Testosterone

Pineapple Enzyme Helps Athletes Bounce Back While Blunting Plunging Testosterone

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Hard training exacts harsh bodily punishment – just ask any competitive athlete. Yet a little-known natural proteolytic enzyme called bromelain, derived from pineapple stems and fruit, shows great promise easing sports recovery and maintaining masculine vitality

In a rigorous 2016 randomized, double-blind, placebo-controlled trial, researchers from New Zealand tested bromelain’s impacts on muscle damage and testosterone levels in highly trained cyclists during consecutive days of intense competition.1 They discovered the supple pineapple enzyme slashed multiple markers of exercise-induced trauma while beneficially preserving testosterone concentrations.

The human body requires adequate testosterone for proper metabolic and reproductive functioning. But extreme physical exertion often depletes circulating testosterone, contributing to fatigue, loss of vigor and impaired adaptive response.2 The enzyme bromelain displays established anti-inflammatory properties and previously reduced soreness in athletes.3 Researchers therefore theorized bromelain might also mitigate testosterone decreases following exhaustive training bouts when muscle breakdown runs high.  

Fifteen top-tier male cyclists entering a six-day professional stage race volunteered for the study. For supplementation, eight riders received 1,000 milligrams of bromelain each day, while seven Controls took visually identical placebos. Cyclists faced over 500 kilometers of grueling competition through variable weather and courses.

Blood samples were drawn before racing began and following days three and six – when cumulative demands peaked. Researchers analyzed the blood for muscle damage indicators creatine kinase (CK), lactate dehydrogenase (LDH) and myoglobin along with total testosterone levels.

As expected, CK, LDH and myoglobin concentration spiked by days three and six, signaling significant muscle trauma from consecutive all-out efforts. However testosterone plunged by day six in the placebo group, indicating stressful overtraining.

Remarkably, the bromelain-supplemented cyclists maintained testosterone concentrations throughout competition. Additionally, their fatigue ratings were significantly lower than controls by day four, when glycogen depletion and muscle breakdown take a toll.

This rigorous investigation proves the power of a little known natural enzyme – bromelain – to alleviate hard training’s bodily blowback. Counteracting exercise-induced immunological and hormonal disruption, bromelain enhanced resilience and recovery across successive days of extreme exertion.

For competitive athletes facing overtraining, bromelain boosts the ability to rebound day after day at peak intensity. But anyone engaged in demanding recreation from weekend warriors to new gym goers may benefit. Additionally, bromelain’s protective effects on testosterone make it attractive for any man seeking to preserve vitality and function during intense life stresses or advancing age.

At last, science confirms pineapple’s ancient cultural status as an esteemed medicinal fruit. Much more than a tasty snack, consuming its proteolytic enzymes directly via supplementation looks to enhance athleticism, virility and quality of life. Those recovering from injury or illness may also gain from bromelain due to improved protein breakdown and anti-inflammatory action.4

So do as top cyclists now discover – give bromelain a try to ease soreness, lift fatigue and maintain your edge. Let pineapple power propel you onward.

What Can (and Can’t) Cause Low Testosterone

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Vasectomies and masturbation don’t lower your testosterone levels

Man pouring wine.

Let’s face it: if you’ve been diagnosed with low testosterone, you’ve probably been scouring the internet for answers. Did your testosterone decrease because you spent years drinking alcohol? Do you have low testosterone because you smoke cigarettes? What about that kick to your groin you suffered during that one soccer match? Or maybe you’re worried that your low testosterone was caused by your prior vasectomy or even, masturbation.

There’s a ton of misinformation out there about low testosterone (hypogonadism). Urologist Lawrence S. Hakim, MD, debunks some of the myths and helps answer some of your most burning questions.

Does masturbation lower testosterone?

Let’s address this myth head on: no, hypogonadism is not caused by frequent masturbation or sex — and masturbation doesn’t have any long-term effects on your testosterone levels. When considering short-term effects, however, more research is needed, as several studies seem to conflict with one another.

Testosterone is linked to your sex drive and sexual performance, so participation in any sexual activity — by yourself or with a partner — will temporarily give your testosterone levels a boost before they return to regular levels after achieving orgasm. One study discovered testosterone levels were mildly higher in men after a three-week period of abstinence. But another small study suggested that frequent masturbation before strength training workouts could provide a prolonged boost in testosterone levels and assist with muscle growth, though more research is needed.

Either way you look at it, there is no proven, scientific evidence of long-term negative effects on testosterone levels from masturbation or sexual activity. So rest easy knowing it won’t harm your testosterone levels in any way.

Does a vasectomy lower testosterone?

Maybe you’ve been considering a vasectomy but haven’t quite finalized your decision yet because you’re worried about the side effects. Or maybe you’ve already been snipped and you’re wondering What if my vasectomy caused my decrease in low testosterone? Wherever you are on that journey to understanding the ins and outs of this simple and potentially reversible procedure, you should know that a vasectomy doesn’t impact your testosterone levels at all.

“People might mistakenly think of a vasectomy as removing the testicles, but you’re not removing the testicles — you’re performing a procedure to disrupt the flow of semen from the testicles to the urethra,” says Dr. Hakim. “A vasectomy has zero impact on testosterone production.”

Does soy lower testosterone?

Relax. You don’t have to cut back on your grande iced triple-shot espresso caramel macchiatos with soy milk (unless of course you’re worried about the effects of caffeine on your overall health).

Soy is a plant-based protein found in edamame, tofu, whole soybeans and a whole host of baked goods. Unfortunately, there’ve been longstanding rumors that consuming soy can lower your testosterone levels and increase estrogen levels. It’s true that a healthy diet can impact your testosterone levels in that it keeps your body optimized to carry out various biological functions — and an increased BMI (body mass index) is often linked to low testosterone. But research into the effects soy has on testosterone levels are conflicting.

One study from 2007 that examined 12 men ages 25 to 47 discovered that consuming soy protein powder over the course of 4 weeks led to a decrease in testosterone — levels that eventually increased to normal within 2 weeks of discontinuing soy protein powder use.

