Low Testosterone

Hormone Imbalance in Men

We usually hear about hormone problems in women, traditionally associated with their period. But men also have hormones, and they can have an imbalance as well.

You have probably heard about low testosterone levels and their consequences.

Other hormones in males include growth hormone and thyroid hormones. Some men even have hormones that shouldn’t be there, such as estrogens and prolactin. 

That will be the main focus of this article. We’re covering the topic of hormone imbalance in men. How does it affect our health? How can you treat these problems or balance your hormones naturally?

What is hormone imbalance?

As the name implies, hormone imbalance refers to a disorder in the levels of circulating hormones. These substances are fundamental to send signals across distant organs, allowing the body to act as a whole.

For example, in women, being pregnant triggers the release of progesterone. This substance acts on the womb to protect the fetus. But it also works on the immune cells, suppressing the reaction against the fetus.

An imbalance in progesterone during pregnancy would isolate the fetus, not letting the rest of the body know a new life is forming in the womb. The result will be a miscarriage unless progesterone is administered as soon as possible.

All types of hormone imbalances work the same way. For example, thyroid hormonal imbalances accelerate or slows down metabolism. The heartbeat becomes rapid, and people suffer from nervousness and hair loss in hyperthyroidism. Obesity, fatigue, depression, and drowsiness are widespread in hypothyroidism.

In most men, hormonal imbalances are not very common. They don’t usually suffer from ups and downs in their sex hormone levels when they’re young. The number of patients with thyroid issues is lower in males than in females. And most hormonal problems come from chronic diseases, especially diabetes.

However, as we grow older, levels of testosterone in men start to drop. In most cases, it is not a dramatic and concerning reduction. In other cases, low testosterone levels trigger significant changes in a man (1).

Hormone levels changes over time

What hormone changes are expected in men over time? As noted above, we usually have a reduction of testosterone as we age. However, this reduction is mild or moderate, and should not cause concerning symptoms. 

Throughout the life of a man, testosterone levels change quite a lot. We do have a cyclic change of testosterone throughout the day. Testosterone production is higher around 8 am and drops after 9 pm. But these changes are very slight and sometimes difficult to measure. The highest variation of testosterone levels can be found as we compare men of different ages.

As a newborn, babies have slightly higher levels of testosterone as compared to infants. That’s because they need testosterone for their growth and development. Then, testosterone levels drop during infancy and childhood. Starting 15 years old, their upper threshold begins to go up, around 750 ng/dL. Interestingly, this upper threshold of normal testosterone is almost the same as a 60-year-old male. But then, at 17 years old, they reach an upper threshold of 800 ng/dL or more. 

The highest level of testosterone in males is usually found between 18 and 21 years old. At this stage, men have up to 1080 ng/dL. It continues to be high for a decade or two. After that, their normal levels of testosterone start to reduce around 1% every year. These changes are gradual and only become significant after turning 50 or 60 years old. At this stage, men get back to the 800 ng/dL upper threshold.

Finally, after 60 years old, testosterone levels have a more rapid decline. However, they should never be lower than 300 ng/dL. Going below that number would start causing severe consequences such as low sexual drive and osteoporosis (1).

What causes hormone imbalance in men?

Male hormone imbalances are not as common as in women, and they usually have an exact cause.

It can be unpredictable such as aging or a consequence of a life event, as in trauma. Since hormonal problems in men typically refer to testosterone, we will now focus on the causes of low sex hormone levels in men (2):

  • Aging: It is the most common cause of hormone imbalances in men. Actually, as noted above, testosterone levels are likely to decline as we age. That is a natural process, but the lower threshold is 300 ng/dL. Having lower levels triggers the signs and symptoms of low testosterone described below.

  • Trauma or infection in the testicles: Anything that causes a structural or functional problem to the testis can cause testosterone problems, for instance, after severe trauma that compromises the blood supply to the testicles. Or it could be an infection, instead, as in the case of orchitis (3).

  • Cancer treatment: Chemotherapy has several side effects. One of them is the ablation of the normal testicle function. Radiotherapy may have a similar impact when directed to the pituitary gland, for example. This is an endocrine gland located in the brain that releases the luteinizing hormone and follicle-stimulating hormone. Both of them are fundamental for normal testicle function.

