The Testosterone Link in Male Health and Well-being

The key role testosterone plays in men’s health

When bringing up the term "hormone health," the majority might immediately consider of the general nature of women’s hormones and the various health issues, which stem from hormonal imbalances. It’s good to remember that we, men, have hormones, too and it’s crucial to broaden the discussions about our proper hormonal health and preventing imbalances, even though the symptoms and consequences may not be as adverse. While men’s hormonal health and overall well-being may not present as many distinct issues, there’s still significant value in addressing them.

Testosterone, the dominant hormone in men, is produced in the testes, but the hormone cascade begins in the brain. The pituitary gland and hypothalamus play pivotal role in controlling hormone production, particularly in men, where they regulate testosterone and sperm production. The hypothalamus releases gonadotropin-releasing hormone (GnRH), which stimulates the pituitary gland to release follicle-stimulating hormone (FSH) and luteinizing hormone (LH). These two messenger hormones instruct the testes to produce sperm and testosterone, respectively.

In general, the testosterone is responsible for:

• Growing up into a man (deepening voice; appearance of facial and pubic hair);
• Collateral aging changes (male-pattern baldness);
• Muscle size and strength;
• Bone growth and strength;
• Sex drive (libido);
• Sperm production.

Unlike the 28-day cycle of the female hormones, the testosterone levels fluctuate on a 24-hour basis. That’s why on a daily basis, testosterone production, usually, peaks in the morning, plateaus in the afternoon, and dips in the evening to late-night hours.

How testosterone impacts cognition and mental health

Little do we know, testosterone is not attributed only to sexual performance and the reproduction. It also plays a significant role in structuring of the brain architecture, as well as determining the cognitive capacity and overall mental health.

The structure of the male brain.

The structure of the male brain may provide insights into behavior and cognition. The male brain is larger in volume compared to the female brain, although the difference is minimal. This larger size impacts the amount of gray and white matter in the brain, which may, in turn, affect the strength and function of communication between the two brain hemispheres and between the lobes or regions of the brain.

The male brain has more white matter by volume compared to the female brain. White matter comprises neural connections that connect all four lobes of the brain and plays a crucial role in normal motor and sensory functions. Although the male brain has more white matter, it may utilize gray matter more extensively. Gray matter contains cells that process information and memories and is also involved in muscle control.

Differences in behavior between men and women may be attributed to structural differences in their brains. A study published in the Journal of Neuroscience revealed that women excelled at verbal and memory tasks, while men performed better at spatial tasks. This correlation aligns with the increased white matter volume and hemispheric specialization observed in men’s brains.

Testosterone, brain function, and cognitive ability

Testosterone directly impact learning and memory as receptors to metabolize testosterone are found on the hippocampus and amygdala (the learning and memory centers of the brain). Testosterone has neuroprotective qualities and has been shown to increase concentrations of nerve growth factor (NGF, a protein responsible for the development of sensory neurons); protect against oxidative stress, which could lead to age-related cognitive decline; and potentially prevent Alzheimer’s disease by preventing amyloid plaque buildup, a hallmark of the condition. The latter may explain why women are more prone to developing Alzheimer’s disease than men.

When it comes to cognitive ability, a 2014 study from the University of Pennsylvania sought to demonstrate that there are clear differences in how areas of the brain communicate with one another. Indeed, researchers found that in male brains there is greater neural connectivity from front to back, “suggesting their brains are structured to facilitate connectivity between perception and coordinated action.” In females, “the wiring goes between the left and right hemispheres, suggesting that they facilitate communication between the analytical and intuition.”

This information is especially important as it helps shape future research on “neuropsychiatric disorders [such as depression, autism, and schizophrenia], which are often sex related.”

Testosterone and mental health

Men generally experience a gradual decline in testosterone levels as we age, starting around ages 40 to 50. In contrast, women undergo perimenopause and menopause, during which hormone levels drop sharply over a short period. This gradual decline in men can make it challenging to pinpoint low testosterone as the sole cause of various symptoms, as numerous external factors can contribute to these general ailments.

When testosterone is lower than normal – whether one is aging or not – possible mental health symptoms include:

• Mood swings;
• Memory loss;
• Irritability;
• Impulsiveness;
• Stress;
• Anxiety;
• Depression.

While there’s limited research that definitively establishes a link between low testosterone levels and an increased risk of mental health disorders, certain studies have indicated correlations between testosterone levels and impaired mental health behaviors, including symptoms of anxiety and depression.

In one study, researchers hypothesized that men with borderline testosterone levels would have higher rates of depression and depressive symptoms. They concluded that while the rate of experiencing such symptoms was significantly higher than the general population, this cohort also had high rates of obesity and physical inactivity. Those who are obese or overweight will likely have increased circulating cortisol (the “stress hormone”) due to chronic inflammation, which also impacts behavior and mental health. Low testosterone may also impact the production of the hormone serotonin, which regulates mood.

The conclusion withdrawn is that it’s important to look at the full picture of someone’s health when discussing hormonal health.

