
Topping Up Testosterone?
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The Testosterone Drop
Testosterone levels decline amongst men over a certain age. Exactly when depends on the individual and also how we measure it, but the age of 45 is a commonly-given waypoint for the start of this decline.
(the actual start is usually more like 20, but it’s a very small decline then, and speeds up a couple of decades later)
This has been called “the male menopause”, or “the andropause”.
Both terms are a little misleading, but for lack of a better term, “andropause” is perhaps not terrible.
Why “the male menopause” is misleading:
To call it “the male menopause” suggests that this is when men’s menstruation stops. Which for cis men at the very least, is simply not a thing they ever had in the first place, to stop (and for trans men it’s complicated, depending on age, hormones, surgeries, etc).
Why “the andropause” is misleading:
It’s not a pause, and unlike the menopause, it’s not even a stop. It’s just a decline. It’s more of an andro-pitter-patter-puttering-petering-out.
Is there a better clinical term?
Objectively, there is “late-onset hypogonadism” but that is unlikely to be taken up for cultural reasons—people stigmatize what they see as a loss of virility.
Terms aside, what are the symptoms?
❝Andropause or late-onset hypogonadism is a common disorder which increases in prevalence with advancing age. Diagnosis of late-onset of hypogonadism is based on presence of symptoms suggestive of testosterone deficiency – prominent among them are sexual symptoms like…❞
…and there we’d like to continue the quotation, but if we list the symptoms here, it won’t get past a lot of filters because of the words used. So instead, please feel free to click through:
Source: Andropause: Current concepts
Can it be safely ignored?
If you don’t mind the sexual symptoms, then mostly, yes!
However, there are a few symptoms we can mention here that are not so subjective in their potential for harm:
- Depression
- Loss of muscle mass
- Increased body fat
Depression kills, so this does need to be taken seriously. See also:
The Mental Health First-Aid That You’ll Hopefully Never Need
(the above is a guide to managing depression, in yourself or a loved one)
Loss of muscle mass means being less robust against knocks and falls later in life
Loss of muscle mass also means weaker bones (because the body won’t make bones stronger than it thinks they need to be, so bone will follow muscle in this regard—in either direction)
See also:
- Resistance Is Useful! (Especially As We Get Older)
- Protein vs Sarcopenia
- Fall Special (How to Proof Yourself Against Falls)
Increased body fat means increased risk of diabetes and heart disease, as a general rule of thumb, amongst other problems.
Will testosterone therapy help?
That’s something to discuss with your endocrinologist, but for most men whose testosterone levels are lower than is ideal for them, then yes, taking testosterone to bring them [back] to “normal” levels can make you happier and healthier (though it’s certainly not a cure-all).
See for example:
Testosterone Therapy Improves […] and […] in Hypogonadal Men
(Sorry, we’re not trying to be clickbaity, there are just some words we can’t use without encountering software problems)
Here’s a more comprehensive study that looked at 790 men aged 65 or older, with testosterone levels below a certain level. It looked at the things we can’t mention here, as well as physical function and general vitality:
❝The increase in testosterone levels was associated with significantly increased […] activity, as assessed by the Psychosexual Daily Questionnaire (P<0.001), as well as significantly increased […] desire and […] function.
The percentage of men who had an increase of at least 50 m in the 6-minute walking distance did not differ significantly between the two study groups in the Physical Function Trial but did differ significantly when men in all three trials were included (20.5% of men who received testosterone vs. 12.6% of men who received placebo, P=0.003).
Testosterone had no significant benefit with respect to vitality, as assessed by the Functional Assessment of Chronic Illness Therapy–Fatigue scale, but men who received testosterone reported slightly better mood and lower severity of depressive symptoms than those who received placebo❞
Source: Effects of Testosterone Treatment in Older Men
We strongly recommend, by the way, when a topic is of interest to you to read the paper itself, because even the extract above contains some subjectivity, for example what is “slightly better”, and what is “no significant benefit”.
That “slightly better mood and lower severity of depressive symptoms”, for example, has a P value of 0.004 in their data, which is an order of magnitude more significant than the usual baseline for significance (P<0.05).
And furthermore, that “no significant benefit with respect to vitality” is only looking at either the primary outcome aggregated goal or the secondary FACIT score whose secondary outcome had a P value of 0.06, which just missed the cut-off for significance, and neglects to mention that all the other secondary outcome metrics for men involved in the vitality trial were very significant (ranging from P=0.04 to P=0.001)
Click here to see the results table for the vitality trial
Will it turn me into a musclebound angry ragey ‘roidmonster?
Were you that kind of person before your testosterone levels declined? If not, then no.