But another study that analyzed findings from 41 peer-reviewed reports published from 2010 to April 2020 revealed that there were no significant effects on testosterone levels caused by soy and phytoestrogens (plant-derived estrogen-like compounds).

So while it appears that soy in excess may have some minimal effect on short-term testosterone levels, indulging in bowls of edamame won’t weaken your reserve of testosterone to the point of hypogonadism — or erectile dysfunction, for that matter.

Does smoking or drinking alcohol lower testosterone?

This one is a bit more nuanced. There are conflicting studies concerning the effect of smoking on testosterone levels. A 2021 study from Egypt demonstrated that serum testosterone levels among smokers were significantly lower compared with nonsmokers. This confirmed earlier studies revealing a significant decrease in total testosterone levels among smokers compared to nonsmokers. While the exact mechanism is unknown, researchers have hypothesized that smoking lowers testosterone levels as a result of damaging Leydig cells in your testicles, which are responsible for testosterone production.

However, other studies have found higher testosterone levels among smokers. Researchers have developed several theories for this, one of which suggests that this increase may be related to smokers having increased levels of sex-hormone-binding globulin (a protein that binds to testosterone and controls how much your body can use).

Even though the exact mechanism of elevated testosterone levels in smokers is not known, there is some concern that the temporary boost or “false elevation” in testosterone levels from smoking may actually be masking undiagnosed hypogonadism.

We do know that smoking often has a negative effect on erectile function because of damage to your blood vessels and the development of atherosclerosis (hardening of your arteries). Smoking can also lead to damage to your heart and lungs.

“Either directly or indirectly, smoking does affect sexual and overall general health,” says Dr. Hakim.

And alcohol functions similarly — excessive alcohol not only lowers your testosterone, but it can decrease your overall libido and cause a variety of other issues that puts additional stress on your body. Excessive alcohol use can lead to damage to the Leydig cells in your testes and may also interfere with the release of certain hormones that affect your testosterone production.

In general, you want to participate in activities that promote a healthy lifestyle because it reduces the overall stress your body is required to handle. And any activity that promotes good health will be beneficial to your biological functions, like producing testosterone and other hormones.

“Anything that negatively affects overall health can diminish testosterone levels,” says Dr. Hakim. “Smoking and excessive alcohol use are controllable factors that you want to eliminate or at least decrease significantly.”

Does titanium dioxide lower testosterone?

Titanium dioxide is a controversial topic at the moment. This white, fine, mineral powder is used in a variety of everyday products — from sunscreens and cosmetics to plastics, food colorants and toothpaste. The inorganic compound is used most often to provide a whiter, bright pigment to products. While the U.S. Food and Drug Association allows this compound to be added to food in the U.S., titanium dioxide was recently banned as a food additive by the European Commission, citing its ability to cause damage to your DNA.

Many concerns regarding titanium dioxide revolve around its potential to be carcinogenic, but what does it do to your testosterone levels? The answer is: we just don’t know enough yet. One small model study showed titanium dioxide caused a decrease in testosterone synthesis, but more research is needed to determine just how titanium dioxide affects testosterone levels in humans. Until we know more, some researchers suggest limiting your intake of titanium dioxide whenever possible.

What else can affect testosterone levels?

So, now that we debunked some popular myths and shed light on others, what exactly does cause testosterone levels to drop?

For adult men and people assigned male at birth (AMAB), healthy testosterone levels normally range from 250 nanograms per deciliter (NG/dL) to 800 NG/dL. Typically, levels below 250-300 NG/dL are considered low or ‘hypogonadal.’

“There are many factors at play that have an impact on testosterone production and men with hypogonadism often present with many different signs or symptoms,” says Dr. Hakim. “It is important to understand the underlying cause so that we know how to treat it.”

Testosterone belongs to a group of sex hormones called androgens that are responsible for starting puberty, the development of your sexual reproductive system and your ability to reproduce. Testosterone is produced by all genders, but when there are low levels of testosterone in men or people AMAB, it can have a number of negative side effects that include:

“In some ways, the symptoms of low testosterone can be similar to what women experience when they begin menopause,” says Dr. Hakim. “These may include hot flashes, loss of facial hair or loss of bone mass, too.”

While testosterone levels may decrease naturally as we get older, the causes of low testosterone can be split into two categories: primary hypogonadism (which involves testicular injury) and secondary hypogonadism (which means your body isn’t producing enough testosterone likely because of interference from your hypothalamus and pituitary gland).

There is also a common clinical scenario in men who present with low testosterone levels and associated signs and symptoms. This syndrome is different from primary or secondary hypogonadism because it may have elements of both. The Sexual Medicine Society of North America has defined this syndrome as adult-onset hypogonadism (AOH) because it occurs commonly in middle-aged and older men.

Primary hypogonadism

Primary hypogonadism refers to a testicular injury or malfunction of some kind that causes a disruption of your testicles’ ability to produce testosterone. These causes can be genetic or acquired later in life through viral or bacterial infections, direct injuries or by other means like chemotherapy or radiation.

“Primary testicular failure is typically due to a problem within the testicles itself,” says Dr. Hakim.

Secondary hypogonadism

With secondary hypogonadism, your testicles may be normal, but are incapable of producing enough testosterone, possibly due to interference from your hypothalamus and pituitary gland. Located in your brain, your hypothalamus and pituitary gland help regulate your production of hormones. The causes of interference or disruption can also be genetic or acquired later in life either through lifestyle choices or other underlying conditions. Some of the most common causes of secondary hypogonadism include:

When to see a doctor

Understanding your low testosterone or hypogonadism diagnosis can be frustrating, but once you sift through all the misinformation and you talk to your doctor about your concerns, there are a variety of treatments that can help restore your testosterone levels and start you on the road to recovery.

Remember, if you experience any physical symptoms, fatigue, poor energy levels, a lack of libido or you’re just concerned about your own testosterone levels, it’s never too early to see your doctor for a checkup.

Can foods lower testosterone?

