The idea that women's health is complex and that men's bodies are simple is vastly incorrect. Many of those who assume that men's bodies are hormonally simple wrongly assume that the best results for boosting men's sexual health can be obtained with testosterone therapy. While there is no doubt that testosterone plays an important role in improving male sexual performance, the male body is far from being mono-hormonal!
Fascinating Facts About Men's Health
Men’s health is a complex and often confusing topic. There are so many hormones and pathways that are interconnected. It can be difficult to know where to start. In this article, we will focus on the effect of testosterone and neighbouring pathways on men’s health.
The Role of Testosterone In Men's Health
Testosterone is responsible for many important aspects of male physiology, including energy levels, stress resilience, mood, hair growth, and sperm production. Low testosterone can lead to several problems such as fatigue, weight gain, depression, insomnia, and erectile dysfunction. Fortunately, there are many ways to increase testosterone levels naturally. It is important to note that testosterone is not the only hormone important for men's health (5,6). Ensuring healthy hormone balance means the adequate synthesis of all gonadal hormones, including testosterone, estradiol, and progesterone (7). Testosterone supplementation on its own is never truly adequate for solving the hormonal issues of all men. It is critical to dive deep and understand the levels of significant hormonal players that affect male health. (8)
Other Players that Significantly Affect Men's Health
The Medical Definition of Low Hormones in Men
Hypogonadism is a condition in which the body does not produce enough of the hormone testosterone. There are two types of hypogonadism: primary and secondary. In Secondary hypogonadism, the brain does not produce enough of the hormone that signals the testicles to produce testosterone (11). Primary hypogonadism occurs when the testicles do not respond properly to the hormone signal from the brain (12). As a result, testosterone production is decreased. Male hypogonadism can lead to symptoms such as low sex drive, erectile dysfunction, and reduced muscle mass. If left untreated, it can also cause osteoporosis.
Hypogonadism is diagnosed using blood tests that measure testosterone levels. It is important to note that though many practitioners attempt to rely on blood work to diagnose hormonal disorders, blood tests do have their limitations.
A blood test measures the serum levels of hormones. As hormones are not soluble in water, the levels of hormones in serum are thought of as a momentary depiction of hormone levels. Their fluctuations make them a less useful tool in the diagnosis of hormonal issues.
Salivary tests and dry urine hormone tests are usually much better at giving an accurate measure of hormone levels. It is always important to evaluate hormone tests for accuracy and reliability as treatment should largely depend on the results of lab evaluation. Treatment depends on the underlying cause but may involve testosterone replacement therapy. (13, 14)
Male hormone issues are not all hormone deficiency issues. Many hormone clinics have a one size fits all approach. Many men are promised that all their issues - from weight regulation issues to mood disorders and sexual dysfunction - will be solved. Unfortunately, even after reaching very high levels of testosterone due to hormone replacement, many men don't get the results they were promised (15, 16). Additionally, those men are not sufficiently warned against the potential side effects of testosterone therapy (17). Scientific research points towards many lifestyle factors and natural ingredients that can act as effective testosterone boosters. Many of those factors include holistic factors like a healthy diet, lifestyle changes that include aiming to get more, higher quality sleep and common ingredients like vitamins and botanicals that are well recognized to improve overall health.
Male hormone imbalances can be caused by several factors, including aging, stress, diet, lifestyle choices, and underlying medical conditions. As a result, it's important to work with a healthcare provider who can help you determine the cause of your symptoms and develop an individualized treatment plan. With the right approach, you can improve your quality of life and reduce your risk of serious health complications.
Natural Pathways of Testosterone Synthesis
Testosterone is a steroid hormone that is produced in the testes in men and the ovaries in women. It is responsible for the development of male characteristics, such as facial hair and a deep voice. Testosterone levels are highest during adolescence and early adulthood, but they begin to decline after the age of 30. (18)
The decline is a steady, healthy decline that leaves the body with enough testosterone to support tissue health and libido, but removes the unnecessary excess that is experienced in peak reproductive years.