Testosterone therapy seeks only to return your testosterone levels to where they were, and this is done through careful monitoring and adjustment. It’d take a lot more than (responsible) endocrinologist-guided hormonal therapy to turn you into Marvel’s “Wolverine”.
Is testosterone therapy safe?
A question to take to your endocrinologist because everyone’s physiology is different, but a lot of studies do support its general safety for most people who are prescribed it.
As with anything, there are risks to be aware of, though. Perhaps the most critical risk is prostate cancer, and…
❝In a large meta-analysis of 18 prospective studies that included over 3500 men, there was no association between serum androgen levels and the risk of prostate cancer development
For men with untreated prostate cancer on active surveillance, TRT remains controversial. However, several studies have shown that TRT is not associated with progression of prostate cancer as evidenced by either PSA progression or gleason grade upstaging on repeat biopsy.
Men on TRT should have frequent PSA monitoring; any major change in PSA (>1 ng/mL) within the first 3-6 months may reflect the presence of a pre-existing cancer and warrants cessation of therapy❞
Those are some select extracts, but any of this may apply to you or your loved one, we recommend to read in full about this and other risks:
Risks of testosterone replacement therapy in men
See also: Prostate Health: What You Should Know
Beyond that… If you are prone to baldness, then taking testosterone will increase that tendency. If that’s a problem for you, then it’s something to know about. There are other things you can take/use for that in turn, so maybe we’ll do a feature on those one of these days!
For now, take care!
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The Real Reason Most Women Don’t Lose Belly Fat
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
Notwithstanding the title, this does also go for men too, by the way—while hormones count, they count differently. People with an estrogen-based metabolism (so usually: women) will usually have more body fat, which can make it harder to get visible muscletone, for those who want that. But people with a testosterone-based metabolism (so usually: men) will have different fat storage patterns, and belly-fat is more testosterone-directed than estrogen-directed (estrogen will tend to put it more to the thighs, butt, back, breasts, etc).
So the advice here is applicable to all…
Challenges and methods
The biggest barrier to success: many people give up when results are not immediate, especially if our body has been a certain way without change for a long time.
- “Oh, I guess it’s just genetics”
- “Oh, I guess it’s just age”
- “Oh, I guess it’s just because of [chronic condition]”
…and such things can be true! And yet, in each of the cases, persisting is still usually what the body needs.
So, should we give ourselves some “tough love” and force ourselves through discomfort?
Yes and no, Lefkowith says. It is important to be able to push through some discomfort, but it’s also important that whatever we’re doing should be sustainable—which means we do need to push, while also allowing ourselves adequate recovery time, and not taking unnecessary risks.
In particular, she advises to:
- remember that at least half the work is in the kitchen not the gym, and to focus more on adding protein than reducing calories
- enjoy a regular but varied core exercise routine
- stimulate blood flow to stubborn areas, which can aid in fat mobilization
- focus on getting nutrient-dense foods
- prioritize recovery and strategic rest
For more details on these things and more, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
Visceral Belly Fat: What It Is & How To Lose It
Take care!
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Fall Asleep In 2 Minutes (Doctor Explains)
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
Beyond “sleep hygiene”, Dr. Siobhan Deshauer has insights to share:
Rest for your body and mind
First, do still do the basics. That means dimming/filtering lights for an hour before bed, lowering the room temperature a little, ensuring you have nice fresh sheets, not having alcohol or caffeine before bed, and getting out of bed if you’re not asleep within half an hour, to avoid associating being in bed with wakefulness.
Next, the extra tips:
- Progressive relaxation: tense and relax each muscle group from toes to head
- Box breathing: inhale, hold, exhale, and hold for 4 seconds each; helps calm the nervous system (it’s called “box breathing” because of the 4:4:4:4 setup)
- Diaphragmatic breathing: focus on belly breathing, with longer exhalation to activate the parasympathetic nervous system (note that this can, and even ideally should, be done at the same time as the previous)
- Cognitive shuffling: think of words starting with each letter of a chosen word while visualizing them (this is like “counting sheep”, but does the job better—the job in question being preventing your brain from moving to anything more strenuous or stressful)
For more on all of these plus some extra side-along advice, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
Non-Sleep Deep Rest: A Neurobiologist’s Take ← a way to get many of the benefits of sleep, while awake
Take care!
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Struggle To Deep Squat? It’s Probably This One Fixable Thing Holding You Back
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Deep squat, Asian squat, Slav squat, resting squat… Whatever we want to call it, many in the West struggle with it.
Nevertheless, this struggle is entirely circumstantial, very fixable, and definitely not some kind of immutable law of the universe:
A strong foundation
A proper deep squat relies on four main factors:
- Ankle dorsiflexion allows the toes to pull toward the shin.