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Some people claim that certain foods, such as soy, dairy, and specific fats, can lower testosterone levels in the body. However, research into testosterone-lowering foods is limited.

A person can also increase testosterone levels naturally by exercising regularly and maintaining a moderate weight.

The food an individual eats can affect many aspects of health. Food powers the cells and may affect some of the body’s other components, including hormones such as testosterone.

This article explores whether diet can lower testosterone and which foods may affect it.

A note about sex and gender

Sex and gender exist on spectrums. This article will use the terms “male,” “female,” or both to refer to sex assigned at birth. Click here to learn more.

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Can diet and food affect testosterone levels?

loaf of bread

Testosterone is one of the major sex hormones in the body. Although males produce more testosterone, it is also an important hormone for females. Testosterone promotes an increase in:

  • muscle mass
  • bone mass
  • body hair

Typically, the body does an effective job regulating the hormones and keeping levels of testosterone where they need to be.

Some individuals claim that an excess of certain foods may interfere with this process, resulting in a hormonal imbalance. People who have concerns about their testosterone levels might choose to limit the following foods.

However, it is important to note that the research regarding food’s ability to lower testosterone levels is limited. As the current evidence exists, it is not possible to draw strong conclusions about the following foods and testosterone levels.

1. Soy products

Soy foods, such as tofu, edamame, and soy protein isolates, contain phytoestrogens. These compounds are physically similar to the estrogen in the body and function in a similar way.

An older 2014 paperTrusted Source noted that although scientists have conducted much research into soy, they still do not understand it fully.

The author notes that many studies have not found a connection between eating soy products and altered serum testosterone or estrogen levels.

In fact, a 2021 meta-analysis concludes that neither soy nor phytoestrogens have any effect on testosterone levels. A technical review the same year confirms there is no evidence supporting the claim that phytoestrogens disrupt the human endocrine system.

2. Alcohol

Anyone with concerns about their testosterone levels might also consider giving up or limiting alcohol. This may be especially true for males.

While some studies have found evidence that a small amount of alcohol increases testosterone levels in males, this is generally not the case. As a 2017 review notes, heavy drinking or regular drinking over long periods causes a decreaseTrusted Source in testosterone in men.

The paper also notes that alcohol consumption causes an increase in testosterone levels in females.

Learn more about alcohol and testosterone.

3. Mint

The menthol in mint may reduce testosterone levels, but there is a lack of human research to support this.

According to a 2017 study, scientists treated female rats with polycystic ovarian syndrome (PCOS) with spearmint essential oil to test its effects on the disorder. Researchers noted that spearmint essential oil reduced testosterone levelsTrusted Source in these rats.

An older 2014 reviewTrusted Source also noted that there is some high quality evidence showing that mint lowers testosterone levels in women with PCOS.

However, there is not enough high quality evidence surrounding the effect of the herb in general, particularly on males who have concerns about their testosterone levels.

Most of the research on the topic focuses on animal models or females. Future studies should investigate the effects of mint on both sexes to get a better overall picture.

4. Bread, pastries, and desserts

A 2018 studyTrusted Source linked a diet high in bread, pastries, and other desserts to low total testosterone levels in Taiwanese men. Additional factors included high dairy consumption, dining out regularly, and not eating enough dark green vegetables.

According to the research, these participants also had decreased muscle mass and increased body fat.

5. Licorice root

A 2018 studyTrusted Source references that licorice root can reduce testosterone in healthy women during menstrual cycles. Animal studies also show that licorice supplementation can lower testosterone levels.

Ideally, any future studies would look into the effects of licorice on both sexes to better understand how the herb acts in general.

6. Certain fats

The type of fat a person eats may also affect their testosterone levels and function. A 2017 study looked at the dietary patterns of young, healthy men in regard to their hormone levels and testicular function.

The research indicated that eating trans fats may lowerTrusted Source testosterone levels in the body. They also found that too many omega-6 fatty acids appear to reduce testicular size and function.

However, eating plenty of polyunsaturated omega-3 fatty acids may increase testicle size and improve function. The researchers called for more studies to confirm their findings, but people concerned about their testosterone levels may want to avoid trans fats and limit omega-6 fats.

Other factors

Other factors that may influence hormone imbalances or low testosterone include:

How to increase testosterone naturally

There may also be some ways to boost testosterone naturally, including:

Frequently asked questions

Does nicotine affect testosterone levels?

It is unclear whether nicotine affects testosterone. Studies have found either no effect, increased testosterone in smokers, or the opposite.

Does masturbating reduce testosterone?

No, masturbating does not reduce testosterone levels.

Which nuts decrease testosterone?

Despite common beliefs that certain nuts decrease testosterone, there is very little scientific evidence to support this. More research is necessary.

Summary

Diet and exercise play an essential role in maintaining health and keeping the hormones balanced. Some people claim that certain foods — especially soy — may reduce testosterone levels in the body.

However, studies largely show a lack of evidence for these claims. Nevertheless, anyone concerned about their testosterone levels may want to limit these foods.

Anxiety and Testosterone Linked to Brain Receptor

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Summary: A new study identified a crucial link between anxiety disorders and the brain receptor TACR3, as well as testosterone. This groundbreaking research found that rodents with high anxiety had low TACR3 levels in the hippocampus, a key area for learning and memory.

Notably, the study showed that testosterone deficiency-related anxiety could be addressed by targeting TACR3. This discovery opens new therapeutic possibilities for treating anxiety disorders, especially in individuals with hypogonadism.

Key Facts:

  1. The research found a significant correlation between low levels of TACR3 in the hippocampus and heightened anxiety in male rodents.
  2. TACR3 deficiency and low testosterone levels are closely linked, suggesting a potential pathway for treating anxiety disorders.
  3. The study employed innovative tools like FORTIS and cross-correlation in multi-electrode arrays, advancing understanding of synaptic plasticity and its role in anxiety.

Source: Ben-Gurion University

A groundbreaking study has unveiled a significant link between anxiety disorders and a brain receptor known as TACR3, as well as testosterone.

