Testosterone is an androgen hormone produced by the adrenal cortex, the testes (in those assigned male at birth), and the ovaries (in those assigned female at birth). It is often considered the primary sex hormone associated with that assigned male at birth. Testosterone stimulates the development of secondary sex characteristics associated with males (like body hair and muscle growth) and is essential in the production of sperm. In that assigned female at birth, among other things, testosterone helps keep bones and the reproductive system healthy and contributes to the sex drive.
Man and woman in plank position, a man with facial hair and bulkier muscles due to increased testosterone
Healthy assigned males who have gone through puberty have 15 times the levels of testosterone compared to a healthy person assigned female at birth.
Testosterone imbalances can cause infertility in any gender. Low levels of testosterone in cisgender men can cause infertility. High testosterone levels are associated with infertility in those who can get pregnant.
Testosterone levels can be evaluated with blood work. This is usually part of an infertility workup for all genders.
Prescription testosterone is used to treat hypogonadism-related conditions in cisgender men and delayed puberty in boys.
While off-label it might be used to treat perimenopause symptoms or a low sex drive, there are no Food and Drug Administration-approved (FDA) indications for testosterone prescription use in those assigned female at birth.
Another area of medicine where testosterone is prescribed is for transmasculine people (those assigned as female at birth but who exist as men).
It is available as a gel, topical solution, patch, or pellet (to be implanted), or as an injection or oral capsule.
Risks of Supplementation
Too much testosterone can cause infertility in any gender. Testosterone supplementation can also increase the risk of stroke, hypertension, accumulation of red blood cells, heart attack, leg clots, pulmonary embolus, and cancer. The FDA only approves its use for hypogonadism and does not recommend its use for low testosterone use due to aging. The Endocrine Society, on the other hand, supports its possible use in older men with confirmed testosterone deficiency aiming to achieve a low-normal level of the hormone, but only after carefully reviewing the risks and benefits.
Do not attempt to supplement testosterone on your own. Several websites are selling “testosterone supplements,” and many are fake and even dangerous. Even if the testosterone supplement is real, it is not harmless and can worsen or cause infertility in any gender.
If you are having your testosterone levels checked, the blood test will likely be scheduled for the morning.
There are two kinds of testosterone found in your blood:
Free testosterone (also known as free T) is testosterone that is not chemically bound to anything else.
Bound testosterone makes up the majority of your total testosterone levels. Around 98 % of the testosterone in your blood is bound to one of two proteins: albumin or sex hormone-binding globulin (SHBG).
When you have your testosterone levels tested, a doctor will look at both your free testosterone levels and your total testosterone levels.
Your total testosterone levels include both free and bound testosterone.
Total testosterone levels vary throughout the day. It men younger than 45, levels are highest in the morning and lower in the evening.
Normal ranges for testosterone partially depend on the lab and a doctor’s interpretation. With that said, here are some general values.
Development of sperm: Testosterone is essential to the production of sperm in the testes. It is a delicate balance, however. Both too little and too much testosterone can lead to low sperm counts.
This includes facial and body hair growth, deepening of the voice, the building of muscle mass, increased size of bones, and distribution of fat in the body.
Infants have similar levels of testosterone. It is only during puberty that cisgender boys begin to produce significantly higher levels of testosterone, leading to the development of the secondary sex characteristics associated with males.
That assigned female at birth with abnormally high levels of testosterone may have problems with facial hair, male pattern balding, and infertility.
Essential to the development of eggs in the ovaries:
Androgens play an important role in ovarian follicle development and estrogen production.
Sex drive (libido):
Higher levels of testosterone cause higher levels of sexual appetite.
Building muscle mass:
Cisgender men are more likely to develop muscle mass than cis women because of their higher testosterone levels.
Testosterone may help people regulate pain levels.
Learning and memory, especially spatial intelligence: Testosterone aids in learning and memory. Vidalista 40mg is especially associated with spatial intelligence.
Cis men with abnormally low testosterone levels are at risk for learning disabilities.
Cognitive empathy involves being able to read another person’s emotions via their body language and facial expressions.
Disease and Disorders That Affect Testosterone Levels
When testosterone levels are abnormally low or high, it affects the overall health and well-being of an individual. This is true for all genders. What can cause abnormal testosterone levels?
In cis men, possible causes of low testosterone include:
- Age (after 50)
- Being underweight or overweight
- Congenital or chromosomal disease like Klinefelter syndrome (XXY) or Kallmann syndrome
- Problems with the pituitary gland
- Diseases involving the testicles
- Abnormally high levels of iron
- Chemotherapy and other cancer treatments
- Major illness or surgery
- Some medications and recreational drugs
- Extremely high levels of stress
In cis men, possible causes of abnormally high testosterone levels include:
- Adrenal or testicular tumors
- Anabolic steroid abuse
- Testosterone supplementation
- Having physical contact with someone using a topical testosterone supplement
- Polycystic ovarian syndrome (PCOS)
- Congenital adrenal hyperplasia (CAH)
- Adrenal or ovarian tumors
- Anabolic steroid abuse
Testosterone is an essential hormone for everyone. If your levels are abnormal, a doctor will likely order more testing to investigate the cause. For those whose levels are low due to the normal effects of aging, testosterone supplementation may be an option to consider.
Also, Read More Blog: The Ejaculation Cycle and Male Fertility