Male sexual health issues are not a normal part of healthy aging (19). Healthy men are expected to enjoy satisfying sexual relationships, maintain their mental health, and other issues with the natural levels of testosterone that their bodies are fully capable of producing. (20)
Several nutrients are essential for testosterone synthesis, including vitamin D, cholesterol, vitamin K and vitamin C. Vitamin D is necessary for the conversion of cholesterol to testosterone, while vitamin C is involved in the maintenance of adrenal health, which is a key player in the regulation of hormone levels.
Factors that can disrupt testosterone synthesis include stress, obesity, and certain medications (21, 22, 23, 24). Chronic stress can lead to a decrease in testosterone levels by causing the body to release cortisol. Cortisol significantly lowers the production of testosterone in the long term. (25)
Obesity can also reduce testosterone levels by increasing aromatase activity, which converts testosterone to estrogen. Thus, in those situations, a significant amount of the testosterone produced is quickly turned into estrogen spiking up the estrogen level and leaving very little testosterone to bind to receptor sites and act physiologically. Additionally, certain medications, such as glucocorticoids and opiates, can also inhibit testosterone synthesis.
Can Prescription Medications Affect Testosterone Levels
Yes, a decrease in testosterone levels can be a side effect of certain prescription medications, such as the following:
Ketoconazole (Extina, Nizoral, Ketoderm) is used to treat infections caused by fungi or yeast (e.g., athlete’s foot, yeast infection of the skin, seborrheic dermatitis, or dandruff.) Ketoconazole can be taken as a pill or used as a cream, foam, gel, or shampoo
Cimetidine (Tagamet) is often prescribed to people with ulcers or gastroesophageal reflux disease (GERD). It’s also available in an over-the-counter form to treat heartburn. It comes in tablet and liquid forms
Spironolactone (Aldactone) may be used with other medicines to treat high blood pressure and heart failure. It may also help people who have too much aldosterone, a hormone, or people who have edema (fluid retention) from heart, liver, or kidney disease
Certain antidepressants may lower testosterone levels. A doctor can advise a patient on which antidepressant is most suitable
Chemotherapy drugs have been shown to lower testosterone levels, possibly because they can damage the testes, the organs that produce testosterone in men
- Opioids are pain relievers like morphine, codeine, hydrocodone (Vicodin), and oxycodone (OxyContin, Percocet)
Natural Testosterone Boosters
Vitamin B3 (Niacin)
Vitamin B6 (Pyridoxine)
Vitamin B9 (FOlate)
L-arginine may significantly enhance the body's ability to synthesize vasodilating compounds and lead to a long-term increase in physical fitness. It is important to note that though doses of 1.5 g to 5 g were shown to significantly help men with erectile dysfunction, those doses may not be safe for all men as they may interact with blood pressure medications and other drugs. It is better to use l-arginine as long-term support of fitness than as a short-term mechanism to engorge the pelvic region with as much blood flow as possible. (50)
Science-Backed Testosterone Building Botanicals
Mucuna prurience is an Ayurvedic bean with a high concentration of L-DOPA. L-DOPA is the natural precursor of dopamine. As the pleasure neurochemical in the brain, it is expected that the velvet bean would function as a mood enhancer. While Mucuna does play a role in improving mood and emotional health, its L-DOPA content makes it an excellent improver of hormone levels. (51)
L-DOPA plays a role in the regulation of testosterone and other sex hormones. The connecting pathway is related to the antagonizing effect that dopamine has on prolactin. Prolactin the lactation hormone is known to have a suppressing effect on the production of sex hormones. (52)
Mucuna is shown to work directly on the hypothalamic- Pituitary- Gonadal axis by stimulating the release of the gonadotropin-releasing hormone (GnRH). The hormone is released from the hypothalamus. The hypothalamic signal increases the production of luteinizing hormone (LH) and Follicular-stimulating hormone (FSH). The two hormones stimulate testosterone production from Leydig cells and spermatogenesis in Sertoli cells. (53)
The increase in testosterone leads to several benefits, including improved metabolism, muscle gain, weight loss, and increased libido. The effects of L-dopa on testosterone levels are thought to be responsible for the improvements in male fertility that have been observed in studies. (54)
While exogenous testosterone therapy can lead to some of the same benefits, the increase in natural testosterone levels that results from L-dopa supplementation is thought to be more effective and more sustainable. As such, L-dopa represents a promising option for those looking to improve their testosterone levels naturally. (55)
Though many adaptogens may theoretically improve testosterone levels by modulating the increase of cortisol due to stress, some adaptogens have been demonstrated to significantly improve hormone levels.
