The following information is a summary of materials featured in the “Men’s Health” overview. It is meant to be a quick reference for use at the point of care. For additional details and a list of helpful references, see the overview.

Hormones change as we go through the life cycle. What is normal for a 20-year-old is not the same normal as for a 60-year-old. Although low testosterone ("low T") is a diagnosis being promoted by the makers of testosterone medications, it is not as simple as just prescribing hormone replacement. A low testosterone level can be due to many factors. A clinician must also take care not to add testosterone too quickly without exploring other therapies first, because once external testosterone is given, it inhibits the body's natural production of testosterone. Testosterone supplementation is also not without risks, and in terms of long-term use, there is much about safety that we do not yet know. 

Key Factors in Optimizing Male Hormones

Maintain Ideal Body Weight

This is probably the most important thing a man can do. As belly fat increases, there is an increase in activity of the enzyme "aromatase" which converts testosterone in the fat cells to estrogen. This reduces testosterone and increases estrogen, which can increase fat deposition in typical female areas (breast, hips, thighs) and increase the risk of enlargement of the prostate and even prostate cancer. With every one-point drop in your body mass index (BMI) your testosterone level will increase by approximately 1 point. In fact, management of obesity may prevent declining total testosterone in the aging male.

Avoid Developing Diabetes

Developing diabetes increases the risk of having a total testosterone level of less than what is considered normal. Over a 10-year period, the risk for developing abnormally low testosterone levels more than doubles in diabetic individuals.

Exercise

A combination of aerobic (increase in heart rate) and resistance (weightlifting) training has been found to increase the production of testosterone. This also helps prevent the most common diseases that men are most likely to die from, heart disease and cancer. Overtraining in endurance sports such as American football and weight-class wrestling and excessive exercise with calorie restriction can cause testosterone deficiency as well.