What is Testosterone?
Testosterone is a male sex hormone that is produced in the testicles. It is responsible for the development of male secondary sexual characteristics, such as facial hair and a deeper voice, as well as the maintenance of muscle mass, bone density, and sperm production. Testosterone levels naturally decrease with age, and low levels of testosterone can lead to a range of health issues, including decreased bone density, decreased muscle mass, and decreased sex drive.
Testosterone is a hormone, or molecular messenger, that travels through your bloodstream and acts on a variety of organs and tissues in your body, including your brain, muscles, fat, bones, and sexual organs.
Testosterone and the brain
Testosterone has a number of effects on the brain and behavior. In men, testosterone levels tend to be highest in the late teenage years and early twenties, and then gradually decrease with age. Testosterone has been shown to have a number of effects on the brain, including effects on cognition, mood, and behavior.
Testosterone has been found to be involved in the regulation of brain regions involved in memory and spatial navigation, as well as in the regulation of mood and behavior. It has also been shown to be involved in the development of the brain’s reward system, which is involved in motivation and pleasure.
Research has also suggested that testosterone may be involved in the development of aggression and competitiveness. However, it is important to note that testosterone is just one factor that can influence these behaviors, and other factors, such as upbringing and environment, also play a role.
It is important to note that the relationship between testosterone and the brain is complex and not fully understood. Further research is needed to fully understand the role of testosterone in the brain and behavior.
Testosterone and muscle
estosterone is a male sex hormone that plays a key role in the development of male secondary sexual characteristics, such as facial hair and a deeper voice. It is also involved in the maintenance of muscle mass, bone density, and sperm production.
Testosterone has anabolic effects on the body, meaning that it stimulates muscle protein synthesis and promotes muscle growth. It also increases bone density and strength, and has been shown to increase muscle mass in men with low testosterone levels.
Research has shown that testosterone replacement therapy can increase muscle mass and strength in men with low testosterone levels. However, it is important to note that testosterone is just one factor that can influence muscle mass and strength, and other factors, such as diet and exercise, also play a role.
It is important to speak with a healthcare provider about the potential risks and benefits of testosterone replacement therapy, as it can have potential side effects.
Testosterone and fat
Research has suggested that testosterone may have a role in the regulation of body fat. Testosterone has been shown to increase the breakdown of fat cells and decrease fat mass in men with low testosterone levels. Testosterone replacement therapy has also been shown to increase lean body mass and decrease body fat in men with low testosterone levels.
However, it is important to note that testosterone is just one factor that can influence body fat, and other factors, such as diet and exercise, also play a role.
Testosterone and bones
Testosterone has been shown to have a positive effect on bone density. It increases bone density and strength, and has been shown to reduce the risk of osteoporosis in men with low testosterone levels. Testosterone replacement therapy has been shown to increase bone density in men with low testosterone levels.
Testosterone and the heart
Testosterone can influence cardiovascular risk factors indirectly through its effect on the amount of fat in your body, and there is evidence it benefits the heart directly. It may help open the coronary arteries, and possibly improve cardiac function in people with heart disease and heart failure.
What is low testosterone (male hypogonadism)?
Low testosterone, also known as male hypogonadism, is a condition in which the body does not produce enough testosterone, a hormone that plays a key role in male development and reproductive function. Testosterone is produced by the testicles and is responsible for a number of physical and sexual characteristics in men, including muscle mass, body hair, and a deep voice. It also plays a role in sperm production, bone density, and sex drive.
Symptoms of low testosterone can vary and may include decreased sex drive, erectile dysfunction, decreased muscle mass, increased body fat, and fatigue. In some cases, low testosterone can also cause mood changes, such as irritability and depression.
Low testosterone can be caused by a variety of factors, including certain medical conditions, certain medications, and aging. It can also be caused by damage to the testicles, such as from injury or infection, or by problems with the pituitary gland, which helps regulate testosterone production.
Treatment for low testosterone may include testosterone replacement therapy, which can be given as a patch, gel, injection, or implant. In some cases, testosterone replacement therapy can help improve symptoms and restore normal testosterone levels. However, it is important to carefully consider the potential risks and benefits of testosterone replacement therapy, as it may have potential side effects and may not be suitable for everyone. It is important to work with a healthcare provider to determine the best treatment approach for your individual needs.
What happens to testosterone levels with age?
Testosterone levels typically peak between the ages of adolescence and early adulthood. Your testosterone level gradually decreases as you age, typically by 1% per year after the age of 30 or 40. It is critical for older men to determine whether a low testosterone level is due to normal aging or a disease (hypogonadism).