Ashwagandha has been used as an aphrodisiac adaptogen for thousands of years. studies demonstrate that it can significantly enhance sperm parameters. All parameters from sperm count, sperm motility and even semen volume were improved by ashwagandha supplementation.
Additionally, it was noted that through the improvement of the stress response, ashwagandha does improve testosterone levels significantly. (56)
Nigella sativa is viewed as an overall healer and improver of health. Many clinical trials demonstrate the capacity of black seed to improve gastrointestinal health, immune health, and even mental health.
Much of the activity of black seed oil has been attributed to its active constituent thymoquinone. While thymoquinone is a key player in black seed, the super-speed contains hundreds of other active constituents.
Studies drew the attention of the public to the potential role of black seed oil to act as a testosterone booster. A rabbit dose equivalent to 12ml daily significantly improved testosterone levels and sperm parameters. (57, 58)
Further, a systematic review conducted in the year 2017 demonstrated that black seed oil is not only an improver of sperm parameters but also could mount positive effects on hormones including testosterone. (59)
Active Ingredients That Work As Natural Erection Boosters
Horny Goat Weed: Also known as Epimedium, is a flowering plant that has been used in traditional Chinese medicine for centuries. In a 2006 study, horny goat weed was evaluated for its effect on erectile dysfunction. The researchers found that the herb increased levels of nitric oxide, which relaxes smooth muscle and promotes blood flow to the sexual organs. The researchers concluded that Horny Goat Weed extract may significantly improve erectile dysfunction and that the herb may offer a natural alternative to conventional medications. (60)
The Effect of 5-Alpha Reductase on Male Health
The Importance of Sleep
Like many components in the body, testosterone is made during the sleep hours. good quality sleep is vital for maintaining healthy hormone levels. Upon waking up in the morning, testosterone levels should be high enough to carry the man throughout the rest of the day. A significant afternoon crash may be one of the early indicators of inadequate testosterone production. A study noted that 1 week of sleeping only 5 hours per night results in a 10% decrease in daytime testosterone! (71, 72)
It is important to wake up with as much testosterone as possible because as many doctors would agree, epinephrine is the killer of testosterone. Upon getting stressed, there is a significant decrease in testosterone levels and that decrease is also followed by a significant decrease in erections. This effect is accentuated by caffeine intake, sugar intake and alcohol intake.
For many men, the use of caffeine along with sweets is a last attempt by the body to kick-start their adrenals that have been drained by continuous stress. Though caffeine might feel helpful in the short term and sugar may act as a quick energy fix, unfortunately, long-term use of both significantly decreases testosterone levels.
The idea that men's bodies are hormonally simple and women's health is complex is incorrect. Men's health is a complex topic, and understanding the interplay of hormones is crucial for maintaining optimal well-being. While testosterone plays a vital role in male physiology and sexual health, it is not the sole hormone responsible. Estrogen, progesterone, and other enzymes like 5 alpha-reductase and aromatase also contribute to men's health.
It is important to note that testosterone therapy alone is not sufficient for addressing all hormonal issues in men. Achieving a healthy hormone balance requires a comprehensive understanding of various hormonal players and their levels. Factors such as 5 alpha-reductase activity, aromatase activity, age, obesity, and lifestyle choices all influence hormone metabolism and overall health.
Addressing male hormone imbalances requires considering factors such as aging, stress, diet, lifestyle choices, and underlying medical conditions. Working with a healthcare provider who can identify the underlying causes and develop an individualized treatment plan is crucial for improving quality of life and reducing the risk of health complications.
Men's health is a multifaceted topic, and testosterone is just one piece of the puzzle. Understanding the complexities of hormone synthesis, regulation, and balance is essential for maintaining optimal well-being in men.