Testosterone: Men and Ageing
Testosterone is a hormone found in both men and women, although men have much higher levels of testosterone than women. Testosterone plays an important role in the feeling of sexual interest and desire – i.e. libido in both men and women.
During puberty in a male, testosterone influences the development of the mature male sex characteristics including: the growth of the genitals (penis and testicles), deepening of the voice due to growth of the larynx and vocal cords, growth of facial, body and pubic hair, development of male pattern hair line (including varying degrees of baldness), the growth of muscles and broadening of the shoulders, an increase in aggressive characteristics, an increase in sexual interest and an increase/thickness of secretions in the skin glands (the reason for acne being more common in men).
Some of the following facts may surprise you:
More sexual activity (by oneself or with a partner) can result in a slight increase in a man’s testosterone levels.
Testosterone levels in healthy men remain at about the same level with increasing age.
Another way to say this:
‘Ageing has only a minuscule effect on testosterone levels in men’.
A recent study (1) calculated the average decline in serum testosterone is 0.5% per year – lower than has been previously claimed (0.8-2% per year).
A marked reduction in healthy mens’ testosterone levels occurs only after the age of 80 years.
A reduction of testosterone levels in men is associated with co-morbidities (co-existing health problems) such as:
- Cardiovascular disease
- Heavy alcohol intake
- Severe disruption to sleep patterns
- Some drugs – e.g.1) opioids and 2) certain statins (cholesterol lowering drugs) particularly atorvastatin
- Loss of a spouse/social defeat/recent fatherhood
- Stopping smoking – please don’t think this is a good reason to keep smoking. Apart from causing damage to many parts of the body and increasing the risks of many cancers, smoking also has long term and DIRECT negative effects on erections.
Further research is required to understand the role that ‘co-morbidities’ play in the levels of testosterone in men as they age.
If you need any help to improve your sex life, particularly if you are concerned about your libido (levels of sexual interest) then do feel free to consult with me, Dr Marie Tudor. I can assess your situation from a medical, psychological and relationship perspective and then offer strategies and solutions suited to your needs.
Please be aware that there are rules regarding the prescription of testosterone for men who have low testosterone levels. In Australia, endocrinologists and sexual health physicians are able to prescribe PBS subsidised testosterone to men. The rules regarding this PBS prescribing are specific and need to be adhered to. I am a doctor with a fellowship in sexual medicine but this qualification does not come under the PBS umbrella of doctors who have permission to prescribe testosterone to men.
If you are specifically concerned about your testosterone level, the first line of call is your general medical practitioner (GP). If your testosterone level is low (shown on two occasions), then the decision to prescribe PBS subsidised testosterone needs to be made via a referral to an endocrinologist or ‘sexual health physician.
Age-specific population centiles for androgen status in men
D J Handelsman, B B Yeap1,2, L Flicker1,3, S Martin4, G A Wittert4 and Lam P Ly
European Journal of Endocrinology (2015) 173, 809-817.
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