August 03, 2023

The Complete Guide to Hormonal Imbalance in Men

photo of Adam Felman

Written By

Adam Felman

photo of Alex Antoniou, MD

Medically Reviewed By

Alex Antoniou, MD

Lifeforce Physician

The Complete Guide to Hormonal Imbalance in Men

Women aren’t the only ones who go through a ‘change’ in midlife. If you’ve been lacking energy, motivation, and libido lately, listen up because we’re here to spill the tea on T and hormone imbalance in men. 

Your total testosterone drops by roughly 1.6% each year after you reach age 40. And more than a third of men over 45 see a doctor for low T. 

But low testosterone isn’t the only midlife change in men. As just one example, diabetes risk also increases with age and affects more men than women. Given the slow and often silent growth of male hormonal changes, being proactive about your hormone health can help replenish your energy levels, improve your relationships, and optimize your health.

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Early Male Hormonal Imbalance Symptoms

If something feels off with your health, but you can’t quite put your finger on it, it might be time to look into your testosterone levels. Diabetes can cause similar symptoms, increasing the risk of testosterone deficiency. Thyroid problems and other hidden health issues can also drive hormonal imbalances in men.

Low Libido

Reduced sex drive is one of the main signs of hormone imbalance in men. When it strikes, it can cause depression and distress, affecting your body image and relationships. One study of 1,475 men found that about 28% have extremely low T.

However, testosterone supplementation may help improve libido, along with other strategies like individual or couples therapy, communicating with your partner, and managing your stress.

We also offer FDA-approved products for sexual optimization. Learn more about them in our article: How To Have a Healthier, More Satisfying Sex Life

Low Energy

You may have noticed that you don’t tackle challenges the way you used to. Low energy is one of the earliest and most common signs of hormonal imbalance in men. Hypogonadism and thyroid problems can impair your cognitive ability, increase body fat, disrupt sleep, and cause muscle loss, draining your energy and reducing your ability to complete important tasks.

Learn more about boosting your energy in our article: 17 Energy Boosters to Level Up Your Day

Low Mood

Male hormonal changes can affect your mood, as your levels fluctuate from day to day, month to month, and even with the seasons. In a massive review of 124 studies, hypogonadism — when the body’s sex glands produce little or no hormones — increased irritability, mood swings, and depression. 

Testosterone replacement therapy (TRT) may help manage depression for some. Exercise, a consistent sleep schedule, staying social, and regular relaxation can all help boost your mood.

Discover other natural daily mood boosts here: 17 Quick Pick-Me-Ups to Improve Your Day
Man tired from working out

Male Hormonal Imbalance Symptoms that Develop Later

If you fail to notice and treat hormonal imbalances when they first appear, they may develop into symptoms like erectile dysfunction (ED), muscle loss, and infertility. But if you check your hormone levels regularly, you’ll have a better chance to treat the condition before it causes harmful or irreversible changes. (Get started by checking your levels with the Lifeforce Diagnostic.) 

Erectile Dysfunction (ED)

ED can leave you depressed and anxious. It’s defined as a reduced ability to achieve and maintain an erection. It’s unclear whether low T causes ED, but a doctor may prescribe TRT for ED before exploring other causes.

Muscle Loss

Muscular strength is a key part of your performance and your self esteem. Yet it peaks in your 30s, dropping 1-3% each year. Testosterone supplementation can help increase the size of muscle fibers and may help you retain muscle mass.

One placebo-controlled study gave TRT to men over 60 for three years. The therapy significantly improved muscle mass and modestly boosted muscle strength and function.

Infertility

Several types of hormonal imbalances in men can lead to infertility. Testosterone is central to healthy sperm production, so declining levels over time can severely impact your reproductive ability.

Other examples of male hormonal imbalance that can lead to infertility include disorders of the:

  • Hypothalamus

  • Pituitary glands

  • Thyroid glands

  • Adrenal glands

Diabetes — an insulin hormone imbalance — can lead to neuropathy or nerve damage, which in severe cases can result in retrograde ejaculation. This is a condition where...' semen enters the bladder instead of leaving the penis during sex. This can drive fertility problems and increase the stress, emotional burden, and relationship difficulties that accompany infertility.

