The level of the main male hormone largely determines the sexual function of a man, and his general health, as well as intelligence and even social success.

How to maintain normal testosterone, told Vice-President of the Russian Society of Urology, Head of the Department of Urology and Human Reproductive Health, Federal State Budgetary Educational Institution of Higher Education “Rostov State Medical University” of the Ministry of Health , Chairman of the Education Committee of the Russian Society of Urology, Honored Scientist , Doctor of Medical Sciences, Professor Mikhail Kogan.

Elena Nechaenko, : – Mikhail Iosifovich, what is the role of testosterone in a man’s life?

Mikhail Kogan: – Testosterone is the “commander in chief” hormone in the body of the stronger sex. It is also produced in women, but in much smaller quantities. After all, it is for the stronger sex that his role is fundamental. Testosterone determines the state of muscle tone (strength of the arms, legs), bone density, as well as the functions of the brain and the autonomic nervous system, which automatically regulates the work of all internal organs (intestines, liver, spleen, kidneys, etc.). And, of course, it determines the sexual function of a person. After all, testosterone is produced mainly by the genitals, and to a lesser extent by the adrenal glands (they synthesize from 5 to 10% of testosterone in a man).

This hormone is indeed omnipotent. Not only physical health depends on it, but also thinking, memory, concentration of attention and other global functions of the brain of a man. Therefore, when it becomes small, a man weakens both physically and intellectually. He thinks that age and illness are to blame for this, but in fact this hormone is to blame, which begins to melt due to various reasons.

Annoying fall

Why does testosterone decrease and at what age does it happen?

– A man reaches the maximum production of this hormone by about 25-30 years. It is no coincidence that it is at this age that most men reach the peak of intellectual capabilities, there is a breakthrough in career growth – all this is directly related to testosterone. Having reached its peak, this hormone is at the top for another five years, and for some 10-15, but then it begins to decline physiologically. On average, by 1-2% per year (but there is also an accelerated decline). In old age, this process goes even faster.

– And then the male menopause (andropause) begins?

These terms are not used today. Now they talk about testosterone deficiency, or androgen deficiency, or hypogonadism. Men don’t have pauses like women do. The process of producing sex hormones in them can slow down, but does not stop.

Is the decrease in testosterone outwardly somehow noticeable?

– Of course. If testosterone melts too intensely, a man’s mood changes (fatigue and irritability appear), thinking slows down, creativity decreases (he loses the ability to create new ideas and generally loses interest in life). Physical activity also worsens: he no longer shakes his hand so hard, he cannot lift the weights that he is supposed to lift by age.

Also, a man can become infertile and lose his former sexual activity, because libido is directly the influence of testosterone. In general, with testosterone deficiency, a person gradually becomes unhappy, since his potential is significantly reduced.

– If a man has lost interest in sex, does it mean that his testosterone has gone down?

– Not necessary. There may be other reasons: for example, depression, undiagnosed diabetes mellitus, arterial hypertension or atherosclerosis. However, diseases that reduce the sexual activity of a man negatively affect the synthesis of testosterone. This is such a vicious circle.

– What, besides age and disease, can accelerate the “melting” of testosterone?

– Unhealthy Lifestyle. For example, smoking and chronic consumption of large doses of alcohol, as well as stress and any damage to the nervous system and psyche.

Is baldness a sign of sexuality?

There are many popular ways to determine the level of testosterone by eye. They say that if a man is short and stocky, bald, but at the same time has lush vegetation on his body, then everything is normal with his male hormone. This is true?

No, these are all legends. There are a huge number of bald and stocky impotent. But, of course, if a man in his 20s still does not shave and has almost no body hair, the doctor may suspect that he has problems with testosterone levels. Or, for example, when an adult male has clearly expressed mammary glands, there is obesity, we can also assume that he has this problem. But we can’t make a diagnosis based on this until we determine the level of testosterone in the laboratory.

Are testosterone and aggressiveness related?

– The more testosterone, the more active a person is, and if he has aggressiveness genes in addition, he will be more aggressive. For example, there are scientific studies that have proven that athletes who competed in red sportswear showed higher testosterone levels and therefore showed higher results. Remember the Soviet hockey team, they always played in red. Testosterone really makes a person stronger.