Prof. Shira Knafo, head of the Molecular Cognitive Lab at Ben-Gurion University, led the research published last month in the journal Molecular Psychiatry.

Anxiety is a common response to stress, but for those dealing with anxiety disorders, it can significantly impact daily life. Clinical evidence has hinted at a close connection between low testosterone levels and anxiety, particularly in men with hypogonadism, a condition characterized by reduced sexual function. However, the precise nature of this relationship has remained unclear until now.

Prof. Knafo discovered male rodents exhibiting exceedingly high anxiety levels had notably lower levels of a specific receptor called TACR3 in their hippocampus. The hippocampus is a brain region closely associated with learning and memory processes. TACR3 is part of the tachykinin receptor family and responds to a substance known as neurokinin.

This observation piqued the researchers’ curiosity and was the foundation for an in-depth investigation into the link between TACR3 deficiency, sex hormones, anxiety, and synaptic plasticity.

The rodents were classified based on their behavior in a standard elevated plus maze test measuring anxiety levels. Subsequently, their hippocampi were isolated and underwent gene expression analysis to identify genes with varying expressions between rodents with extremely low anxiety and those with severe anxiety.

One gene that stood out was TACR3. Previous research had revealed that mutations in genes associated with TACR3 led to a condition known as “congenital hypogonadism,” resulting in reduced sex hormone production, including testosterone. Notably, young men with low testosterone often experienced delayed sexual development, accompanied by depression and heightened anxiety. This pairing led researchers to investigate the role of TACR3 further.

Prof. Knafo and her team were aided in their research by two innovative tools they crafted themselves. The first, known as FORTIS, detects changes in receptors critical for neuronal communication within living neurons. By utilizing FORTIS, they demonstrated that inhibiting TACR3 resulted in a sharp increase in these receptors on the cell surface, blocking the parallel process of long-term synaptic strengthening, known as LTP.

The second pioneering tool employed was a novel application of cross-correlation to measure neuronal connectivity within a multi-electrode array system. This tool played a pivotal role in uncovering the profound impact of TACR3 manipulations on synaptic plasticity.

Synaptic plasticity refers to the ability of synapses, the connections between brain cells, to change their strength and efficiency. This dynamic process is fundamental for the brain’s adaptation to the environment. Through synaptic plasticity, the brain can reorganize its neural circuitry in response to new experiences.

This flexibility allows for the modification of synaptic connections, enabling neurons to strengthen or weaken their communication over time. Essentially, synaptic plasticity is a key mechanism by which the brain encodes and stores information, adapting continuously to the ever-changing external stimuli and internal states.

Importantly, it revealed that deficiencies stemming from TACR3 inactivity could be efficiently rectified through testosterone administration, offering hope for novel approaches to address challenges related to anxiety associated with testosterone deficiency.

TACR3 is seemingly a central player in bridging anxiety and testosterone. The researchers have unraveled the complex mechanisms behind anxiety and opened avenues for novel therapies, including testosterone treatments, that could improve the quality of life for individuals grappling with sexual development disorders and associated anxiety and depression.

Prof. Knafo is a member of the Department of Physiology and Cell Biology in the Faculty of Health Sciences as well as The National Institute for Biotechnology in the Negev.

Abstract

Interplay between hippocampal TACR3 and systemic testosterone in regulating anxiety-associated synaptic plasticity

Tachykinin receptor 3 (TACR3) is a member of the tachykinin receptor family and falls within the rhodopsin subfamily. As a G protein-coupled receptor, it responds to neurokinin B (NKB), its high-affinity ligand. Dysfunctional TACR3 has been associated with pubertal failure and anxiety, yet the mechanisms underlying this remain unclear. Hence, we have investigated the relationship between TACR3 expression, anxiety, sex hormones, and synaptic plasticity in a rat model, which indicated that severe anxiety is linked to dampened TACR3 expression in the ventral hippocampus.

TACR3 expression in female rats fluctuates during the estrous cycle, reflecting sensitivity to sex hormones. Indeed, in males, sexual development is associated with a substantial increase in hippocampal TACR3 expression, coinciding with elevated serum testosterone and a significant reduction in anxiety. TACR3 is predominantly expressed in the cell membrane, including the presynaptic compartment, and its modulation significantly influences synaptic activity.

Inhibition of TACR3 activity provokes hyperactivation of CaMKII and enhanced AMPA receptor phosphorylation, associated with an increase in spine density. Using a multielectrode array, stronger cross-correlation of firing was evident among neurons following TACR3 inhibition, indicating enhanced connectivity.

Deficient TACR3 activity in rats led to lower serum testosterone levels, as well as increased spine density and impaired long-term potentiation (LTP) in the dentate gyrus. Remarkably, aberrant expression of functional TACR3 in spines results in spine shrinkage and pruning, while expression of defective TACR3 increases spine density, size, and the magnitude of cross-correlation.

The firing pattern in response to LTP induction was inadequate in neurons expressing defective TACR3, which could be rectified by treatment with testosterone. In conclusion, our study provides valuable insights into the intricate interplay between TACR3, sex hormones, anxiety, and synaptic plasticity.

These findings highlight potential targets for therapeutic interventions to alleviate anxiety in individuals with TACR3 dysfunction and the implications of TACR3 in anxiety-related neural changes provide an avenue for future research in the field.

Testosterone Treatment and Fractures in Men with Hypogonadism

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Abstract

Background

Testosterone treatment in men with hypogonadism improves bone density and quality, but trials with a sufficiently large sample and a sufficiently long duration to determine the effect of testosterone on the incidence of fractures are needed.

Methods

In a subtrial of a double-blind, randomized, placebo-controlled trial that assessed the cardiovascular safety of testosterone treatment in middle-aged and older men with hypogonadism, we examined the risk of clinical fracture in a time-to-event analysis. Eligible men were 45 to 80 years of age with preexisting, or high risk of, cardiovascular disease; one or more symptoms of hypogonadism; and two morning testosterone concentrations of less than 300 ng per deciliter (10.4 nmol per liter), in fasting plasma samples obtained at least 48 hours apart. Participants were randomly assigned to apply a testosterone or placebo gel daily. At every visit, participants were asked if they had had a fracture since the previous visit. If they had, medical records were obtained and adjudicated.

