T and counting
It seems that, unlike a good claret or a fine single malt, male bodies don’t always improve with age – the brain, perhaps, but not the brawn.
- Lowering testosterone levels can be related to age and lifestyle factors. These include excess body fat, cardiovascular disease, cancer, drugs and also COVID-19
- There’s a close link between obesity – particularly when accumulated around the belly – and low testosterone levels
- A key treatment for hypogonadism (low testosterone levels) is testosterone replacement therapy
One key behind your demise is that after the age of around 40 your testosterone levels naturally begin to fall by around one percent a year, says Professor Geoff Hackett professor of Men’s Health and Diabetes at Aston University. Geoff is also a Consultant in Urology and Sexual Medicine at Spire Hospital, Little Aston, Birmingham, UK.
Here’s what you need to know
To put things into context, we’re the lucky ones. Women going through menopause experience a sudden menopausal plunge when they hit menopause, with the tell-tale hot flushes, increased irritability and all the other symptoms we should be grateful we don’t experience.
Indeed, around the age of 70, testosterone levels in men plateau within the ‘ low normal range’ in at least 75 percent of men.
Having said that, illness and lifestyle (see below) are known to affect your testosterone levels. Many men show signs of low testosterone that can be helped medically.
What else affects testosterone levels?
Age and lifestyle related factors are also known to contribute in lowering testosterone levels. These include:
- delayed puberty or problems in childhood, such as non-descended testicles or hernia repair.
- excess body fat
- Type 2 diabetes
- alcohol abuse and liver damage
- high blood pressure
- heart disease
- high cholesterol
- HIV and AIDS
- long-term use of some medications such as opioid painkillers (for example, Cocodamol)
- injury or infection
- treatment for cancer such as chemotherapy
- hormone-based medical treatments such as those used in prostate cancer
- taking anabolic steroids
- acute or stress
- Covid-19 infection can lead to severe falls in testosterone levels, linking to more severe illness outcomes in men.
- intense exercise and over-training.
Slow and steady
It might be great for your waistline, but overdosing on exercise can hammer your hormones.
One study is suggesting stressful, endurance training coupled with a lack of sleep and food can be reducing testosterone. Potentially, down to levels normally seen in men who have been castrated (1.7 nmol/l or lower). Not the result you were hoping for.
Men with genuinely ‘low’ testosterone – defined as total testosterone or TT below 8 nmol/l or free testosterone or FT below 0.18 nmol/l – click here to read more about how testosterone is measured – have a condition called hypogonadism.
There are two types:
Primary hypogonadism – around 10 percent of cases where the problem lies in the pituitary gland in the brain. This is associated with low levels of Luteinizing Hormones (LH) which controls the production of testosterone and oestrogen.
Secondary hypogonadism – around 90 percent of cases, where the problem is caused by low testosterone production in the testes, where LH levels may be high or normal.
When bigger definitely isn’t better
There’s a close link between obesity and low testosterone levels – not good for guys who let time take its toll on their previously rippling torsos.
As men age, they tend to put on a specific type of ‘white’ fat around their bellies – this produces a hormone called leptin, which converts testosterone to oestrogen, a female hormone.
Of course, lifestyle changes around diet and exercise are important, but a key treatment for hypogonadism is testosterone replacement therapy (TRT).