortex. In premenopausal women, the ovaries are the main source of testosterone with minor contributions by the adrenal glands and peripheral tissue s. After menopause, ovarian testosterone production is significantly diminished. Testosterone production in testes and ovaries is regulated via pituitary-gonadal feedback involving luteinizing hormone (lh) and, to a lesser degree, inhibins and activins.

What happens to testosterone levels with age?

Testosterone levels generally peak during adolescence and early adulthood. As you age, your testosterone level gradually declines — typically about 1% a year after age 30 or 40. For older men, it's important to determine if a low testosterone level is due to normal aging or if it is due to a disease (hypogonadism). Hypogonadism hampers the ability to produce normal amounts of testosterone due to a problem with the testicles or with the pituitary gland that controls the testicles. Testosterone replacement therapy, in the form of injections, pellets, patches or gels, can improve the signs and symptoms of low testosterone in these men.

The two charts below list the general normal ranges of testosterone based on age and sex. The level is measu red in nanograms per deciliter (ng/dl). It’s important to note that the normal ranges for testosterone levels can vary based on the type of blood test done and the laboratory where it is done. Your provider will always reference your laboratory’s normal ranges when interpreting your results. Talk to them if you have questions. Normal testosterone levels for people assigned male at birth:.

Some persons are born with conditions that cause testosterone deficiency (td) such as: klinefelter syndrome ambiguous genitalia (when the sex organs develop in ways that are not typical looking) some men may develop low-t because of conditions like these: damage to testicles by accident removal of testicles because of cancer chemotherapy or radiation pituitary gland disease leading to hormone deficiency infection autoimmune disease (when the body makes antibodies that attack its own cells) basically, if your testicles keep making less testosterone than normal, your blood levels of testosterone will fall. Many men who develop td have low-t levels linked to: metabolic syndrome (high blood pressure, high blood sugar, unhealthy cholesterol levels, and belly fat).

Having too much naturally-occurring testosterone is not a common problem among men. That may surprise you given what people might consider obvious evidence of testosterone excess: road rage, fighting among fathers at little league games and sexual promiscuity. Part of this may be due to the difficulty defining "normal" testosterone levels and "normal" behavior. Blood levels of testosterone vary dramatically over time and even during the course of a day. In addition, what may seem like a symptom of testosterone excess (see below) may actually be unrelated to this hormone. In fact, most of what we know about  abnormally high testosterone levels in men comes from athletes who use anabolic steroids, testosterone or related hormones to increase muscle mass and athletic performance.

What are the risks of testosterone therapy for normal aging?

Too much testosterone can cause infertility in any gender. Testosterone supplementation can also increase the risk of stroke, hypertension, accumulation of red blood cells, heart attack, leg clots, pulmonary embolus, and cancer. The fda only approves its use for hypogonadism and does not recommend its use for low testosterone use due to aging. The endocrine society, on the other hand, supports its possible use in older men with confirmed testosterone deficiency aiming to achieve a low-normal level of the hormone, but only after carefully reviewing the risks and benefits.

In 2002, the national institute on aging (nia) and the national cancer institute requested that the institute of medicine (iom) (now the national academy of medicine) assess the status of clinical research on testosterone therapy for older men. In 2003, the iom committee concluded that the evidence that testosterone treatment for older men with low testosterone was beneficial was insufficient and recommended that the nia fund a coordinated set of clinical trials to determine whether this treatment has any benefits and to fund a larger trial to determine the possible risks only if benefits were found ( 14 ).

Should you talk to your doctor about testosterone therapy?

The purpose of testosterone testing is to evaluate the amount of the hormone in the blood. Testosterone levels that are outside of a normal range can cause changes to health and physical appearance. Measuring testosterone can help diagnose medical conditions or monitor your response to therapy: diagnosis doctors may check testosterone levels to determine the cause of your symptoms. Testing can help identify deficiency or an elevated level of testosterone. Tests may be part of assessing if you have health conditions that can affect hormone levels. Monitoring this is how doctors follow your health over time. If you have had abnormal testosterone tests, follow-up testing may be used to track your testosterone levels.

For people who are worried about low or high testosterone, a doctor may perform a blood test to measure the amount of the hormone in the patient's blood. When doctors find low-t, they may prescribe testosterone therapy, in which the patient takes an artificial version of the hormone. This is available in the following forms: a gel to be applied to the upper arms, shoulders or abdomen daily; a skin patch put on the body or scrotum twice a day; a solution applied to the armpit; injections every two or three weeks; a patch put on the gums twice a day; or implants that last four to six months.

The fda approved testosterone as replacement therapy only for men who have low testosterone levels from disorders that cause hypogonadism. Testosterone levels in men usually decline after age 30. Other causes of low t include an injury to the testicles, cancer treatments, chronic diseases and stress. Lack of this key sex hormone can also cause health issues, including osteoporosis, loss of muscle mass and strength (sarcopenia) and psychological symptoms. Doctors prescribe testosterone drugs to treat these symptoms.

Testosterone replacement therapy, or trt, can help treat some low testosterone symptoms in men. Doctors often recommend trt as a treatment option for male hypogonadism, a condition in which the body doesn’t make enough testosterone (often due to testicular failure). Ultimately, this condition can lead to symptoms of low testosterone in males. Testosterone therapy can improve muscle strength and erectile function in hypogonadal men, as well as boost energy and protect against bone loss. Testosterone can be administered in several different ways, including skin patches, gels applied to the skin, injections, and implants.