Male Hormone Imbalance

What is a hormonal imbalance in men?

Hormones are chemical messengers produced by the body's endocrine system to relay information to different parts of the body through the bloodstream.1 Hormonal imbalances are caused by the fluctuating production of hormones. This term is often used to describe when the body over or under produces a particular hormone or a group of hormones. 

Hormones regulate fundamental bodily functions and have an effect on things like heart rate, sexual and reproductive function, mood, and metabolism. For this reason, there are a variety of symptoms resulting from hormonal imbalance in men.

Types of hormone imbalance in men

Hormone imbalances and fluctuations are normal for the most part and affect many people at some point in their lives, for example when they are particularly stressed.2 There are different types of hormonal imbalances that affect both men and women, such as hypothyroidism, a common endocrine disorder in which crucial hormones are underproduced by the thyroid gland.3 As testosterone is the primary male sex hormone, imbalances in it can lead to detrimental side effects.4

Male hypogonadism is the condition used to describe low levels of sex hormones in men. It can be divided further into classical hypogonadism (primary and secondary) and late-onset hypogonadism, also known as andropause or ‘male menopause.5 Late-onset hypogonadism is the one often discussed when the topic of male hormonal imbalance comes up, as it is the most common.

Signs of hormonal imbalance in men

As the symptoms of hormonal imbalances are similar to other conditions and some are the natural side effects of ageing, many men do not recognise that they are experiencing hormonal imbalances.6 Often, health practitioners also struggle with diagnosing the problem for the same reason. Although these signs are not unique to hormonal imbalances, here are a few common indicators;5

  • Gynecomastia is a medical condition characterised by tenderness in the chest area and the enlargement of breasts in men. It is believed to be a result of an imbalance between testosterone and oestrogen (a hormone that regulates female reproduction)7
  • Decreased Libido is the most common symptom of hypogonadism since testosterone is the main hormone responsible for sex drive and plays an important role in sexual desire and satisfaction4
  • Erectile dysfunction is something many men experiencing hormone imbalances deal with. However, the reason why isn’t clearly understood and research suggests that this isn’t a causal relationship since quite a few men with low testosterone levels have frequent erections.8
  • Loss of muscle is usually a side effect of decreased testosterone as this hormone plays a role in muscle (and bone) development. As a result, male hormone imbalances often come with decreased physical strength, increased body fat, and weight gain4
  • Mood changes are something that most people experiencing male hormone imbalance endure. This is usually felt through low mood or depression, increased irritability, or poor concentration.4
  • Acne can be triggered by testosterone imbalances, as this hormone regulates the production of sebum - a substance when, in excess, can lead to acne breakouts.9 
  • Hair loss and thinning can occur with low levels of testosterone. This hormonal imbalance can cause reduced growth of both facial and pubic hair.

Causes of hormonal imbalance in men

Late-onset hypogonadism

Unlike the noticeable and often drastic hormonal imbalances that occur when women near menopause, late-onset hypogonadism progresses slowly and gradually.6 Between the ages of 30-40, men’s levels of testosterone naturally decrease by 2% every year.2 Although most still remain within in a range considered to be normal, this hormonal imbalance is more severe in some men and often comes with uncomfortable symptoms that affect their quality of life.10

Health conditions

Hormonal imbalances, particularly lower than normal levels of testosterone, can be caused by;4,11 

  • Genetic conditions - Klinefelter syndrome (which occurs when a man is born with an additional x chromosome);
  • Diseases and treatments that affect the pituitary gland - autoimmune conditions, HIV/AIDS, tumours, obesity,  heart disease, type II diabetes, and medications comprising of morphine or steroids;
  • Diseases and treatments directly affecting the testes - infections, tumours, injury to the reproductive organs, radiation and chemotherapy.

Diagnosing hormonal imbalance in men

As levels of hormones for men aren’t routinely measured and hormonal imbalances are often misdiagnosed, the diagnostic process can be quite difficult. For this reason, it is important to be aware of your symptoms, discuss them with your GP, and advocate for your health.12 Male hormone imbalances, such as testosterone deficiency, are usually diagnosed through measuring the hormone levels with a blood test.2 Typically, your GP completes the diagnostic stage but then an endocrinologist would prescribe a suitable form of treatment for you.

Treatment options

Drug treatments

Testosterone therapy is an effective form of treatment for testosterone deficiency and can be taken in the form of gels, implants, tablets, patches, and injections.2 However, for conditions like late-onset hypogonadism, it may not be suitable for people who only have borderline low testosterone levels. Taking supplements while producing a sufficient amount of testosterone can actually be detrimental.13 Nevertheless, this form of treatment can improve a number of male hormone imbalance symptoms, including depression, loss of muscle mass, erectile dysfunction, and low libido.11 

Testosterone therapy is not without risks though. It is important to note that some potential side effects include increased risks of prostate cancer, sleep disorders, and detrimental cardiovascular occurrences. Additionally, this form of treatment is not recommended for those with a history of heart failure or prostate cancer.5,13 There also is insufficient evidence on the long term effect (safety and effectiveness) of testosterone therapy for those experiencing late-onset hypogonadism.5  

Natural Remedies

Lifestyle alterations - such as doing more physical exercise, not smoking, having a balanced diet, and weight reduction for those who are obese - are often recommended for those experiencing male hormone imbalance.11,13,14

Oral dietary supplements: As the safety and effectiveness of natural supplements have not been thoroughly investigated in human trials, they are not generally recommended by healthcare providers.15 In fact, medical informational resources suggest that you should be wary of such herbal supplements for the following reasons:16-17 

  • Some side effects of natural herbal supplements include an unpredictable change in the concentration of hormones in the bloodstream which can negatively affect your liver and the fat profiles in your body. 
  • These supplements are also able to change the body’s response to the natural hormones it produces.
  • Some studies testing the use of such supplements for increasing testosterone levels highlighted an increased risk of cardiovascular disease and liver damage.