  • Iron toxicity: Too much of a good thing is not always a good thing. In the case of iron, having too much of this mineral causes a disorder called hemochromatosis. One of the consequences is a reduction in serum levels of testosterone (4).

  • Side effects of medications: Certain opioids used for pain management may reduce testosterone levels. Anti-androgenic drugs used for prostate cancer leave testosterone levels as they are, but reduce circulating androgens’ effect. And steroids can cause a depletion of testosterone synthesis.

  • Alcoholism: Abusing alcohol can significantly reduce your levels of testosterone. It causes regulatory defects in many-body substances, not only reproductive hormones (5).

  • Metabolic stress: Chronic stress causes alterations in many-body systems. By interfering with cortisol secretion, stress causes changes in testosterone and other hormones as well. It also happens in the case of acute and chronic illnesses.

  • Chronic renal failure: One example of chronic disease with low testosterone levels is renal failure. Half of the renal failure males also have low testosterone, even after transplantation. 

  • Genetic disease: Several diseases cause abnormalities in testosterone levels-for example, Kallman or Klinefelter syndrome. But we can also have congenital problems and other malformations during intrauterine growth. 

  • Obesity: Weight gain, fat, and testosterone do not get along very well. There’s an enzyme in the fatty tissue called aromatase. This enzyme turns testosterone into estrogen. Testosterone itself suppresses obesity. So, in most cases, obese individuals have a higher tendency to have androgen deficiency (6).

  • Extreme weight loss: Losing weight dramatically can alter hormonal secretion. The body perceives extreme diets as starvation and activates metabolic alarms. Instead of creating testosterone and other hormones, the body prefers to use the energy for more pressing matters. Thus, testosterone levels suffer a severe drop.

  • Poorly controlled diabetes mellitus: Diabetes affects blood circulation and the synthesis of other hormones. That’s why it is associated with lower levels of testosterone, erectile dysfunction, and other problems.

  • High estrogen levels: Estrogen is the female sex hormone and has opposite functions to those of testosterone. Levels of estrogen can increase in males due to environmental exposure, for example, in the case of Bisphenol A, which mimics estrogens in the body. This type of exposure creates estrogen dominance in men, a condition that worsens as we age.

  • Hypothyroidism: Low thyroid hormone levels slow down the metabolism of the rest of the body. That includes the testis. As a result of hypothyroidism, we can also have low testosterone levels. That’s why the thyroid gland is considered an important ally of testicle function (7).

Symptoms

How do you know you have a hormone imbalance? Depending on the hormone, you can have a variety of symptoms. For example, thyroid hormone imbalances cause nervousness and irritability (hyperthyroidism) or drowsiness and depression (hypothyroidism).

A deficit in growth hormone causes developmental retardation and severe bone problems. And the most common is insulin imbalances, which cause type 1 and type 2 diabetes.

But what about testosterone imbalances? Low testosterone levels cause the following signs and symptoms (1):

  • Mood swings: Men with deficient testosterone levels have similar symptoms to those experienced by women during menopause. One of them is becoming irritable and having mood swings. They may become easily agitated and anxious during stressful situations and change their mood rapidly.

  • Hot flushes: This is another symptom that both aging men and women share. In the case of men, it is caused by andropause. It is the equivalent of menopause, but not considered normal because men’s testosterone levels should never be under 300 ng/dL regardless of their age.

  • Low libido: This is the same as not having sex drive or having a lower sex desire than normal. This should not be confused with performance anxiety and other sexual problems where sex drive is intact, but males cannot perform sexually as they would like.

  • Reduced semen volume: Semen volume is an indirect measure of testosterone levels. Testosterone stimulates the seminal vesicles and the prostate. With hormone deficiency, these organs do not produce a normal volume of semen. The sperm count and sperm cell integrity may be compromised as well.

  • Fatigue: Normal testosterone levels give a man more energy and resistance. For example, it increases oxygen availability in the blood by stimulating the formation of red blood cells and hemoglobin. For this and other reasons, it is very common to experience fatigue as a symptom of low testosterone levels.

