The male hormone, testosterone, regulates sex differentiation. It is responsible for producing spermatogenesis, fertility, and male characteristics. Testosterone influences start in the fetus seven weeks after conception. It starts the development of testicles using the related Y-chromosomes.
Testosterone initiates sexual development and plays a key role in defining a male. In most men, testosterone matters in the following ways:
● Production of spermatogenesis
● Penis enlargement
● Testis development
● Enhancing libido
● It affects bone and muscle mass
● The way males store fat in the body
● Red blood cell production
Both males and females can produce testosterone from the ovaries in women and testicles in men. Signals from the pituitary gland in the brain control the production of testosterone.
Excessive naturally occurring testosterone is not a common condition among men. Part of this may be due to varying levels of testosterone over time and even during the day. Abnormal high testosterone levels are common in people who use anabolic steroids, testosterone, or other related hormones.
Symptoms associated with increased testosterone levels may not relate to the hormone. Problems of artificial high testosterone in men include:
● Low sperm count, shrinking of testicles, and impotence
● Damage to the heart muscle increases the risk of heart attack
● Urinating difficulties due to prostate enlargement
● Liver disease
● Mood swings, irritability, delusions, euphoria among others
In women, the most common cause of high testosterone levels is polycystic ovary syndrome (PCOS). It is a common disease affecting 6% to 10% of premenopausal women. Symptoms of high testosterone levels in women include:
● Irregular periods
● Reduced male fertility
● Excess hair on the face, trunk, pubic area, and extremities
● Male pattern baldness
● Depression and anxiety
● Weight gain
one of the treatments for these symptoms is spironolactone. It is a special type of diuretic or water pill that blocks the action of testosterone.
As men age, testosterone levels drop gradually, about 1% to 2% each year. The reason is that the pituitary gland sends fewer signals to make testosterone for the tests. Also, with age, the liver produces more sex hormone-binding globulin (SHBG), which binds to the testosterone in blood circulation.
All of this reduces the level of the active or free forms of testosterone in the bloodstream. However, defining the optimal levels of testosterone is controversial and tricky.
Signs of low levels of testosterone in adult men include:
● Reduced body and facial hair
● Loss of muscle mass
● Low libido, small testicles, reduced sperm count, impotence and
male infertility
● Increased risk of fracture and brittle bones
● Hot flashes
● Increased breast size
● Irritability, depression, and poor concentration
Some men experiencing testosterone deficiency can mitigate the symptoms by taking testosterone replacement. For example, in managing osteoporosis, you can increase bone strength and reduce fracture risk with testosterone replacement.
Women can also show symptoms of testosterone deficiency. Affected women may experience reduced bone strength, low libido, depression, or poor concentration.
In men, a drop in testosterone may arise due to the following diseases or conditions affecting the:
● Testes – physical injury, infection, chemotherapy, radiation
treatment, tumors, castration
● Pituitary gland or hypothalamus – medication, certain infections,
tumors, and autoimmune conditions
● Klinefelter syndrome – a genetic disease in which a man has an extra
X-chromosome
● Hemochromatosis – an abnormal gene causing excessive accumulation of iron in the body, including the pituitary gland
In women, low levels of testosterone may arise due to diseases of the hypothalamus, pituitary, or adrenal glands. Removal of ovaries can also contribute to testosterone deficiency in women. Estrogen therapy reduces the amount of free, active testosterone in the body. Estrogen increases the level of sex hormone-binding globulin, just like in aging men.
Healthcare providers have approval to use testosterone therapy in case of delayed male puberty and abnormally low production of testosterone due to malfunction of the pituitary, hypothalamus, or testes.
You can be eligible for testosterone therapy if you show
signs of extreme low T levels (hypogonadism) and symptoms such as:
● Low energy
● Problems with cognition
● Problems with sex drive
● Generalized weakness
● Erectile dysfunction
However, these symptoms can also manifest in men with normal testosterone levels. So, there is no clear direct connection between testosterone levels and the symptoms. As a result, a controversy exists on which men should use supplemental testosterone.
In women, testosterone therapy can work for a patient showing low levels of the male hormone. However, it's unclear the effectiveness of using testosterone treatment to improve sexual function or cognition in post-menopause.
