- Most male hormone imbalances involve testosterone, the primary sex hormone in men,
- Aging, obesity, and illness can cause hormone levels to become imbalanced.
- If you have symptoms of hormone imbalance, blood tests can reveal if your hormone levels are within a healthy range. If physicians find an imbalance, testosterone replacement therapy or other hormone replacement can often help.
The last time you gave thought about hormones, you were probably a pimply teen bemoaning your latest breakout or breaking voice. But men’s hormones can be thrown off-kilter at any age. Hormone imbalance in men may be connected to a host of unpleasant symptoms. Imbalanced hormones may cause you to gain weight, zap your energy, make maintaining muscle mass difficult, negatively impact your sex life, and more.
The glands and organs in your endocrine system work together to secrete hormones that control or impact your metabolism, stress response, mood, reproduction, sexual function, and more. It can all happen in a chain reaction or domino effect: Often when one hormone is secreted, it stimulates the release and production of another. So when one domino topples—or in this case, a hormone gets out of balance—it can impact the others further down the line, and disrupt your health and well-being (1).
Many types of hormone imbalance in men affect testosterone. And when testosterone is impacted, a host of concerns from fatigue to sexual dysfunction may ensue. Here we look at some of the causes of hormone imbalance in men and how they are treated.
Related: What Is Testosterone?
Aging and Hormone Imbalance in Men
Your endocrine system is complex, and controlled by parts of your brain and glands that send out signals to ramp up or scale back the production of multiple hormones.
The hypothalamus, located in your brain, produces gonadotropin-releasing hormone (GnRH), which stimulates the pituitary gland to produce and release of follicle-stimulating hormone (FHS) and luteinizing hormone (LH).
In men, FSH triggers sperm production, while LH prompts Leydig cells in the testes to produce testosterone. Testosterone is involved with many processes that help keep your body healthy, including a role in the production of red blood cells and sperm, maintaining bone health, and regulating sex drive, fat distribution, and muscle mass and strength.
Aging can throw this delicately balanced system off-kilter (2) and lead to a drop in testosterone. Generally, men’s testosterone levels decrease with age at a rate of about 1 percent every year after the age of 30. But some men may experience a steeper drop-off in a shorter amount of time, or at an earlier age (3). If your testosterone levels drop below 300 ng/dL and are accompanied by symptoms like weight gain, loss of libido, fatigue, and low mood, you may be diagnosed with low T.
What Causes Testosterone Levels to Decline?
Along with adding more candles to your birthday cake, several underlying conditions can cause your testosterone levels to decline.
One big culprit: obesity. In one study, men with a body mass index (BMI) over 30 had lower total and free testosterone levels, and their T levels declined more quickly than the men with a healthy BMI of 20 to 25. Research suggests that both elevated inflammatory markers and insulin resistance may be associated with a decline in testosterone levels. Plus, an enzyme in fat tissue metabolizes testosterone into estrogen in men, potentially worsening any testosterone deficiency.
While testosterone is the main sex hormone for men, guys also need estrogen for healthy functioning. The key here is that testosterone and estrogen must work in a delicate balance. Too much estrogen may cause similar symptoms as low T, including sexual dysfunction, and may even impair T production. Excess estrogen may also put men at risk for diseases like prostate cancer.
Weight loss can help boost depleted testosterone levels. But that can be a hard goal to achieve, as low testosterone levels can impact fat loss and muscle gain (4). And men tend to lose muscle mass and gain visceral fat (fat around the middle) as they age. So obesity and low testosterone can lead to a vicious cycle.
Obesity may also lead to insulin resistance, prediabetes, and Type 2 diabetes, all potentially chronic conditions that may impact testosterone levels—and vice versa.
A host of other often chronic illnesses may also be linked to testosterone levels, from rheumatoid arthritis and high blood pressure to cardiovascular disease and some cancers. In a study of nearly 4,000 middle-aged men consulting for sexual dysfunction, such as erectile dysfunction (a symptom of low T), researchers evaluated their level of chronic disease. They gave the men a chronic disease score based on medications taken and other factors. Higher chronic disease scores (5) were associated with lower total and free testosterone concentrations.
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Symptoms of Low Testosterone
Low testosterone may trigger a wide range of symptoms, including the following:
- Hair Loss
- Cognitive issues
- Decrease in bone density
- Decrease in exercise performance
- Erectile dysfunction
- Loss of libido
- Larger breasts
- Mood changes
- Muscle loss
- Smaller testicles
- Sleep disturbances
- Weight gain
Other Common Causes of Hormone Imbalance in Men
Low T isn’t the only hormone imbalance in men. Here, we look at some other hormone imbalances in men and how they are treated.