Hypogonadism impairs testosterone production due to a problem with the testicles or the pituitary gland, which controls the testicles. Testosterone replacement therapy in the form of injections, pellets, patches, or gels can help these men with the signs and symptoms of low testosterone.
Does a naturally declining testosterone level cause the signs and symptoms of aging?
Testosterone levels naturally decline with age, and this decline can contribute to some of the signs and symptoms of aging in men. Testosterone is important for maintaining muscle mass and strength, bone density, and sex drive. As testosterone levels decline with age, men may experience changes in these and other areas. For example, they may have a decrease in muscle mass and strength, an increase in body fat, and a decrease in sex drive.
However, it is important to note that the signs and symptoms of aging are complex and can be influenced by many factors, including genetics, lifestyle, and overall health. Testosterone levels alone do not fully determine the aging process.
It is normal for testosterone levels to decline with age, and many men do not experience significant symptoms as a result. However, if a man is experiencing significant symptoms that are thought to be related to low testosterone, a healthcare provider can evaluate his testosterone levels and consider testosterone replacement therapy as a treatment option. It is important to work with a healthcare provider to determine the best approach for managing the signs and symptoms of aging.
Can testosterone therapy promote youth and vitality?
Testosterone therapy can potentially improve certain signs and symptoms that are associated with low testosterone, such as decreased sex drive, decreased muscle mass and strength, and increased body fat. However, it is important to note that testosterone therapy is not a “fountain of youth” and will not necessarily reverse the aging process or promote youth and vitality.
The effectiveness of testosterone therapy in improving the signs and symptoms of low testosterone varies from person to person and can depend on the underlying cause of the low testosterone. Testosterone therapy is not a one-size-fits-all solution and may not be suitable for everyone. Although some men believe they feel younger and more vigorous if they take testosterone medications, there’s little evidence to support the use of testosterone in otherwise healthy men.
What are the risks of testosterone therapy for normal aging?
Testosterone therapy can have various risks and side effects, particularly if it is used in people who do not have a deficiency of the hormone. Here are some potential risks and side effects of testosterone therapy:
- Cardiovascular risks: Some studies have suggested that testosterone therapy may increase the risk of heart attack, stroke, or death. However, other studies have not found such an association.
- Prostate cancer: Testosterone therapy may increase the risk of prostate cancer or worsen the symptoms of prostate cancer if it is present.
- Blood clotting: Testosterone therapy may increase the risk of blood clotting, which can lead to serious health problems such as deep vein thrombosis or pulmonary embolism.
- Sleep apnea: Testosterone therapy may worsen sleep apnea, a condition in which a person has pauses in breathing during sleep.
- Male breast growth: Testosterone therapy may cause male breast growth, a condition called gynecomastia.
- Decreased sperm count: Testosterone therapy may decrease sperm count and fertility.
- Skin irritation: Testosterone therapy may cause skin irritation at the site of the injection.
Do I have Low Testosterone?
It is possible that you may have low testosterone, but the only way to know for sure is to have a testosterone level test. Testosterone levels naturally decrease as men age, but low testosterone, also known as hypogonadism, can also be caused by other factors such as injury or infection to the testicles, certain medications, or conditions such as obesity or diabetes.
Symptoms of low testosterone can include:
- Decreased sex drive
- Erectile dysfunction
- Decreased muscle mass and strength
- Increased body fat
- Decreased bone density
- Fatigue
- Depression or irritability
- Loss of motivation
None of these signs or symptoms are specific to testosterone deficiency and many are hard to differentiate from normal aging. Our role is to evaluate any signs or symptoms of low testosterone, and then to see how they correlate with your hormone levels.
Potential Benefits of Therapy
Testosterone therapy can have various potential benefits, particularly for people who have a deficiency of the hormone. Here are some potential benefits of testosterone therapy:
- Improved sex drive: Testosterone therapy can increase sex drive and improve sexual function in people with low testosterone levels.
- Increased muscle mass and strength: Testosterone therapy can increase muscle mass and strength, which may improve physical performance.
- Improved mood and well-being: Testosterone therapy may improve mood and well-being, reducing feelings of depression and anxiety.
- Improved bone density: Testosterone therapy may improve bone density, which can reduce the risk of osteoporosis and fractures.
- Improved cognitive function: Testosterone therapy may improve cognitive function, including memory and concentration.
Physical Benefit
- Increased energy
- Increased bone density
- Reduced risk of obesity, diabetes and metabolic syndrome
- Reduced risk of cardiovascular disease
- Reduced risk of osteoporosis
- Reduced body fat
- Reduced risk of anaemia
- Increased lean body mass and muscle strength
Sexual Benefit
- Increased libido
- Increased sexual enjoyment
- Increased satisfaction with erections
- Increased sexual activity
Psychological Benefit
- Improved mood and sense of well being
- Improved cognition and memory function
Factors That Affect Testosterone Levels in Men
There are several factors that can affect testosterone levels in men. These include:
- Age: Testosterone levels naturally decline with age, starting around the age of 30.