Results

The full-analysis population included 5204 participants (2601 in the testosterone group and 2603 in the placebo group). After a median follow-up of 3.19 years, a clinical fracture had occurred in 91 participants (3.50%) in the testosterone group and 64 participants (2.46%) in the placebo group (hazard ratio, 1.43; 95% confidence interval, 1.04 to 1.97). The fracture incidence also appeared to be higher in the testosterone group for all other fracture end points.

Conclusions

Among middle-aged and older men with hypogonadism, testosterone treatment did not result in a lower incidence of clinical fracture than placebo. The fracture incidence was numerically higher among men who received testosterone than among those who received placebo

Testosterone Tx Improves Anemia in Male Hypogonadism

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Testosterone replacement therapy (TRT) is more effective than placebo in both correcting anemia and preventing anemia in middle-aged and older men with hypogonadism, according to a new analysis published online in JAMA Network Open.

The analysis comes from a randomized, placebo-controlled trial that included 5,204 men with hypogonadism at 316 U.S. sites. This study was nested within the Testosterone Replacement Therapy for Assessment of Long-term Vascular Events and Efficacy Response in Hypogonadal Men (TRAVERSE) Study. That study looked at whether TRT had an effect on major cardiovascular events and results were published earlier this year in the New England Journal of Medicine.

Hypogonadism increases with age

Hypogonadism includes specific symptoms in addition to a low testosterone level and has a lower prevalence (about 6%-12% vs. about 25% with low testosterone alone) in men 40-70 years old in the Massachusetts Male Aging Study (MMAS). But it is still common and increases with age, note authors of the current study, led by Karol M. Pencina, PhD, with the Research Program in Men’s Health: Aging and Metabolism, at Brigham and Women’s Hospital and Harvard Medical School, Boston.

Symptoms of hypogonadism include lower libido, erectile dysfunction, fatigue, reduced muscle mass, poor concentration, and disturbed sleep.

No approved treatment

Currently, there is no approved treatment for unexplained anemia during aging and nearly 15% of older men with hypogonadism experience anemia, the authors explain.

The proportion of participants whose anemia was corrected was significantly higher in the TRT group than the placebo group at 6 months (143 of 349 [41.0%] vs. 122 of 360 [27.5%]), 12 months (45.0% vs. 33.9%), 24 months (42.8% vs. 30.9%), 36 months (43.5% vs. 33.2%), and 48 months (44.6% vs. 39.2%); omnibus test P = .002.

A second aim in the study was to determine the effect of TRT on the development of anemia in participants who did not have anemia at enrollment.

In that group, a significantly smaller proportion of participants in the treatment group developed anemia, compared with the placebo group at 6 months (143 of 1,997 [7.2%] vs. 203 of 1,958 [10.4%]), 12 months (7.1% vs. 9.0%), 24 months (10.0% vs. 12.3%), 36 months (10.0% vs. 12.9%), and 48 months (9.0% vs 10.2%); omnibus test P  = .02.

The men in the study had an average age of 64.8; 66.7% were White; 30.3% were Black; 2% were other.

Clinical implications

Shabbir M. H. Alibhai, MD, MSc, with the Institute of Health Policy, Management, and Evaluation, Institute of Medical Sciences, department of medicine, University of Toronto, writes in an invited commentary that this is one of the largest trials of TRT and was well-designed and executed. He points out that it had a long follow-up (mean duration on TRT was more than 20 months).

Given the results, he says, “TRT appears to be generally safe in middle-aged and older men with symptomatic hypogonadism, corrected mild anemia in 10%-15% of recipients, and prevented anemia in 2%-3%, with small improvements in energy but no effect on self-reported cognitive function.”

He said that without further details on long-term benefit, “I would not offer TRT primarily to treat asymptomatic normocytic anemia in men with low testosterone levels. It is reasonable to offer TRT to men with symptomatic hypogonadism regardless of hemoglobin level.”

He advises counseling patients that they could see small increases in hemoglobin levels with TRT, with a small boost in energy if they had anemia, but the effect on cognition, well-being, or function is unclear.

He further advised, “Hemoglobin levels should be monitored in men starting TRT (to detect the development of polycythemia), and prostate-specific antigen levels should be normal prior to start of treatment. Of course, a basic workup for causes of anemia, guided by history and basic parameters such as the mean corpuscular volume and blood film, should be performed in all men with anemia regardless of levels.”

Kisspeptin injection could treat low libido, bring back desire for men and women

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A new hormone injection could treat low sex drive in both women and men, according to researchers in the United Kingdom. A team from Imperial College London says kisspeptin can boost sexual responses in men and women suffering distress as a result of their low libido.

Two studies, both published in JAMA Network Open, show that giving patients kisspeptin can boost sexual responses in people who have hypoactive sexual desire disorder (HSDD) – a condition where patients experience psychological distress due to their low sexual desire. Women taking part in the trial reported feeling “more sexy” during the kisspeptin treatment.

HSDD affects up 10 percent of women and roughly one in 12 men worldwide. It can have “devastating” psychological and social impacts. Study authors explain that kisspeptin is a naturally-occurring hormone which stimulates the release of other reproductive hormones in the body. The team previously demonstrated that kisspeptin can enhance responses to sexual stimuli and boost attraction brain pathways independent of other reproductive hormones like testosterone in men with intact sexual desire. Now, they’re investigating the effects in women and men with low sexual desire for the first time.

The two clinical trials involved 32 pre-menopausal women between the ages of 19 and 48, and 32 men with HSDD. In both studies, researchers scanned participants using brain MRI imaging, as well as blood and behavioral tests. Taking kisspeptin improved sexual brain processing in both women and men. This resulted in positive boosts in each person’s sexual behavior compared to those who did not receive the injections.

The clinical trials are the first to explore the ability of kisspeptin to boost sexual pathways in people suffering distress from low libido. The researchers believe that the results provide the groundwork for kisspeptin-based therapies for people with HSDD.