- Hip flexion and external rotation bring the thighs close to the torso while slightly rotating outward.
- Knee flexion ensures the thighs and calves make contact.
- Maintaining the center of mass over the midfoot is essential for balance.
Correspondingly, the reason for struggling can be a case of…
- Limited ankle mobility, which prevents the knees from moving forward, shifting weight backward.
- Tight glutes and weak hip flexors making it hard to bring the torso close to the thighs, often causing people to fall backward.
- Quad tightness can also restrict depth if the thighs cannot meet the calves.
- Proportionally longer femurs than average can cause extra difficulty as the pelvis shifts further back, requiring more knee travel for balance.
However, we said “one thing”, not “four things”, so what’s the deal?
For most people, we are told in this video, ankle mobility is the biggest limiting factor in achieving a deep squat. Thus, she recommends working on that, and (at the end of this video) links to another video with specifically ankle exercises.
For all of this plus visual demonstrations, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like:
The Secret To Better Squats: Foot, Knee, & Ankle Mobility
Take care!
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Science of HIIT – by Ingrid Clay
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We previously reviewed another book in this series, Science of Yoga. This one’s about HIIT: High Intensity Interval Training!
We’ve written about HIIT before too, but our article doesn’t have the same amount of room as a book, so…
This one lays out 90 key HIIT exercises that you can do at home without special equipment. By “without special equipment”, we mean: there are a few exercises that use dumbbells, but if you don’t want to get/use dumbbells, you can improvize (e.g. with water bottles as weights) or skip those. All the rest require just your body!
The illustrations are clear and the explanations excellent. The book also dives into (as the title promises) the science of HIIT, and why it works the way it does to give results that can’t be achieved with other forms of exercise.
Bottom line: if you’ve been wanting to do HIIT but have not yet found a way of doing it that suits your lifestyle, this book gives many excellent options.
Click here to check out Science of HIIT, and level-up yours!
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Languishing – by Prof. Corey Keyes
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We’ve written before about depression and “flourishing” but what about when one isn’t exactly flourishing, but is not necessarily in the depths of depression either? That’s what this book is about.
Prof. Keyes offers, from his extensive research, hope for those who do not check enough of the boxes to be considered depressed, but who are also definitely more in the lane of “surviving” than “thriving”.
Specifically, he outlines five key ways to make the step from languishing to flourishing, based not on motivational rhetoric, but actual data-based science:
- Learn (creating your personal story of self-growth)
- Connect (building relationships, on the individual level and especially on the community level)
- Transcend (developing psychological resilience to the unexpected)
- Help (others! This is about finding your purpose, and then actively living it)
- Play (this is a necessary “recharge” element that many people miss, especially as we get older)
With regard to finding one’s purpose being given the one-word summary of “help”, this is a callback to our tribal origins, and how we thrive and flourish best and feel happiest when we have a role to fulfil and provide value to those around us)
Bottom line: if you’re not at the point of struggling to get out of bed each day, but you’re also not exactly leaping out of bed with a smile, this book can help get you from one place to the other.
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How To Clean Your Brain (Glymphatic Health Primer)
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That’s not a typo! The name “glymphatic system” was coined by the Danish neuroscientist Dr. Maiken Nedergaard, and is a nod to its use of glial cells to do a similar job to that of the peripheral lymphatic system—but this time, in the CNS. Today, we have Dr. Jin Sung to tell us more:
Brainwashing (but not like that)
The glymphatic system may sound like a boring job, but so does “sanitation worker” in a city—yet the city would grind to a messy halt very very quickly without them. Same goes for your brain.
Diseases that are prevalent when this doesn’t happen the way it should include Alzheimer’s (beta-amyloid clearance) and Parkinson’s (alpha-synuclein clearance) amongst others.
Things Dr. Sung recommends for optimal glymphatic function include: sleep (7–9 hours), exercise (30–45 minutes daily), hydration (half your bodyweight in pounds, in ounces, so if your body weighs 150 lbs, that means 75 oz of water), good posture (including the use of good ergonomics, e.g. computer monitor at right height, car seat correct, etc), stress reduction (reduces inflammatory cytokines), getting enough omega-3 (the brain needs certain fats to work properly, and this is the one most likely to see a deficit), vagal stimulation (methods include humming, gargling, and gagging—please note we said vagal stimulation; easy to misread at a glance!), LED light therapy, and fasting (intermittent or prolonged).
For more on each of these, including specific tips, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
- Ask Not What Your Lymphatic System Can Do For You…
- The Vagus Nerve (And How You Can Make Use Of It)
- Casting Yourself In A Healthier Light
- Intermittent Fasting: How Does It Work?
Take care!
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