- Health conditions: Certain health conditions, such as obesity, diabetes, and kidney or liver disease, can affect testosterone production.
- Medications: Certain medications, including steroids, opiates, and some antidepressants, can affect testosterone levels.
- Lifestyle factors: Certain lifestyle factors, such as excessive alcohol consumption, smoking, and chronic stress, can affect testosterone production.
- Genetic factors: Some men may have a genetic predisposition to low testosterone levels.
It is important to note that testosterone levels can vary widely among men and can be affected by many different factors. It is important to speak with a healthcare provider if you are concerned about your testosterone levels. They can order a blood test to determine your testosterone levels and recommend treatment if necessary.
Other Factors
DHEA
Dehydroepiandrosterone (DHEA) is a hormone produced from cholesterol that then proceeds through one of two pathways, both of which involve two-step enzymatic conversions, to produce either estrogens or testosterone. Thus, DHEA levels can influence estrogen and testosterone levels, though DHEA alone is rarely sufficient to restore testosterone levels in aging men.
Aromatase
Aromatase is an enzyme that converts androgens, such as testosterone, into estrogens. It plays a role in the regulation of estrogen levels in the body.
In men, aromatase is present in small amounts in tissues such as fat and muscle. It converts testosterone into estrogen, which can have effects on body fat, muscle mass, and bone density.
In some cases, high levels of aromatase activity can lead to an excess of estrogen in the body, a condition known as estrogen dominance. This can cause symptoms such as weight gain, decreased muscle mass, and gynecomastia (male breast growth).
Aromatase inhibitors are medications that block the activity of aromatase, reducing the production of estrogen. They are used to treat certain types of breast cancer and may also be used off-label to treat other conditions, such as gynecomastia.
Obesity
Obesity and associated hyperinsulinemia suppress the action of luteinizing hormone (LH) in the testis, resulting in lower circulating testosterone levels, even in men under the age of 40. Furthermore, increased belly fat mass has been linked to increased aromatase levels.
The hypogonadal/obesity cycle refers to the vicious circle of low testosterone and obesity. A low testosterone level causes increased abdominal fat, which leads to increased aromatase activity in this cycle. This increases the conversion of testosterone to estrogens, lowering testosterone levels and increasing the tendency to gain abdominal fat.
Sex hormone-binding globulin (SHBG)
The majority of testosterone in the bloodstream is bound to sex hormone-binding globulin (SHBG) (60%) or albumin (38%). Only a small percentage (2%) is unbound, or “free”.
Testosterone binds to SHBG more tightly than albumin. As a result, only albumin-bound testosterone and free testosterone are bioavailable forms of testosterone that are accessible to target tissues and carry out the essential hormone’s actions. As a result, the level of SHBG influences testosterone bioavailability.
Men as they age experience an increase in aromatase activity as well as an increase in SHBG production. As a result, the estrogen-to-testosterone ratio rises while total and free testosterone levels fall. It is critical to balance this skewed ratio.
Liver Function
The liver is in charge of eliminating excess estrogen and SHBG, and any decline in liver function could exacerbate hormonal imbalances and jeopardize healthy testosterone levels. As a result, it is critical that aging men strive for optimal liver function.
Should you talk to your doctor about testosterone therapy?
It is generally recommended to speak with a healthcare provider before starting testosterone therapy or any other treatment for low testosterone. Testosterone therapy can have potential risks and benefits, and it is important to discuss these with a healthcare provider to determine if it is appropriate for you.
A healthcare provider can help to diagnose low testosterone by ordering a blood test to measure testosterone levels. They can also consider other factors, such as symptoms and medical history, to determine the cause of low testosterone and the most appropriate treatment.
If testosterone therapy is recommended, a healthcare provider can help to monitor the therapy and make any necessary adjustments to the dosage or treatment plan. They can also discuss potential side effects and how to manage them.
Treatment
Testosterone may be administered, when clinically appropriate, through 1 of 2 methods, depending on the patient’s needs: intramuscular injections or transdermal applications.
- Intramuscular injections: Testosterone Cypionate is given by injection once every 7 to 14 days. Dosing is dependent on your age, testing results and symptoms. The testosterone injections we prescribe are only manufactured by FDA-Approved manufacturers. Testosterone injections are given in our clinics or you can self-inject at home.
- Transdermal Application: Testosterone is applied to the skin using a gel or cream on a daily basis. the concentration of testosterone in the blood goes up within a few doses.