Gynecomastia

Men can experience gynecomastia — enlarged breast tissue — at any age, but the condition affects 24 - 65% of men aged 50 and over. The most common cause is a male hormonal imbalance that’s part of the natural aging process. 

Like women, men also produce estrogen, the female sex hormone. If your testosterone levels aren’t high enough to balance your estrogen levels, you may see an increase in female traits like breast tissue growth.

Metabolic Symptoms of Hormonal Imbalance in Men

Hormonal changes in men can affect many different systems in the body, including the metabolism. This can lead to:

  • Slow or rapid heartbeat

  • Unexpected weight gain or loss

  • Digestive issues like constipation or diarrhea

  • High blood cholesterol

  • Irregular body fat distribution

Several hormone imbalances in men can affect metabolism: 

  • Hypothyroidism can slow down the metabolism due to a shortfall in thyroid hormone.

  • Hyperthyroidism speeds up the metabolism.

  • Diabetes can make your cells struggle to remove glucose from the bloodstream for energy.

  • Low testosterone can increase body fat and reduce muscle mass.

These changes aren’t sex-specific, but they’re worth monitoring before you see a doctor for hormonal imbalance.

older man looking out over lakeCauses of Male Hormonal Imbalance

Hormonal imbalance is complex. Your body’s hormones closely interact, and the causes of imbalance aren’t always clear. Various conditions can drive hormonal imbalance in men, and you may not be able to rebalance your hormones until a physician identifies the underlying cause.

Aging

Your hormone levels will naturally change throughout your life. Aging decreases testosterone, but it also reduces aldosterone and cortisol levels. Aldosterone helps your body control fluid and electrolyte balance, so lower levels can lead to orthostatic hypotension, making you feel faint shortly after standing up. Cortisol is part of your body’s stress response, and while a low level is generally a good thing, when cortisol is consistently low, it can be associated with decreased energy, decreased cognitive performance, and impaired glucose regulation. 

Discover how science is responding to aging here: Can Science Really Reverse Aging? What the Future Looks Like

Diabetes

Diabetes is the leading hormonal condition in the U.S. It develops when the body can’t make or use enough insulin, affecting how much glucose your body can use. Men are more likely to develop type 2 diabetes than women, as they store more belly fat — a known risk factor. Diabetes may also increase your testosterone deficiency risk.

Thyroid Disorders

Your thyroid gland produces hormones that moderate your metabolism. When it makes too little (hypothyroidism) or too much (hyperthyroidism), it can affect your metabolism and sexual function. In women, these conditions are often caused by autoimmune disorders, but in men, the underlying causes, such as goiter, are generally unrelated to the immune system

Hormone Therapy

Some people with prostate cancer take androgen suppressors to reduce their levels of androgens — male sex hormones like testosterone. Androgens can feed the growth of prostate cancer cells. However, androgen suppressors can also drive a hormonal imbalance in men who take them.

Cancer Treatments

Some cancer treatments can damage the endocrine glands. For example, radiation therapy can injure the thyroid. Up to 50% of people who receive radiation treatment for head and neck cancers develop hypothyroidism. Also, surgery to remove the prostate for prostate cancer may trigger a significant drop in testosterone levels.

Tumors and Growths

A benign or malignant growth on the endocrine glands like the thyroid, pituitary, and adrenal glands can lead to a hormone imbalance in men. Tumors affecting your neuroendocrine system, which sends signals throughout the body using hormones, can also affect your levels. Tumors either reduce or increase hormone production.

Stress

Stress is a natural reaction to challenges, but when it’s prolonged and constant, it can impact other hormones by elevating your cortisol levels. When that happens, it can lead to a drop in testosterone, which recovers during lower-stress periods. Chronic stress, however, can affect the cells that make testosterone and reduce production. 

Pro Tip: A few conscious deep breaths at strategic times throughout the day can help zap your stress. See our article: 5 Science-Backed Ways to Reduce Stress

Injuries, Damage, and Trauma

Surgical injuries, restricted blood flow, bacterial and viral illnesses, and head trauma can damage different endocrine glands. Damage to the pituitary gland, hypothalamus, or thyroid can lead to production issues and cause changes to hormone levels. Men have a higher rate of traumatic brain injuries than women.

