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Men’s Health Month: Let’s talk about testosterone, too much or too little.

By: Kathy Hubbard

It’s men’s health awareness month, so we’re going to talk about testosterone. Testosterone is primarily produced in the male testicles, but to be clear, it’s also produced in women’s ovaries and adrenal cortex, but at a much lesser extent.

“Testosterone, part of a hormone class known as androgens, is produced by the testicles after stimulation from the pituitary gland, which is located near the base of the brain and sends signals to a male’s testicles that spark feelings of sexual desire,” MedlinePlus says.

Harvard Medical School’s website says that typically when we think of testosterone, we think about macho men showing aggressive and impatient behavior, even violence. But most of that is just a myth.

“Testosterone plays a number of important roles, such as the development of the penis and testes; the deepening of the voice during puberty; the appearance of facial and pubic hair starting at puberty. Later in life, it may play a role in balding; muscle size and strength; bone growth and strength, sex drive (libido); and sperm production,” Harvard says. “Testosterone may also help maintain normal moods, and there may be other important functions of this hormone that have not yet been discovered.”

Men with abnormally high testosterone levels may cause low sperm counts, shrinking of the testicles, and impotence, about which Harvard remarks, “seems odd, doesn’t it?” Other problems include heart muscle damage, prostate enlargement, difficulty urinating, liver disease, acne, high blood pressure and cholesterol, insomnia, headaches, and the list goes on.

Without sufficient testosterone, adolescent boys may not experience normal masculinization. Their genitals may not enlarge, facial and body hair may not develop, and their voices may not get deeper. Men need testosterone to make sperm. The hormone usually peaks in adolescence and early adulthood.

In general, testosterone levels tend to decrease with age. Normal testosterone levels are between 300 and 750 nanograms per deciliter (ng/dL). The average man will see a decrease of around two percent a year after age thirty. Levels are determined by a blood test.

The American Urological Association says that when men have low testosterone levels it’s called testosterone deficiency syndrome (TDS) or low testosterone (Low-T). “Deficiency means that the body does not have enough of a needed substance. Syndrome is a group of symptoms that together suggest a disease or health condition.”

Low-T is indicated when the blood testosterone is less than 300 ng/dL. It’s indicated also by signs and symptoms such as low sex drive, fatigue, reduced lean muscle mass, irritability, erectile dysfunction, and depression.

“There are many other possible reasons for these symptoms, such as opioid use, some congenital conditions, loss of or harm to the testicles, diabetes, and obesity. See your doctor if you have any of these symptoms,” AUA says.

The symptoms for testosterone deficiency (TD) are pretty much the same as Low-T but also include a “loss of body hair including less beard growth; lower energy level, endurance, and physical strength; poor memory; difficulty with finding words to say; poor focus, and not doing well at school.”

Some males are born with conditions that will cause TD, such as Klinefelter syndrome, Noonan syndrome, or ambiguous genitalia. Others develop Low-T after an accident that damages the testicles or the removal of testicles due to cancer. Chemotherapy or radiation, pituitary gland disease, infection, and autoimmune disease can also be the cause.

“Many men who develop TD have Low-T levels linked to aging, obesity, metabolic syndrome (high blood pressure, high blood sugar, unhealthy cholesterol levels, and belly fat), use of medications such as antidepressants and narcotic pain medications,” AUA says.

All the experts I researched agreed that taking over-the-counter supplements or those you can order online should be avoided. Because they aren’t regulated by the Food and Drug Administration, the safety and efficacy of these medications can’t be guaranteed.

 “Men and women [that’s a subject for another day] need the proper amount of testosterone to develop and function normally,” Harvard says. “Checking testosterone levels is as easy. The difficult part is interpreting the result.”

A visit to your primary care provider will help you decide if therapy is necessary and, if so, in what form. Treatment typically is by medication, but how it’s administered differs.

Kathy Hubbard is a member of the Bonner General Health Foundation Advisory Council. She can be reached at kathyleehubbard@yahoo.com. This article was written for publication in the Bonner County Daily Bee: June 15, 2023.

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