Testosterone is the key hormone in men responsible for making sperm, regulating sex drive, and maintaining muscle and bone mass. According to the Hospital for Special Surgery, testosterone levels begin to decline by as much as 2% each year at the age of 40, which means up to one-third of men could experience low testosterone levels after age 45. Low testosterone levels could mean reduced muscle and bone mass and problems with depression.
While low testosterone is common in older men, naturally high testosterone is less common. Bodybuilders might see elevated testosterone levels if they take steroids, but elevated testosterone can be a sign of problems with your adrenal gland or testicular cancer. High testosterone could also cause an enlarged prostate.
People with elevated testosterone can have symptoms such as acne, aggressive behavior, mood swings, or insomnia. It might be tempting to boost your libido by taking steroids or over-the-counter testosterone supplements, but you could see a low sperm count if your testosterone levels are too high.
The relationship between testosterone and the prostate
As testosterone levels decline with age, the prostate grows larger. According to MedlinePlus, an enlarged prostate is so common among aging men that 90% of men over 80 have benign prostatic hyperplasia (BPH). The relationship between testosterone and prostate growth is complex, according to a 2014 article in the Asian Journal of Andrology. Androgen-blocking drugs that reduce testosterone production can help shrink the prostate and improve urinary symptoms associated with BPH. Similarly, testosterone therapy for people with low testosterone can stimulate the growth of the prostate.
Some researchers believe that dihydrotestosterone (DHT) might be partially responsible for the development of BPH. Every day, about 10% of testosterone is converted to DHT, and DHT production in the prostate causes it to grow. If you have elevated testosterone levels, that’s more testosterone that could be converted to DHT. Medications like finasteride reduce the size of the prostate by preventing the conversion of testosterone to DHT.
However, elevated testosterone or DHT levels aren’t the sole cause of BPH. A 2019 article in Sexual Medicine Reviews suggested that inflammation plays a major role in BPH. This inflammation could be caused by infections, high cholesterol, and metabolic syndrome.
Keeping your testosterone levels in a healthy range
Having naturally higher testosterone levels (but not abnormally high) tends to be linked with better health, according to a 2007 study in Circulation. Researchers followed more than 11,000 men aged 40 to 79 for about 10 years and found that men with the highest testosterone levels had a 41% lower risk of death from any cause compared to those with the lowest testosterone. They were also less likely to die from heart disease or cancer.
(Here are some foods that can kill your testosterone levels.)
A normal testosterone level can range between 193 and 824 ng/dL (nanograms per deciliter), so your doctor can offer solutions such as testosterone therapy if your testosterone levels fall below this range. You can naturally increase your testosterone levels by keeping a low-fat diet that’s low in processed foods, limiting alcohol, quitting smoking, getting sufficient sleep, and exercising 150 minutes a week.
If your doctor says you have elevated testosterone levels, you might need additional testing to rule out tumors in your testicles or adrenal glands. Some people might have genetically high testosterone levels, which can increase your risk of kidney disease. You should also be honest with your doctor about steroid use since it not only artificially elevates your testosterone but also could lead to high cholesterol, high blood pressure, or liver disease.