Kenneth Glad
Several common health problems can produce similar warning signs. Doctors therefore combine a patient’s history with carefully timed and repeated blood tests.
Tiredness, reduced sexual interest and poor concentration are sometimes blamed on ageing or falling testosterone. Yet sleep disruption, stress, serious illness, medication and other medical conditions can produce much the same picture.
In an edited extract from his book published by the Daily Express, British men’s health specialist Dr Jeff Foster argues that testosterone has a wider role than its familiar association with strength and sexual function.
Produced by the testicles in response to hormonal signals from the brain, it contributes to fertility, red blood cell production, bone maintenance and muscle mass.
Testing takes more than one visit
Clinical guidance from the Endocrine Society says hypogonadism should be diagnosed only when characteristic symptoms accompany consistently low testosterone. Confirmation requires a repeat fasting morning measurement using a reliable test.
Patient guidance from the organisation specifies at least two early-morning blood tests. Levels fluctuate through the day and can temporarily fall during severe illness, poor nutrition or intense exercise, making an isolated result potentially misleading.
Doctors may examine free testosterone when the total measurement does not provide a clear answer. Further hormone tests can then help establish whether the problem begins in the testicles or in the signalling system that controls them.
Foster maintained that low testosterone may affect mood, metabolic health and muscle retention before clear symptoms emerge. Nevertheless, a low laboratory result without a matching clinical picture does not by itself establish the condition.
Treatment also demands individual assessment. Externally supplied testosterone can suppress sperm production, so future fertility must be discussed before therapy begins. Age is only one consideration when doctors weigh the expected benefits against the risks.
Familiar claims need context
Foster wrote that vasectomy should not lower testosterone because the procedure does not interrupt hormone production or the testicles’ blood supply.
He also rejected claims that sexual abstinence reliably increases testosterone or improves sporting performance, describing the evidence as insufficient.
Concerns about baldness are more complicated. Foster linked the risk to DHT and genetic susceptibility to male-pattern hair loss rather than treating testosterone therapy as a universal cause.
Persistent symptoms should prompt medical investigation, not self-diagnosis based on libido, ageing or online advice.
Sources: Daily Express; Endocrine Society