“Low sexual desire can be distressing and so result in HSDD. This can have a major detrimental impact on relationships, mental health, and fertility. Even though it is relatively common, treatment options in women are limited, carry significant side-effects and in some cases can be harmful to even try. And unfortunately, these treatments have limited effectiveness. In men there are currently no licensed treatments and none on the horizon. Therefore, there is a real unmet need to find new, safer and more effective therapies for this distressing condition for both women and men seeking treatment,” says Dr. Alexander Comninos from the Department of Metabolism, Digestion and Reproduction at Imperial College London in a media release.

“Our two studies provide proof-of-concept for the development of kisspeptin treatments, as we provide the first evidence that kisspeptin is a potentially safe and effective therapy for both women and men with distressing low sexual desire,” Dr. Comninos continues.

“Additionally in men, we demonstrate that kisspeptin can have positive effects not only in the brain but also in the penis by increasing rigidity. Furthermore, kisspeptin was well-tolerated by both women and men with no side-effects reported, which is crucial from a drug development point of view. We now plan to take things forward to hopefully realize the potential of kisspeptin therapeutics in psychosexual disorders – sexual problems which are psychological in origin, such as unexplained low libido.”

“Our studies build on our previous work to assess the effectiveness of kisspeptin and its boosting effects in terms of arousal and attraction. It is highly encouraging to see the same boosting effect in both women and men, although the precise brain pathways were slightly different as might be expected,” adds Professor Waljit Dhillo, an NIHR Senior Investigator and co-senior study author.

“Collectively, the results suggest that kisspeptin may offer a safe and much-needed treatment for HSDD that affects millions of people around the world and we look forward to taking this forward in future larger studies and in other patient groups.”

The treatment creates more ‘happiness about sex’

During kisspeptin or placebo treatments, female participants underwent functional MRI scans while watching erotic videos and viewing male faces to see how these videos affected brain activity. Non-erotic exercise videos served as a control in the experiment. The team found that kisspeptin improved sexual and attraction brain activity in key brain areas in women.

Results also show that women suffering from distress due to low sexual function had greater kisspeptin-enhanced brain activity in the hippocampus — a key structure that scientists say plays a role in female sexual desire. Researchers found that the more kisspeptin activated the posterior cingulate cortex — another key behavioral brain area — when participants saw attractive male faces, the less sexual aversion the women had.

In the second study, 32 heterosexual men between 21 and 52 with HSDD underwent a similar study. However, the team also measured penile rigidity between January and September 2021. The study demonstrated that kisspeptin significantly boosted brain activity in the “sexual brain network,” while also increasing penile rigidity by up to 56 percent in comparison to taking a placebo.

Similar to the study with women, kisspeptin had greater effects in key brain regions in men who were more distressed by their low sexual desire. Psychometric analyses reveal that kisspeptin improved “happiness about sex” among men.

What do the patients say about the treatment?

“I got involved in the trial because I had previous problems with my sexual appetite and performance,” says a 44-year-old man named “Peter,” who took part in the trails.

“The issue had always been detrimental to sustaining relationships. I would often make excuses as to why my sexual appetite was low. For example, I would blame stress at work or tiredness as a reason instead of being honest. I had tried other performance supporting medication like Viagra. However, this proved ineffective as the issue was simply one of low desire. It was highly embarrassing and not something I felt able to talk to my previous partners about. I feared they would confuse it with lack of attraction to them,” the trial participant continues.

“I was keen to learn whether there was a solution to my problem and learn more about my condition.”

“I received the kisspeptin infusion in June 2021 and I noticed a difference in terms of my sexual desire. The week I had the kisspeptin infusion we conceived our son, who was born in March 2022. I had the best possible outcome as a result of the trial.”

“I also learnt a lot more about myself and my condition. I am really pleased to have contributed to this trial, which has been life-changing for me. I’m glad that others in a similar position could benefit from the treatment.”

“I took part in the trial as I was experiencing low sexual libido. Initially, I put it down to having small children and being exhausted as a result. However, this continued and started to impact my wellbeing. I wanted to see whether there was another reason for why I was feeling this way,” adds another trial participant and 43-year-old mom named “Eve.”

“I had two study visits in 2020 where I received the placebo and the kisspeptin infusions without knowing which one I was getting at the time. I did notice a bit of a difference once I received the kisspeptin infusion and it was fascinating to be part of the process,” Eve adds.

“I am glad that I took part in the study as many women wouldn’t like to admit they are experiencing this and may not seek help. I’m glad to know that kisspeptin could be a treatment option for other women.”

Dr. Comninos and Prof. Dhillo now plan larger studies in order to develop kisspeptin as a realistic treatment for both men and women dealing with sexual disorders.

What happens when a woman has low testosterone?

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A female’s testosterone levels fluctuate throughout life, the menstrual cycle, and at different times of the day. Low testosterone levels can affect the production of new blood cells, sex drive, and other hormone levels.

Testosterone belongs to a group of hormones known as androgens. Testosterone levels affect fertility, sex drive, red blood cell production, muscle mass, and fat distribution.

Many people think of testosterone as a male sex hormone, but everyone requires a certain amount. While males have more testosterone than females, female adrenal glands and ovaries produce small amounts of this hormone.

This article explains when doctors may consider testosterone levels low in a female as well as the symptoms, causes, and treatments for low testosterone.

A note about sex and gender

Sex and gender exist on spectrums. This article will use the terms “male,” “female,” or both to refer to sex assigned at birth. Click here to learn more.

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What is low testosterone in females?

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At this time, there are no conclusive guidelines for what should be considered “low” testosterone levels in females.

According to the United Kingdom’s National Health Service (NHS), testosterone levels in a female typically decrease throughout life.

Healthcare professionals consider a person’s symptoms when diagnosing low testosterone levels, but they may need to take a blood test for a conclusive diagnosis.

Symptoms

Low testosterone can cause one or more of the following symptoms in females:

However, many females with low testosterone levels do not experience these symptoms.