Tony Robbins“The importance of hormones can't be overstated. These natural messengers regulate our growth and development, our blood pressure, our sex drive, our sleep, and just about all our body's core functions.”- Tony Robbins, LIFE FORCE

Male Hormone Imbalance Tests & Diagnosis

If your hormones are out of balance, there are now effective ways to spot the problem and treat it. If your physician suspects that your symptoms result from a male hormone imbalance, they’ll likely request blood tests to measure your serum levels. 

In some cases, you may need to test more than once. Your levels of testosterone, insulin, and glucose change throughout the day, so your physician may order multiple tests for maximum accuracy.

Your doctor will likely perform a physical exam too, and ask about your medical history and symptoms.

You can take a proactive approach by getting an at-home blood test with the Lifeforce Diagnostic. You’ll then have a consultation with a Lifeforce physician to review your results and create a personalized plan of action.  

What are optimal levels of testosterone? 

At Lifeforce, our mission is to optimize your health, not just improve it. That is why we look at optimal levels in our blood tests, instead of simply normal levels. 

Most blood tests are checked against “normal” levels based on the average of the people who go to that lab. These ranges are typically focused on highlighting serious health conditions, not on helping people understand how their levels compare to what’s optimal for performance.

At Lifeforce, these are what we consider optimal levels of testosterone in men: 

  • Total testosterone (the total amount of testosterone in your body): 700 - 1,200 ng/dL

  • Free testosterone (the portion of testosterone that is not bound to proteins, and is therefore available to act on cells and tissues throughout the body): 150 - 190 pg/mL

Learn more in our article: Testosterone Optimization: What Every Man Over 30 Needs to Know 

man having his blood drawnTreating Hormonal Imbalance in Men

The treatment for a male hormonal imbalance depends on the particular hormone causing symptoms. Generally, treatment involves supplementing a deficient hormone and restoring hormone balance for men, but conditions like diabetes require daily management through healthy lifestyle choices.

Treatment for Low Testosterone

TRT is the flagship treatment for low T. It’s done in a lifelong supplementation process that physicians can administer in several ways, including:

Learn more about Lifeforce’s Hormone Optimization For Men Program here

Learn about natural ways to increase testosterone here: 12 Ways to Naturally Increase Testosterone

Treatment for Insulin Imbalance (Diabetes)

Controlling diabetes involves managing your blood sugar, cholesterol, and blood pressure. This includes:

  • Following a meal plan (usually set by a dietitian) packed with whole grains, beans, lean white meat, and low-fat dairy.

  • Engaging in more than 30 minutes of physical activity on most days.

  • Regularly monitoring blood glucose.

  • Taking Metformin as advised by your physician.

Your physician should consistently monitor your insulin and glucose levels to gauge improvement.

Treatment for Thyroid Hormone Imbalance

If you feel sluggish and cold, you’re gaining weight, you feel depressed, and your face is puffy, your thyroid hormones may be out of line. Thyroid hormone therapy provides synthetic substitutes that boost thyroid hormone levels in those who don’t produce enough. You’ll need to keep seeing your physician to monitor this condition, as your levels can continue to drop over time.

Lifeforce’s pharmaceutical offerings include Desiccated Thyroid, a combination of hormones that are normally produced by the thyroid gland to regulate your body's energy and metabolism. We prescribe this when the thyroid does not produce enough of this hormone on its own.

If you need treatment for a different condition, let your provider know about your thyroid therapy, since other medications might affect the dosage.

Summary

Male hormonal imbalance doesn’t only involve testosterone. Insulin, thyroid hormone, and other hormones can interact with processes across the body to reduce libido, mood, and energy before causing physical changes like gynecomastia and muscle loss.

Aging can naturally affect your hormone levels, but injury and illness can also factor into hormonal changes in men. Treatment usually revolves around supplementing low hormones.

Since hormones underpin so many of your body’s systems, and affect your health, mood, self-esteem, and overall well being, it’s essential to monitor and optimize your levels.

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This article was medically reviewed by: 

Alex Antoniou, MD, ABNM Board Certified in Nuclear Medicine

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