But aggressive people can be at any level of testosterone, since this quality is associated more with genes. It is they who in many ways endow us with a propensity for one behavior or another. For example, there are genes for aggressiveness, and there are genes for laziness. And these qualities with age in us either increase or weaken due to various factors (upbringing, in particular). If the upbringing promotes the development of aggression, then the person will be aggressive, and if the upbringing is kind, humane, then these aggressiveness genes will be suppressed. That’s all.

Is it a lot or a little?

How to measure testosterone?

– Just take a blood test for total testosterone, many network laboratories do it. However, it is difficult to draw conclusions from this analysis. The fact is that the limits of testosterone levels are very wide, which even modern science cannot explain now. There are hypersexual men, their level is very high. In hypo- or normosexual, it is significantly lower. Sexual function is different for everyone – just like muscle strength and intellectual abilities. That is, for a doctor, it is not so much the quantitative indicator of testosterone that is important, but the level of its decrease. If testosterone has dropped from a very high to a moderate level, then although this looks like the norm, in fact it will already be a significant decrease.

So, is it better to take such an analysis at the age of 25, and then compare it with it?

– That’s right, that’s why I have long recommended to every man, while he is healthy, at the age of 25-30 to find out his testosterone. And then in 10, 20 or 30 years, if some health problems begin, it will be possible to take this analysis and compare. But you should not self-diagnose hypogonadism. If there are problems, you need to go to an endocrinologist or immediately to a urologist. Doctors will help you figure out whether sexual problems are related to testosterone or not.

Turn back time!

Is it possible to raise testosterone levels without medication?

– Yes. With a healthy lifestyle, proper nutrition and sports, we must begin. It is not necessary to play sports professionally, it can be a regular fitness with cardio loads. And testosterone preparations should be prescribed by doctors when a hormone deficiency is detected.

– Is this treatment a course? How long?

“It’s lifelong hormone replacement therapy. It can be compared to the therapy that a person takes who has had their thyroid gland removed. The injection method of treatment in this situation is simpler. I took an injection once, and it lasts for three months, but at the same time, testosterone reaches a high level very quickly, and then begins to gradually decline. The most physiological and effective are skin preparations (creams, patches), because they allow you to slowly increase the level of testosterone in the blood and maintain it at an optimal level. In addition, if due to a side effect it will be necessary to urgently stop treatment, then removing the patch or washing off the cream is much easier than waiting for months until the effect of the injectable drug wears off. In addition, the patient himself is engaged in skin therapy (but the doctor teaches him).

Why is self-medication with testosterone dangerous? And is it possible to take this hormone as a preventive measure to slow down its physiological decline?

— No, not at all. These drugs are used only for the treatment of secondary, late hypogonadism, and a healthy lifestyle is sufficient for prevention.

Self-medication is unacceptable. Firstly, because there are contraindications for taking testosterone, the presence of which the person himself may not be aware of. For example, in the presence of hormone-dependent cancer (in particular, the prostate and breast), as well as in serious diseases of the heart, liver or kidneys, testosterone preparations are not used. Secondly, only a doctor can determine the optimal dose of the drug. And the use of testosterone outside of medical purposes, which bodybuilders sometimes sin, is simply destructive for the body. In an effort to increase the speed of gaining muscle mass, some athletes exceed the testosterone norm by 2-2.5 times, and an excess of testosterone is just as dangerous as its deficiency. Over time, this leads to a decrease in muscle tone, muscle and sexual activity. And sometimes these changes are irreversible. The patient cannot and should not decide for himself whether testosterone is indicated for him at one or another level or not, and in what doses.

In your opinion, how useful are educational projects (in particular, the social project “Wild Male Nature”) that talk about the role of testosterone?

Of course they are useful. If they are carried out by professionals who are able to present information in an accessible way, then such projects will increase men’s knowledge of the symptoms of testosterone deficiency, and may encourage men aged 35 to 60 to get a medical examination and get tested for the definition of their main male hormone. I hope that thanks to such projects, more men will realize the importance of regular examinations and will be more careful about their own health.