Because the symptoms linked to low testosterone are so common and can be vague, a doctor looks for signs of other issues or conditions before making a diagnosis.

A doctor may check for:

Causes

The two main causes of low testosterone are:

  • diminishing levels of the hormone as a normal result of menopause and aging
  • problems with the ovaries or the pituitary or adrenal glands

Testosterone naturally decreasesTrusted Source as a female ages. Levels of other hormones, such as estrogen, also reduce over time, especially when menopause starts.

Around the time that menopause begins, a female may be more likely to have less testosterone because the ovaries are producing less hormones.

Also, medications that address the side effects of menopause can lower testosterone levels. One such medication is oral estrogen.

Problems with the ovaries and adrenal glands can also cause lower levels of testosterone. A female may have lower levels after removal of the ovaries, for example, or if they have adrenal insufficiency. This means the adrenal glands do not work correctly.

Diagnosis

There is currently a lack of research into the treatment of low testosterone in females. Many doctors are much more concerned about high testosterone levels.

In 2014, a task force of healthcare organizations recommended against routinely measuring testosterone levels in females, as research has yet to prove a link between testosterone levels and symptoms.

If a female reports any of the symptoms listed above, a doctor will likely check for other, more common conditions first.

To diagnose low testosterone in females, a doctor starts with a physical exam and asks about any symptoms. If the doctor suspects low testosterone, they order a blood test.

If a female has not yet reached menopause, the doctor is likely to advise on the best time to test testosterone levels. This is because they fluctuate throughout the menstrual cycle.

Treatment

Some estrogen replacement drugs contain testosterone. However, the quantity of testosterone in the medication may not be enough to raise levels, or the body may not be able to absorb them sufficiently.

A doctor may administer testosterone injections or pellets, expecting these treatments to have the same effect on females as on males: raising energy levels, decreasing fatigue, and increasing sex drive.

However, many doctors advise females not to take testosterone. Likewise, the Food and Drug Administration (FDA) has approved fewTrusted Source testosterone-based treatments for females.

Although the treatment is typically safeTrusted Source, further research into the long-term effects is necessary. The side effects can include:

A 2020 articleTrusted Source suggests doctors may prescribe testosterone to menopausal females with low sexual desire if hormone replacement therapy alone is not effective in relieving symptoms.

Alternative therapies

A doctor may also recommend alternative therapies to treat the symptoms of low testosterone in females. These treatments and lifestyle strategies can include:

DHEA is a steroid hormone that comes from the adrenal glands. However, researchers have yet to prove that supplementation is safe and effective in the long term.

The side effects of DHEA supplementation can be similar to those of too much testosterone.

Summary

Doctors and researchers still do not fully understand how low testosterone levels affect females or how best to treat the deficiency.

Testosterone levels change as a person ages, and they may drop as a female approaches menopause. If a female experiences symptoms of low testosterone, the results of a blood test can help a doctor make a diagnosis.

Never take testosterone replacement therapy without a doctor’s recommendation. Supplements and replacement therapies may cause more unpleasant side effects than they relieve.

Safety and efficacy of testosterone for women: a systematic review and meta-analysis of randomised controlled trial data

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The benefits and risks of testosterone treatment for women with diminished sexual wellbeing remain controversial. We did a systematic review and meta-analysis to assess potential benefits and risks of testosterone for women.

Methods

We searched MEDLINE, Embase, the Cochrane Central Register of Controlled Trials, and Web of Science for blinded, randomised controlled trials of testosterone treatment of at least 12 weeks’ duration completed between Jan 1, 1990, and Dec 10, 2018. We also searched drug registration applications to the European Medicine Agency and the US Food and Drug Administration to identify any unpublished data. Primary outcomes were the effects of testosterone on sexual function, cardiometabolic variables, cognitive measures, and musculoskeletal health. This study is registered with the International Prospective Register of Systematic Reviews (PROSPERO), number CRD42018104073.

Findings

Our search strategy retrieved 46 reports of 36 randomised controlled trials comprising 8480 participants. Our meta-analysis showed that, compared with placebo or a comparator (eg, oestrogen, with or without progestogen), testosterone significantly increased sexual function, including satisfactory sexual event frequency (mean difference 0·85, 95% CI 0·52 to 1·18), sexual desire (standardised mean difference 0·36, 95% CI 0·22 to 0·50), pleasure (mean difference 6·86, 95% CI 5·19 to 8·52), arousal (standardised mean difference 0·28, 95% CI 0·21 to 0·35), orgasm (standardised mean difference 0·25, 95% CI 0·18 to 0·32), responsiveness (standardised mean difference 0·28, 95% CI 0·21 to 0·35), and self-image (mean difference 5·64, 95% CI 4·03 to 7·26), and reduced sexual concerns (mean difference 8·99, 95% CI 6·90 to 11·08) and distress (standardised mean difference −0·27, 95% CI −0·36 to −0·17) in postmenopausal women. A significant rise in the amount of LDL-cholesterol, and reductions in the amounts of total cholesterol, HDL-cholesterol, and triglycerides, were seen with testosterone administered orally, but not when administered non-orally (eg, by transdermal patch or cream). An overall increase in weight was recorded with testosterone treatment. No effects of testosterone were reported for body composition, musculoskeletal variables, or cognitive measures, although the number of women who contributed data for these outcomes was small. Testosterone was associated with a significantly greater likelihood of reporting acne and hair growth, but no serious adverse events were recorded.

Interpretation

Testosterone is effective for postmenopausal women with low sexual desire causing distress, with administration via non-oral routes (eg, transdermal application) preferred because of a neutral lipid profile. The effects of testosterone on individual wellbeing and musculoskeletal and cognitive health, as well as long-term safety, warrant further investigation.

5 Proven Ways to Boost Testosterone Naturally

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The alternative path is to support the body's natural production of testosterone both by removing testosterone-blocking chemicals and supporting one's own body's ability to produce more testosterone endogenously.(Shutterstock)

The alternative path is to support the body’s natural production of testosterone both by removing testosterone-blocking chemicals and supporting one’s own body’s ability to produce more testosterone endogenously.(Shutterstock)

Boosting testosterone has become all the rage today, but unless you activate your body’s innate ability to do it naturally you will have to face the possibility of serious side effects.