  • Brain fog: Another feature of testosterone has to do with focus and cognitive improvements. Without this hormone, men lose their sharpness of mind and may experience recurrent episodes of brain fog.

How is men’s health affected?

Besides the symptoms described above, testosterone has a vast number of functions in the body. Thus, men’s health can be significantly affected by low levels of this hormone. We can have the following health problems (1):

  • A reduction in muscle mass: Testosterone is a powerful promoter of cell division, and that includes muscle mass formation. Low testosterone levels are often associated with lower muscle mass in males.

  • A reduction in bone mineralization: Like women during menopause, men with low levels of testosterone have a higher risk of osteoporosis and fractures.

  • Anemia: Testosterone promotes red blood cell formation, as well. Thus, men with low levels of this hormone typically display anemia (low hemoglobin levels).

  • Infertility: Low semen volume in males with low testosterone is often accompanied by low fertility rates. Severe testosterone deficiency may lead to complete infertility, as in Klinefelter disease.

Treating hormone imbalance

Luckily, there are many ways to treat hormone imbalances in men. There are medical treatments and some natural solutions we can use, too. Medical treatments are reserved for diagnosed cases and should be administered by a doctor. For example (1):

How to naturally balance your hormone (Bullets)

But we can also fix low testosterone levels with natural solutions. They work as a complementary treatment or as a standalone treatment in very mild cases:

  • Eating appropriately, with enough protein and healthy fats

  • Practicing stress management techniques to reduce circulating levels of cortisol

  • Getting plenty of rest at night and enough sun exposure during the day

  • Using vitamin D supplements and calcium if necessary

  • Exercising daily with both aerobic and anaerobic physical activity

  • Using testosterone boosters such as Tribulus Terrestris (8), Ginger (9), and boron supplements (10).

Conclusion

Hormone balance in males is not always compromised. But we do experience a reduction of testosterone levels as we age. Other factors may also contribute to hormone deficiency.

As a result of this testosterone imbalance, we can experience symptoms such as fatigue and irritability. However, most males are deeply concerned about their sexual drive and erectile dysfunction

These cases can be solved using testosterone replacement therapy, a few lifestyle changes, and some natural approaches. However, many men with milder cases do not require testosterone and will only be ok with natural remedies.

Sources

  1. Hohl, A. (Ed.). (2017). Testosterone: From Basic to Clinical Aspects. Springer.
  2. Millar, A. C., Lau, A. N., Tomlinson, G., Kraguljac, A., Simel, D. L., Detsky, A. S., & Lipscombe, L. L. (2016). Predicting low testosterone in aging men: a systematic review. Cmaj, 188(13), E321-E330.
  3. Angele, M. K., Ayala, A., Monfils, B. A., Cioffi, W. G., Bland, K. I., & Chaudry, I. H. (1998). Testosterone and/or low estradiol: normally required but harmful immunologically for males after trauma-hemorrhage. Journal of Trauma and Acute Care Surgery, 44(1), 78-85.
  4. Kley, H. K., Stremmel, W., Kley, J. B., & Schlaghecke, R. (1992). Testosterone treatment of men with idiopathic hemochromatosis. The clinical investigator, 70(7), 566-572.
  5. Maneesh, M., Dutta, S., Chakrabarti, A., & Vasudevan, D. M. (2006). Alcohol abuse-duration dependent decrease in plasma testosterone and antioxidants in males. Indian journal of physiology and pharmacology, 50(3), 291.
  6. Kelly, D. M., & Jones, T. H. (2015). Testosterone and obesity. Obesity Reviews, 16(7), 581-606.
  7. Wortsman, J., Rosner, W., & Dufau, M. L. (1987). Abnormal testicular function in men with primary hypothyroidism. The American journal of medicine, 82(2), 207-212.
  8. Santos, H. O., Howell, S., & Teixeira, F. J. (2019). Beyond tribulus (Tribulus terrestris L.): The effects of phytotherapics on testosterone, sperm and prostate parameters. Journal of ethnopharmacology, 235, 392-405.
  9. Banihani, S. A. (2018). Ginger and testosterone. Biomolecules, 8(4), 119.
  10. Pizzorno, L. (2015). Nothing boring about boron. Integrative Medicine: A Clinician’s Journal, 14(4), 35.

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