Research on treating declining testosterone

Category: Blog

Does naturally declining testosterone during aging  cause health problems or contribute to making the symptoms worse as widely reported? Some doctors think no – lifestyle choices are much more important to preventing low testosterone than aging.

Studies have demonstrated an association between low levels of testosterone and obesity, type 2 diabetes and metabolic syndrome – major risk factors for cardiovascular disease.  Low levels of testosterone are also associated with an increased risk of all-cause and cardiovascular mortality as biochemical evidence indicates that testosterone is involved in glucose and cholesterol utilization.1

Other medical studies cite declining testosterone as the primary cause for such age-associated reduced muscle and bone mass, obesity, sleep apnea, cognitive impairment, and depression.

However, recently presented research at the Endocrine Society’s 94th Annual Meeting said that the long-term drop in testosterone in men is more likely to result from a man’s behavioral and health changes than by aging.

Declining testosterone levels are not an inevitable part of the aging process

“Declining testosterone levels are not an inevitable part of the aging process, as many people think,” said study co-author Gary Wittert, MD, professor of medicine at the University of Adelaide in Adelaide, Australia. “Testosterone changes are largely explained by smoking behavior and changes in health status, particularly obesity and depression.”

In this study, the authors analyzed testosterone measurements in more than 1,500 men who had measurements taken at two clinic visits five years apart.  On average, testosterone levels did not decline significantly over five years; rather, they decreased less than 1 percent each year, the authors reported. However, when the investigators analyzed the data by subgroups, they found that certain factors were linked to lower testosterone levels at five years than at the beginning of the study.

“Men who had declines in testosterone were more likely to be those who became obese, had stopped smoking or were depressed at either clinic visit,” Wittert said. “While stopping smoking may be a cause of a slight decrease in testosterone, the benefit of quitting smoking is huge.”

In fact in supportive research, doctors identified the most logical approach to initial treatments of low testosterone levels are lifestyle modification, weight reduction and good treatment of comorbid diseases. 2

Depression and low testosterone

Past research has linked depression and low testosterone. This hormone is important for many bodily functions, including maintaining a healthy body composition, fertility and sex drive. “It is critical that doctors understand that declining testosterone levels are not a natural part of aging and that they are most likely due to health-related behaviors or health status itself,” he said.

Unmarried men in the study had greater testosterone reductions than did married men. Wittert attributed this finding to past research showing that married men tend to be healthier and happier than unmarried men. “Also, regular sexual activity tends to increase testosterone,” he explained.

The study findings were presented by Andre Araujo, PhD, who was a visiting professor at the University of Adelaide and is vice president of epidemiology at New England Research Institutes, Watertown, Mass. 3

How to treat declining testosterone

When we see a male patient entering the “andropause” or male “change of life” in their late 30′s to early 50′s, we typically see a male patient who complains of:

1. lack of sex drive and or erectile dysfunction
2. Muscle weakness or loss of strength
3. Belly fat, obesity
4. Depression, mood swings
5. Or, they just don’t “feel the same.”

These are classic symptoms of low testosterone levels or more commonly referred to “Low T.” Men can suffer from sex hormone deficiency just as women do, and be treated for this deficiency in the same manner as women that is with prescribed hormonal replacement or supplementation. The difference of course is in the primary hormone; Estrogen for women, Testosterone for men.

So when these male patients’ testosterone levels are checked and many find that their levels are below normal or at the bottom reaches of the “normal level,” the first thing they want to know is “what can you do for me?”

When we reply, “What would be the benefit you would want the most from low-T treatment?” They respond a chance for a more youthful, masculine appearance.

In a soon to be published medical paper in The Endocrine Society’s Journal of Clinical Endocrinology & Metabolism (JCEM), researchers found that higher levels of testosterone were indeed associated with reduced loss of lean muscle mass in older men, especially in those who were losing weight. In these men, higher testosterone levels were also associated with less loss of lower body strength.

In other words, in the right program under a physician’s supervision, a more youthful, masculine appearance is possible.


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1. Huhtaniemi I.Late-onset hypogonadism: Current concepts and controversies of pathogenesis, diagnosis and treatment. Asian J Androl. 2013 Dec 19. doi: 10.4103/1008-682X.122336. [Epub ahead of print]

2. Rao PM, Kelly DM, Jones TH. Testosterone and insulin resistance in the metabolic syndrome and T2DM in men. Nat Rev Endocrinol. 2013 Jun 25. doi: 10.1038/nrendo.2013.122. [Epub ahead of print]

3. http://www.newswise.com/articles/declining-testosterone-levels-in-men-not-part-of-normal-aging-study-finds