Testosterone: Everything You Need to Know

Testosterone which is also known as the male hormone is an androgen hormone which develops physical characteristics in the body that are considered typically male. This is the primary sex hormone in men but is also produced in women in smaller amounts. In men, testosterone is produced by the testicles after stimulation by the pituitary gland. In women, it is produced by the ovaries. This hormone sends signals to a male's testicles or to a woman's ovaries that spark feelings of sexual desire in the body.

Role of Testosterone in Men and Women

Testosterone plays a crucial role in males during puberty as it is the time when a man reaches sexual maturity and can reproduce. Young men witness physical changes in their bodies during the time of puberty such as the penis and testicles growing, the voice deepening, height increasing, facial, pubic and body hair development and muscles and bones becoming stronger.

Testosterone regulates bodily functions like sperm production, fat distribution, bone density, production of red blood cells and development of muscle strength and mass. It is also responsible for the growth of facial and body hair and producing sex drive and is also linked with aggression in men.

In women, testosterone is produced in the ovaries and adrenal glands and stimulates the sex drive. It also helps to secret hormones which are important in regulating the menstrual cycle.

Changes in Testosterone Levels

In men, testosterone levels will usually peak somewhere between the ages of 20 and 30. Later on, the levels gradually decrease and are estimated to decrease by 1 per cent annually after age 30 to 40.

In women, testosterone levels will peak in their 20s and may gradually begin to decline after 30. When a woman starts to witness menopause, her testosterone levels reach half the level as the adrenal glands will make less testosterone during menopause. The ovaries continue to produce testosterone in women even after menopause but the estrogen and progesterone hormones are not produced. This may cause the majority of age-related changes in women.

The normal testosterone levels in women range from 15 to 70 nanograms per decilitre (ng/dL) of blood, while in males, it ranges from 300 to 1000 ng/dL. Men have higher levels of testosterone as compared to women. However, if the levels become imbalanced, adverse symptoms may occur in men and women.

Low Testosterone

Testosterone levels are generally high early in the morning in young men, although this may not be the case in older men. A total testosterone blood test can be performed to find out if the levels are in the normal range. The test should be done on an empty stomach and early in the morning. Not all men with age-related low testosterone may experience symptoms, but some may face trouble with mood, sleep and energy levels.

Low Testosterone in Men

Testosterone levels may gradually drop in males as a natural process due to ageing. Additionally, lifestyle factors like too much exercising or eating an unhealthy diet may also affect testosterone production.

Low testosterone (Low T) may also occur due to certain medications and being overweight. If there is a problem with the testicles or the pituitary gland and they are unable to produce the normal amount of testosterone, it could be a medical condition known as hypogonadism. Some of the symptoms of low testosterone in middle-aged and older men may include sleep disturbances, low energy, low sex drive, depressed mood, low sperm count, problems while getting and maintaining an erection, infertility, lack of body hair and loss of muscle and bone strength.

Low Testosterone in Women

Although women produce low testosterone as compared to men, the relatively low testosterone levels in women may cause excessive fatigue and increase the risk for osteoporosis, fractures and bone loss. Low testosterone can also result in infertility, irregular or absence of menstrual periods known as amenorrhea or decreased sex drive in women. If a woman uses oral contraceptives for a long time or experiences ovarian failure, the levels of testosterone may drop.

High Testosterone

Excessive testosterone in males may be caused due to a medical condition known as congenital adrenal hyperplasia (CHA) which is a disorder of adrenal glands. Furthermore, if men consume anabolic steroids or develop tumors in testicles or adrenal glands, the testosterone levels may increase in their bodies.

In women, excess testosterone may cause a medical condition known as hirsutism where a woman may develop body hair like a male. When women produce an excess amount of testosterone or other androgens, their bodies can’t keep up with converting it to estrogen and hence, they may develop virilization. This disorder may develop a masculine appearance in women and create baldness and a deep voice.

In a premenopausal woman, if the testosterone levels are too high, it can lead to polycystic ovary syndrome (PCOS). This condition increases the risk of irregular or absent menstrual cycle, infertility, skin problems, miscarriage and excess hair growth. High testosterone in women may also cause high blood pressure, cholesterol and insulin resistance and increase the risk of developing diabetes and heart disease.

Consuming medications like anticonvulsants, barbiturates, clomiphene or medicines for estrogen therapy can increase testosterone levels in both men and women. Hence, you must consult your doctor before you take or stop taking any of these medicines.

How to treat Testosterone Imbalances?

It's extremely difficult to find a cause of testosterone imbalance and hence, the doctor may prescribe testosterone replacement to correct the low levels. Topical gels, patches and injectable and implantable testosterone may treat hypogonadism or low testosterone.

Testosterone Replacement Therapy (TRT)

Testosterone Replacement Therapy (TRT) is approved by the United States Food and Drug Administration (FDA) for men who have been diagnosed with hypogonadism. Testosterone which is available in the form of gels, creams, patches and injections is surgically placed beneath the skin to provide the body with the hormone.

There are no possible long-term effects of TRT but scientific evidence suggests that this therapy may have an impact on cardiovascular health and cause sleep apnea. People who take testosterone in any form should consult a doctor immediately if they experience symptoms of heart attack or stroke such as chest pain, shortness of breath, slurred speech, weakness in one side of the body or trouble breathing.

Some of the possible side effects of TRT in both men and women are as follows −

• Risk of polycythemia which may increase the risk of blood clots and stroke.

• Acne.

• Breast tenderness or enlargement in women.

• Infertility.

• An increased amount of red blood cells.

• Small testicles in males.

• Swelling of the low extremities.

• Oily skin.

• Fluid retention.

Conclusion

Testosterone is most commonly associated with sex drive in men but is essential for performing bodily functions in men as well as women. This hormone can also affect mental health, bone and muscle strength, fat storage and the production of red blood cells.

You can check your testosterone levels with a blood test and males can treat the low levels with the help of testosterone therapy. FDA has not approved the therapy for women as the link between this therapy in women and breast cancer and cardiovascular health is currently being studied.