Ageless Forever Anti-Aging News Blog

Testosterone - Men

Does Sex Boost Testosterone Levels?

Testosterone is popularly known as the “sex hormone”, with “sex” referring to both its masculinizing effects that gives rise to sex differences between men and women, as well as sex (the activity).
 
In terms of the latter, testosterone is well known for its libido boosting effect, in both men [1-4] and women [5-9] regardless of age.
 
Testosterone increases sex drive even in older women, and has thus been designated as the "infallible aphrodisiac" as early as 1940.[10]
 
But does it work the other way around also… Does sexual activity increase testosterone levels? Let’s see what research shows…
 
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Health Consequences of Subclinical Testosterone Deficiency - riskier than previously thought

 
In discussions about diagnosis and health consequences of hypogonadism, aka testosterone deficiency, the prime focus is given to testosterone levels and signs/symptoms.[1-3] However, emerging research has identified a less clinically evident gonadal dysfunction called “subclinical” hypogonadism (or “compensated” hypogonadism).[4, 5]
 
Subclinical hypogonadism is characterized by normal testosterone levels in the presence of elevated LH level. As testosterone levels are not markedly reduced in subclinical hypogonadism, intuitively one may think it does not confer negative health consequences.
 
However, a recent study by Corona et al., which specifically was conducted to investigate the potential health ramifications of subclinical hypogonadism, shows that it should not be neglected. Surprisingly, subclinical hypogonadism is associated with an almost 10-fold increased risk of cardiovascular mortality, which is comparable to that for overt hypogonadism! [6]
 
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How well informed are general practitioners and cardiologists about testosterone deficiency and its consequences?

A rapidly growing body of medical research is showing that testosterone deficiency (aka hypogonadism and low-T) is strongly associated with a wide range of detrimental health outcomes [1, 2], and that testosterone replacement therapy improves those health parameters that are negatively affected by testosterone deficiency.[2, 3]
 
Therefore, leading testosterone scientists now view testosterone deficiency as a cardiovascular risk factor that contributes to the development of cardiovascular disease.[4-7]
 
As general practitioners and cardiologists primarily care for these patients with cardiovascular disease, a survey study was conducted to assess their knowledge, beliefs and clinical practice with respect to testosterone deficiency and cardiovascular health.[8]
 
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Is hypogonadism, aka "andropause", the male version of menopause?

Many men who reach middle-age start to experience symptoms that resemble those of menopause; reduced libido, lack of energy, weight gain, fatigue, depression and osteoporosis, to name a few.[1-5]
 
Therefore these conditions are frequently seen as being equivalent, and hypogonadism (which sometimes get the prefix "late onset") has therefore been called "andropause", "male climacteric", "male menopause" or "MANopause.[6, 7] 
 
However, this is very misleading. In this article I will contrast and comment on the differences between hypogonadism, also known as testosterone deficiency, and menopause.[8]
 
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Adverse health effects of testosterone deficiency in men

 
Testosterone deficiency, also known as hypogonadism, is a state with sub-optimal circulating levels of testosterone concomitant with clinical signs and symptoms attributed to low physiological testosterone levels.[1-3] 
 
Sexual dysfunction is the most commonly recognized symptom of testosterone deficiency. However, testosterone also plays a broader role in men's health. A growing body of evidence has established associations between low testosterone levels and multiple risk factors and diseases including the metabolic syndrome, obesity, type-2 diabetes, sarcopenia, frailty, mobility limitations, osteoporosis, cognitive impairment, depression, cardiovascular disease, and reduced longevity.[3-12]
 
This summary gives an overview of the detrimental impact of testosterone deficiency on a wide range of health outcomes.[13]
 
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Low free testosterone levels and loss of muscle mass

Hypogonadism, aka testosterone deficiency or low-T, is primarily diagnosed by low total testosterone levels. However, more and more research is showing that free testosterone, which is the active fraction of total circulating testosterone, is independently associated with important health outcomes.

Levels of free testosterone decline more steeply than total testosterone as menage.[1-7 In many cases, total testosterone levels can be relatively high, but free testosterone low. Therefore it is important to assess both total and free testosterone levels in order to get a clear picture of the androgen status.

A recent study specifically assessed if baseline testosterone (total and free) levels predict muscle loss in middle-aged and elderly Japanese men over a 10 year period.[8]

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Testosterone and Diabetes in Men - is there any association?

Low levels of testosterone in men may contribute the development of insulin resistance and diabetes.[1-4] However, few studies have examined the association between testosterone levels and diabetes in men in the general population. 

An interesting study was cunducted to test the hypothesis that low normal levels of total, free, and bio-available testosterone are associated with prevalent diabetes in men.[5]

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The 20-year public health impact and direct cost of testosterone deficiency in U.S. men

Recent evidence strongly suggests that testosterone deficiency is a predisposing factor for various chronic illnesses, including cardiovascular disease, diabetes and osteoporosis.[1-3]Testosterone deficiency has also been implicated as a modifiable disease risk factor for various chronic diseases in otherwise well patients.[4-7]

Cardiovascular disease, diabetes and osteoporosis-related fractures consume a significant portion of the $2.3 trillion in annual U.S. health expenditures. The economic impact of diabetes is estimated at $503 billion, $152 billion for cardiovascular disease, and $6 billion for osteoporosis-related fractures.[8-10]

Thus, the total burden of these diseases is over $660 billion, representing approximately 29% of all U.S. health care expenditures in 2008. Since testosterone deficiency is a potentially modifiable risk factor for these and other medical conditions, it may be responsible for substantial financial and quality-of-life burden on the U.S. health care system.[11]

 A study was conducted to specifically quantify the cost burden imposed by consequences of testosterone deficiency ...[12]

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Young men can also suffer health consequences of low testosterone levels

The consequences of low testosterone levels (aka low-T) have been primarily investigated in middle-age and older men. However, low-T in young men aged 20-39 years can confer health risks as well...

 Low total testosterone levels are associated with an adverse blood lipid profile, which includes high TG and low HDL, [1, 2] and a decline in total testosterone levels predisposes men to increased risk of cardiovascular disease (CVD) and mortality.[3-7]

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Prediabetes is associated with an increased risk of testosterone deficiency, independent of obesity and metabolic syndrome.

Prediabetes is a condition in which blood glucose level is higher than normal but does not reach the level for diabetes diagnosis.[1, 2] Studies have shown that people with prediabetes tend to develop type 2 diabetes within 10 years, and are at increased risk for cardiovascular disease.[1]

Among US adults over 18 years, the prevalence of prediabetes has increased from 29.2% in 1999 to 36.2% in 2010.[3] Considering the entire US population in 2010 (approx. 309 million, data from US Cencus), this corresponds to 112 million US adults, or over one third of the US population.

Data from non-diabetic men have revealed an inverse association between insulin resistance and testosterone levels; i.e. a higher degree of insulin resistance is associated with lower testosterone levels.[4-6] This raises the question whether prediabetes, which is a state of increased insulin resistance, is also associated with low testosterone. However, few studies have investigated testosterone levels in men with prediabetes, and the risk of testosterone deficiency in men with prediabetes has not been reported.

Because the prevalence of prediabetes is affecting such a large number of Americans, and is on the rise, it is important to investigate how this condition might affect testosterone levels. Knowing that can help
detect men who are likely to have testosterone deficiency and might be at risk for health derangements caused by low-T.

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Dr. Pierce's Medical Organization Affiliations

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