Understanding Men’s Hormonal Health: What Every Man Should Know
Testosterone has long been wrapped up in cultural ideas of masculinity: strength, energy and vitality. So, when levels begin to decline, it can feel personal. Or like something is failing you.
The reality is that it’s not failure, it’s biology.
Many men tend to brush off symptoms or power through them, but there’s a smarter approach: being proactive about your hormone health before small changes turn into bigger ones.
Healthy hormone levels aren’t just about how you feel today. They play a critical role in your overall health, affecting how you function and thrive in the long term.
The Slow Fade: Why Symptoms Are Easy to Miss
Unlike women, who often experience more rapid hormonal shifts during menopause, male hormone changes are a gradual testosterone decline with age.
“For women, perimenopause changes hit like falling off a cliff,” explains Dr. Jennifer Bettenhausen, a Vail Health family physician who specializes in hormone replacement therapy for both men and women. “With men, it’s a slow, steady decrease, which makes it harder to recognize.”
Testosterone levels typically drop about 1% per year, or 10% per decade, starting around age 30. That might not sound like much, but over time, it adds up, becoming more noticeable in the mid-40s and 50s. Because the change is subtle, symptoms are often overlooked.
Common low testosterone symptoms to watch for:
- Mood shifts
- Fatigue
- Decrease in muscle mass
- Increase in abdominal fat
- Changes in libido or loss of sexual function
- Poor sleep
- Irritability
- Depression
- Fatigue
Why Testosterone Matters for Long-Term Health
Testosterone does more than influence mood or libido: it plays a key role in men’s health and aging.
Maintaining healthy testosterone levels helps:
- Preserve muscle mass and strength
- Support bone density and reduce the risk of fracture
- Regulate metabolism
- Maintain cardiovascular health
“Over time, lower testosterone levels can be associated with a higher risk of cardiovascular disease, diabetes, stroke, dementia, anxiety and depression,” warns Dr. Barry Sandler, medical director of the Vail Healthspan program.
Healthy testosterone levels aren’t just about how you feel; it’s about how well your body functions as you age.
When and How to Test
By age 40, it’s worth considering a baseline hormone panel, even if you feel fine.
“It’s important to get a baseline number so you know where to start when your numbers begin to decline,” says Sandler. “We always take a whole-person approach first to see if the person is doing everything they can before hormone replacement therapy.”
Hormone panels aren’t typically included in routine screenings, but they can be requested through your primary care provider or a specialist.
The First Line of Defense: Lifestyle
Foundational habits should be dialed in before someone considers hormone replacement therapy.
“Eating a healthy diet, getting high-quality sleep, exercising regularly, limiting alcohol and marijuana, and living a healthy lifestyle will help your symptoms, but not change your hormone levels,” Bettenhausen explains. “Most of the decrease in hormone levels is due to age and we haven’t figured out how to age backward.”
Some supplements, like zinc and selenium, may support testosterone production, along with adequate protein and creatine intake.
When to Consider Treatment
If you’ve already made adjustments to your lifestyle and still aren’t seeing a change, that’s when treatment can make a meaningful difference. But, like many things in medicine, deciding when to get treatment is not black and white; instead, it falls into the gray area based on several factors.
“We would consider hormone replacement therapy for men whose testosterone levels fall below 300 nanograms per deciliter and have symptoms,” Sandler says.
There are several common forms of testosterone therapy, which include:
- Weekly or bi-weekly injections
- Long-lasting pellets placed under the skin
- Daily topical creams
Understanding the Risks
Like any medical therapy, testosterone treatments aren’t without risks.
Testosterone can increase red blood cell production, which is already elevated at altitude. Without proper oversight, this can thicken the blood, leading to health risks.
There are also considerations around prostate health. While testosterone therapy has not been proven to cause prostate cancer, it may accelerate the growth of the prostate and uncover an undiagnosed condition.
The takeaway: treatment should always be guided and closely monitored by a qualified provider.
Aging Well is an Active Process
Aging is inevitable. How you age is not.
Addressing hormone health will improve your overall quality of life, including sleep, mood, sexual health and overall well-being. So, pay attention to your body, recognize subtle changes and take action early by seeking out a professional and asking questions.
It’s about investing in your health, both now and for the long run.
Want to understand your health?
Connect with one of our hormonal health experts to take the next step in your health care journey.