No doubt you’ve heard of menopause in women. Many men experience a similar hormonal shift called andropause. Like women going through menopause, guys going through andropause might complain about fatigue, depression, and decreased libido, which is why andropause has been dubbed “male menopause.” Simply put, andropause is a collection of symptoms caused by the slow, progressive decrease in testosterone as you age (6).
Every woman will go through menopause, typically in their early 50s. But there’s no such average age of andropause for men. In fact, not all men even experience andropause. Ultimately the rate of testosterone loss and related symptoms—if any—vary dramatically from person to person. That’s why andropause, which clinicians call late-onset hypogonadism (LOH), is often underdiagnosed (7).
LOH has been defined as a symptomatic testosterone deficiency, with serum testosterone levels below the reference ranges of young, healthy adult males. Common symptoms may include erectile dysfunction, reduced morning erections, decreased sex drive, decreased muscle mass, increased body fat, depressed mood, fatigue, and cognitive issues.
If you’re experiencing any of these symptoms, talk to your doctor. A widely-used treatment for LOH is testosterone replacement therapy (TRT), where supplemental testosterone is prescribed to make up for what your body isn’t producing on its own.
Imbalanced hormones may cause you to gain weight, zap your energy, and more.
Primary Adrenal Insufficiency
Primary adrenal insufficiency—better known as Addison’s Disease—is another type of hormone imbalance in men. Addison’s is a rare condition where your body doesn’t produce enough cortisol (the stress hormone) and aldosterone (a hormone that regulates salt and water in the body).
If you have Addison’s, which is often caused by damage to the adrenal glands (8), you might experience low blood pressure, extreme fatigue, dizziness, and mood changes.
Treatment for Addison’s Disease often involves steroid hormone replacement therapy to make up for the insufficient cortisol and aldosterone. But some people with Addison’s Disease are treated with androgen replacement therapy, such as testosterone or dehydroepiandrosterone (DHEA).
BTW: adrenal insufficiency isn’t the same as adrenal fatigue. The latter was originally described as a type of stress overload that resulted in the failure of the adrenal glands to function properly after so much overuse. But a systematic review published in 2016 (9) of 58 studies debunked it as a myth and not an actual medical condition.
Although more common in women, thyroid issues are another type of hormone imbalance in men. Your thyroid, a small butterfly-shaped gland at the base of your neck, produces hormones that play vital roles in regulating your metabolism, how fast your heart beats, digestion, muscle control, and more.
But sometimes, the thyroid doesn’t work as well as it should. One fairly common thyroid condition, called hypothyroidism, is when your thyroid gland becomes sluggish, failing to produce enough thyroid hormones to meet your body’s needs. One of the most common causes of hypothyroidism is Hashimoto’s Disease, an autoimmune disorder where your own immune system attacks your thyroid gland and damages it so that it is unable to make enough thyroid hormones.(10)
When your body doesn’t get enough of the necessary hormones from the thyroid gland, you may feel tired and depressed. You may also gain weight and experience sexual dysfunction. About 59 to 63 percent (11) of men with hypothyroidism experience sexual dysfunction, such as erectile dysfunction, delayed ejaculation, and a decrease in sex drive.
The sexual dysfunction symptoms are often explained by hypothyroidism’s association with hypogonadism—the low or no production of sex hormones. Men with hypothyroidism tend to have low testosterone levels (12).
Hypothyroidism can be diagnosed with a blood test. The TSH test checks the levels of thyroid stimulating hormone (TSH), which is produced by the pituitary gland and balances your thyroid hormones. When TSH is elevated, two other hormones can be checked to confirm hypothyroidism: thyroxine (T4) and triiodothyronine (T3).
Hypothyroidism is treated with levothyroxine, a synthetic thyroid hormone. For men who are experiencing sexual dysfunction, it’s worth asking your physician to also check your TSH. Treating hypothyroidism often normalizes testosterone levels and improves sexual function.
The Bottom Line
Generally, men naturally lose some testosterone as they age. But weight gain and some chronic conditions can also exacerbate the issue, leading to further hormone imbalance. Additionally, a disruption anywhere in the endocrine system can lead to a domino effect that potentially impacts testosterone.
If you are experiencing symptoms—like unexplained fatigue, sexual dysfunction, or mood changes—talk to your doctor. Often hormone supplementation or treatment of a chronic condition can help rebalance the body, remedy symptoms, and improve overall well-being.