Summary 

One of the most detrimental types of hormonal imbalance in males is low levels of testosterone. This condition is referred to by several names including ‘male menopause’, but the medical term used to describe this deficiency in testosterone is hypogonadism. As hormones act as chemical messengers and since testosterone is the primary male sex hormone, imbalances in it can lead to a variety of side effects. Some signs of male hormone imbalance are: low libido, reduced muscle mass, acne, growth of breast tissue, weight gain, and mood changes. As the symptoms of hormonal imbalances are similar to other conditions and some are the natural symptoms of ageing, many men don’t realise that they are experiencing hormonal imbalances and should therefore discuss their symptoms with their GP. A common form of treatment is testosterone therapy, a process in which external testosterone is introduced into your body through tablets or injections. Dietary herbal supplements to increase levels of testosterone are not recommended as their safety and effectiveness on humans have not been sufficiently studied. However, lifestyle changes like increasing physical exercise, not smoking, and eating healthily are natural ways to help with symptoms.

References

  1. Hormonal Control in Humans | You and Your Hormones from the Society for Endocrinology. https://www.yourhormones.info/students/topics/hormonal-control-in-humans/. Accessed 18 Mar. 2022.
  2. The ‘Male Menopause.’” Nhs.Uk, 3 Oct. 2018, https://www.nhs.uk/conditions/male-menopause/.
  3. Saran, Sanjay, et al. “Effect of Hypothyroidism on Female Reproductive Hormones.” Indian Journal of Endocrinology and Metabolism, vol. 20, no. 1, 2016, p. 108. DOI.org (Crossref), https://doi.org/10.4103/2230-8210.172245.
  4. Kocsis, Mike. “What Does Testosterone Do?” Balance My Hormones, 17 Mar. 2021, https://balancemyhormones.co.uk/what-does-testosterone-do/.
  5. Male Hypogonadism | You and Your Hormones from the Society for Endocrinology. https://www.yourhormones.info/endocrine-conditions/male-hypogonadism/. Accessed 18 Mar. 2022.
  6. Martelli, Margherita, et al. “Influence of Work on Andropause and Menopause: A Systematic Review.” International Journal of Environmental Research and Public Health, vol. 18, no. 19, Sept. 2021, p. 10074. DOI.org (Crossref), https://doi.org/10.3390/ijerph181910074.
  7. Nordt, Christina A., and Amy D. DiVasta. “Gynecomastia in Adolescents.” Current Opinion in Pediatrics, vol. 20, no. 4, Aug. 2008, pp. 375–82. DOI.org (Crossref), https://doi.org/10.1097/MOP.0b013e328306a07c.
  8. Rajfer, Jacob. “Relationship Between Testosterone and Erectile Dysfunction.” Reviews in Urology, vol. 2, no. 2, 2000, pp. 122–28. PubMed Central, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1476110/.
  9. Elsaie, Mohamed L. “Hormonal Treatment of Acne Vulgaris: An Update.” Clinical, Cosmetic and Investigational Dermatology, vol. 9, Sept. 2016, pp. 241–48. PubMed Central, https://doi.org/10.2147/CCID.S114830.
  10. “Understanding Aging and Testosterone.” Mayo Clinic, https://www.mayoclinic.org/healthy-lifestyle/mens-health/in-depth/male-menopause/art-20048056. Accessed 16 Mar. 2022.
  11. “Testosterone — What It Does And Doesn’t Do.” Harvard Health, 16 July 2015, https://www.health.harvard.edu/medications/testosterone--what-it-does-and-doesnt-do.
  12. Kocsis, Mike. “TRT UK On NHS.” Balance My Hormones, 3 Aug. 2017, https://balancemyhormones.co.uk/trt-uk-nhs/.
  13. Huhtaniemi, Ilpo. “Late-Onset Hypogonadism: Current Concepts and Controversies of Pathogenesis, Diagnosis and Treatment.” Asian Journal of Andrology, vol. 16, no. 2, 2014, p. 192. DOI.org (Crossref), https://doi.org/10.4103/1008-682X.122336.
  14. “Erectile Dysfunction (Impotence).” Nhs.Uk, 13 Nov. 2017, https://www.nhs.uk/conditions/erection-problems-erectile-dysfunction/.
  15. Smith, Stephen J., et al. “Examining the Effects of Herbs on Testosterone Concentrations in Men: A Systematic Review.” Advances in Nutrition, vol. 12, no. 3, June 2021, pp. 744–65. DOI.org (Crossref), https://doi.org/10.1093/advances/nmaa134.
  16. “Testosterone Level: Can You Boost It Naturally?” Mayo Clinic, https://www.mayoclinic.org/healthy-lifestyle/sexual-health/expert-answers/testosterone-level/faq-20089016. Accessed 21 Mar. 2022.
  17. Kovac, Jason R., et al. “Dietary Adjuncts for Improving Testosterone Levels in Hypogonadal Males.” American Journal of Men’s Health, vol. 10, no. 6, Nov. 2016, pp. NP109–17. DOI.org (Crossref), https://doi.org/10.1177/1557988315598554.
This content is purely informational and isn’t medical guidance. It shouldn’t replace professional medical counsel. Always consult your physician regarding treatment risks and benefits. See our editorial standards for more details.

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