As men reach their mid-forties their testosterone levels begin to decline, with approximately a 1 to 2 percent decrease in measurable blood levels annually, and then dropping off precipitously after age 60 into full blown “andro-pause.”  This ever-increasing decline can have a wide range of adverse effects, both physically and psychologically, ranging from muscle loss to insulin resistance and low libido to depression.

Today, an increasing number of aging men are opting for testosterone replacement therapy, some with dramatic results. But this approach, while often positive in the short term, can have some serious drawbacks in the long term, especially if the underlying and modifiable factors causing the deficiency are not addressed at their root.

First, testosterone replacement therapy often involves administering levels far higher than a normal physiologic dose, which can increase the risks of serious side effects, including certain cancers.

Second, when testosterone is replaced, a negative endocrine feedback loop is activated sending a signal to the gonads to reduce its production further, ultimately feeding the original deficiency and even leading to testicular atrophy.

Third, when testosterone levels are suddenly increased through exogenous sources, there is often a concomitant increase in testosterone metabolites such as dihydrotestosterone (DHT) and estradiol, both which can lead to some particularly undesirable downstream effects, which include male pattern hair loss and excessive prostate growth.

Given these risks, the alternative path is to support the body’s natural production of testosterone both by removing testosterone-blocking chemicals and supporting one’s own body’s ability to produce more testosterone endogenously.

Here Are 5 Natural Things That May Help Boost Your Testosterone Naturally:

1. Zinc

It is well known that a zinc deficiency can lead to testicular suppression, including suppression of testosterone levels.

The male prostate happens to have one of the highest concentrations of zinc of any organ within the body, indicating how important it is to the male reproductive system. Also, physical activity in both normally sedentary men and elite athletes can lead to both testosterone and thyroid hormone suppression, which can be mitigated by zinc supplementation.

Zinc has also been found to protect against heavy metal (cadmium) associated DNA damage to the testicles, preserving their ability to produce testosterone. Animal research also indicates that it can improve erectile function along with optimizing levels of prolactin and testosterone.

Keep in mind that minerals are connected in a matrix of interdependence. Excess zinc can lead to copper deficiency and vice versa. This speaks to the importance of working with a licensed health professional versed in this area of expertise to help clinically ascertain your deficiencies and rectify them without causing unintended adverse effects.

When in doubt, locate food sources of the minerals you are trying to replenish your body with from food, as minerals have a far lower risk of causing imbalances when found in food form. You can always use the USDA-based database SELF Nutrition Data to find the top nutrient-containing foods of your choice.

2. Vitamin C

One of the most important ways to optimize testosterone levels is to preserve its activity and regenerate it when it naturally converts to a transient hormone metabolite.

Preliminary research indicates that vitamin C, a well-known electron donor, may be able to both regenerate testosterone and reduce levels of its toxic hormone metabolite. Read the article “Sunshine Vitamin Regenerates and Detoxifies Your Hormones” on GreenMedInfo.com, to learn more.

3. Magnesium

Magnesium levels are strongly and independently associated with the anabolic hormones testosterone and IGF-1 in the elderly. This observation indicates that this mineral, which is involved in over 300 enzyme pathways, can help to positively modulate the anabolic/catabolic equilibrium, which is often disrupted in elderly people.

One proposed mechanism for magnesium’s testosterone boosting role is that it inhibits the binding of testosterone (TT) to sex hormone-binding globulin (SHBG) leading to an enhancement of bioavailable TT.

4. Saw Palmetto/Astaxanthin

One of the best ways to increase testosterone naturally is to block it from converting to dihydrotestosterone and estrogen (estradiol). This can be accomplished through natural aromatase enzyme inhibitors and 5-alpha reductase inhibitors.  An enzyme, 5-alpha reductase  converts testosterone into dihydrotestosterone and aromatase enzyme converts testosterone into estradiol.

A promising study from 2009 found that in healthy males between 37–70 years of age a combination of these two substances resulted in exactly such an improved ratio: increased testosterone, decreased estrogen, and dihydrotestosterone.

5. Phosphatidyl Serine

This critically important cell membrane component, mainly found in meat, fish, and dairy products, but also found in soy and sunflower lecithin, has been found to decrease cortisol levels and increase testosterone levels following moderate physical activity in athletes.

Here Are 5 Things That One Should Avoid to Keep Testosterone Production Optimal:

1.     Statin Drugs

No category of drug is so thoroughly confirmed in the biomedical literature to suppress testosterone production and/or libido in men. Not only are these drugs misrepresented as ‘lifesaving’ for cardiovascular disease, but they may contribute to over 200 different adverse health effects. Any man concerned with preserving his production of testosterone should consider avoiding this drug.

2.     Bisphenol A

This ubiquitous endocrine disrupter found mostly in plastics, canned foods, and thermal printer receipts, has been found to block testosterone production in the testicles and to have potentially “feminizing” estrogenic effects. Also, don’t be fooled by so-called Bisphenol A free products, because it turns out that many contain other bisphenols, which have at least the same toxicity profile.

3.     Phthalates

Mainly used in plastics to make them flexible (that is, a plasticizer), but also found in pharmaceuticals as an excipient and in cosmetic products, it has been found to suppress testosterone production.

4.     Parabens

Another ubiquitous petrochemical found as a preservative in a wide range of products, but especially cosmetics and body care productions, it has been found to disrupt testosterone levels.

5.     Glyphosate (GMO food)

This testosterone-disrupting chemical is now found virtually everywhere in regions where GM agriculture predominates. Most GMO foods are designed to survive being sprayed with glyphosate, and therefore are contaminated with significant residues. But even explicitly non-GMO foods like oats are sprayed with the stuff as a pre-harvest desicant. Therefore the best way to avoid exposure is to eat 100 percent organically certified foods.