What Happens to Testosterone as You Age

While doctors believe age has a lot to do with the decline, something else might also be going on. “Is this a natural drop off or is this secondary to other medical comorbid conditions?” says Dr. Masterson. “After the third decade of life, you also have an increase in high blood pressure, diabetes and heart disease,” he adds, all of which decrease testosterone production. Obesity is another factor: 40% of obese men (and 50% of obese men with diabetes) have low testosterone levels, studies show.

The pea-sized pituitary gland, located at the base of the brain, is known as the master gland. That’s because it tells other glands, like the testicles, to release hormones. As you age, the signaling isn’t as efficient and the entire system doesn’t work as well as it did when you were younger, says Tracy Gapin, M.D., a urologist and men’s health specialist in Sarasota, FL. Sometimes the testicles aren’t responding to the signal from the pituitary gland (that’s primary hypogonadism). Or the testosterone levels are already low and the pituitary gland isn’t sensing those lower levels—and therefore not stimulating testicles to produce more testosterone (known as secondary hypogonadism).

正常水平的睾丸激素水平在每分解符（Ng/dl）的300至1,000纳图之间，但睾丸激素最低的含量为零。“那不是典型的，”马斯特森博士说。“那将是通常在其他情况下接受治疗的男人。”他说，例如，在患有前列腺癌的男性中，医生故意试图使他们达到所谓的“ castrate”水平。医生通常将低t定义为低于300 ng/dl。同时，约翰·霍普金斯大学（Johns Hopkins University）的研究人员建议，根据年龄的不同，目标是从400年代中期到600年代中期。

Gapin博士说：“普遍的误解是睾丸激素仅关乎性和肌肉，但是在正常代谢，正常情绪，骨骼健康和认知功能方面，睾丸激素至关重要。”他解释说，在整个身体中，您都有雄激素受体，将睾丸激素可以与细胞结合并引起变化 - 无论是在骨骼和肌肉中引起变化，还是支持神经功能。低水平的激素使您患心脏病发作和中风和2型糖尿病的风险更高。并且有证据表明，这导致整体健康状况较差和早期死亡。

这些症状中的一些与其他疾病重叠（例如甲状腺问题或睡眠不佳），但确实会影响您的生活质量。Gapin博士说：“这些症状如大脑雾，难以集中精力和工作中的生产力差。”“一个人可能抱怨能量和疲劳低，他在傍晚就睡着了。他晚上在卧室里表现出色。尽管他尝试的尽力，但他无法摆脱体内脂肪。”其他迹象包括：

• 减少肌肉质量
• Achy breasts
• 无法解释的贫血

要被诊断出患有低睾丸激素，您必须在上午10点之前抽血的症状和水平低于300 ng/dl（早晨的激素水平达到峰值）。但是“我们试图排除其他条件或其他可更正的原因，” Masterson博士说。其中包括低甲状腺，抑郁症，大脑的小良性肿瘤（称为催乳素瘤），血液疾病甚至睡眠呼吸暂停。他说：“一旦我们将它们排除在外，那就是我们谈论睾丸激素的替代品的时候。”

即使您最终走了睾丸激素的替代路线，也可以通过清理某些习惯来提高水平。吃太多加工的食物，没有获得优质Z的食物，压力过多会使激素含量水平。这就是为什么Gapin博士建议他的患者锻炼和力量训练，吃更健康的食物，减肥并找到减轻压力的方法，以及其他提高T型策略的原因。Gapin博士说，如果您超过65岁，它可能不会使您的睾丸激素达到最佳水平，但可以提供帮助。

毫无疑问，睾丸激素的提升将启动您的性生活，这是一个加号。有一些关于老年男性的小型研究的证据表明，它将积累瘦肌肉质量（您想要）加强肌肉，以便您可以更轻松地爬楼梯。睾丸激素疗法也可以改善您的骨骼健康，尤其是在脊柱和臀部和贫血中。是否可以改善记忆力丧失和专注力，尽管您的情绪低落似乎来自睾丸激素水平较低，但它是否可以改善记忆力丧失和注意力。

The biggest is infertility because testosterone replacement therapy lowers FSH, a hormone responsible for stimulating sperm production. “About 60% of guys will become what’s called azoospermic, meaning there will be no sperm in their ejaculate,” says Dr. Masterson. That may not bother you if you’re an empty-nester, but if you’re young that can be an issue. “If a young guy is really sure he wants to do testosterone therapy, I typically offer at least a semen analysis and possibly even sperm freezing beforehand,” Dr. Masterson adds. Other side effects include hair loss and acne, notes Dr. Gapin.

Testosterone replacement doesn’t cause prostate cancer, but if you’ve had it, doctors typically don’t recommend testosterone therapy. Testosterone replacement can also over-stimulate red blood cell production, so it’s not advised for men with erythrocytosis (when you have too many red blood cells) or a history of blood clots. And if you have heart disease and are frail and elderly, your risk of strokes or heart attacks may be higher. The bottom line: If you’re older and have serious health conditions, speak to your doctor but don’t be surprised if your provider nixes the testosterone prescription.