How testosterone impacts well-being and longevity

While testosterone possesses neuroprotective properties, its role in safeguarding the immune system may be limited. Men face challenges in combating infections due to testosterone’s suppression of inflammation, as evidenced by research published in Scientific American. Interestingly, women possess two X chromosomes, whereas men have only one, which is hypothesized to contribute to their stronger immune responses. Conversely, higher testosterone levels are associated with an increased risk of certain cancers, particularly prostate cancer.

When it comes to longevity, men generally have a shorter life expectancy compared to women. Testosterone, a hormone in men, may increase the risk of cardiovascular challenges, which can lead to fatal cardiovascular events, especially in older age. Additionally, men tend to engage in more risky and potentially life-threatening behaviors, which could further contribute to the reduced life expectancy. While research is limited in understanding the exact mechanisms behind testosterone’s impact on life span, it suggests that female hormones may offer significantly greater protective benefits.

Since testosterone plays a crucial role in various bodily functions and processes, lower-than-normal testosterone levels can manifest in both physical and mental/emotional effects on the body.

Physical symptoms of low testosterone include:

• Decreased libido;
• Erectile dysfunction;
• Hair loss;
• Fatigue;
• Irritability;
• Poor concentration;
• Sleeping difficulties;
• Decreased muscle mass;
• Increased body fat;
• Loss of bone mass.

Common concerns of high testosterone include:

• Aggressive behavior
• Fluid retention and weight gain
• High blood pressure
• High cholesterol
• Impotence
• Mood swings
• Prostate enlargement.

Just as external diet and lifestyle factors can contribute to mental and emotional symptoms of low testosterone, they can also impact physical symptoms. For optimal hormonal balance, men should prioritize adopting healthy lifestyle behaviors, including regular exercise, quitting smoking, abstaining from excessive alcohol consumption, and nurturing positive relationships. Additionally, maintaining a balanced diet rich in whole foods is crucial. 

The most prevalent serious health conditions among men are:

• Colorectal cancer is the second leading cause of cancer-related deaths in Europe and Bulgaria. It is more prevalent in men and increasingly affects those under the age of 55. According to the European Cancer Information System (ECIS), over 250,000 new cases were diagnosed in men in the EU in 2020, with significantly higher mortality rates in men, especially in Eastern Europe. In Bulgaria, colorectal cancer ranks as the second most common cancer in men, and 5-year survival rates remain among the lowest in the EU.
• Cardiovascular diseases are the leading cause of death among men both in EU. The European Society of Cardiology reports that men in Eastern Europe face a particularly high risk due to increased smoking rates, poor diet, and limited access to preventive care. In Bulgaria, cardiovascular diseases account for more than 60% of all male deaths. Early signs such as erectile dysfunction, low testosterone, and chronic stress may indicate underlying heart conditions.
• Prostate cancer is the most frequently diagnosed cancer in men across Europe. Data from Eurostat and GLOBOCANshow that approximately 1 in 8 men in Europe will be diagnosed with prostate cancer during their lifetime. In Bulgaria, it is the most common cancer in men, particularly affecting those over 65.
• Testicular cancer, though relatively rare, is the most common cancer in men aged 15 to 40. Incidence rates are gradually increasing across Europe. Fortunately, when detected early, it is highly treatable, with a survival rate exceeding 95%. In Bulgaria, between 80 and 120 new cases are diagnosed each year, mostly in early stages.

Men should prioritize living a preventive lifestyle.

Men can take several daily actions to promote both short-term and long-term health. Disease prevention begins with regular self-examinations of the physical body to identify any changes in appearance or sensation. It’s also crucial to be aware of potential risk factors, such as family history, age (especially in younger men), and race (more common in white men), which can increase the risk of testicular cancer. Symptoms of testicular cancer primarily affect the testes area but may also include back pain, breast enlargement, or tenderness.

In addition to self-examination, adopting healthier dietary and lifestyle habits is essential for disease prevention. If you smoke, drink alcohol, are sedentary, or don’t maintain a balanced, nutritious diet, these habits can significantly increase your risk of developing colorectal cancer. However, engaging in regular physical activity, quitting smoking, increasing fiber intake, and optimizing digestion and bowel movements can dramatically reduce this risk.

Health coaching for a healthier life

As a Health Coaches, I help my clients reach their health goals by providing support and accountability. I facilitate dialogue with my clients around how bio-individuality is at the root of understanding their unique body and health needs, which can include how their hormones are impacted by the foods they eat and the behaviors they engage in.

The health and wellness space, often perceived as predominantly female, emphasizes the significance of engaging men in conversations about health, including hormonal health, as it impacts men as well. My position is ideal as a facilitators in these discussions, fostering a supportive environment where men can openly discuss their health concerns and aspirations.

Men also desire to feel confident in their bodies, boost their energy levels, and improve their mental well-being. Understanding the intricacies of the body and how to optimize health through diet and lifestyle is incredibly empowering, and something that men should have the opportunity to achieve by becoming or working with your favorite Health Coach.