Testosterone information center

Testosterone Introduction

What is Testosterone?

Testosterone is a hormone that plays a key role in male health and development. It's responsible for male physical features and also affects mood, energy levels, and sexual function. While primarily associated with men, women also produce testosterone, but in much smaller amounts. Testosterone helps with muscle mass and strength, bone density, and the production of red blood cells. Its levels can vary and may decrease with age, impacting various bodily functions.

Importance of Testosterone in Post-Developed Males

In post-developed men, testosterone continues to play significant roles in various aspects of health and well-being. Some of the key roles of testosterone in adult men include:

  1. Maintenance of muscle mass and strength: Testosterone helps promote the growth and maintenance of muscle tissue. It plays a vital role in protein synthesis, which is essential for building and repairing muscles. Adequate testosterone levels support muscle strength and prevent muscle loss associated with aging.
  2. Regulation of bone density: Testosterone is important for the maintenance of bone health in men. It helps stimulate bone mineralization and the production of new bone tissue. Sufficient testosterone levels contribute to the prevention of osteoporosis and the maintenance of overall bone strength and density.
  3. Influence on libido and sexual function: Testosterone plays a significant role in male sexual desire (libido) and sexual function. It contributes to the initiation and maintenance of erections, as well as the overall quality of sexual experiences. Adequate testosterone levels are essential for a healthy and satisfying sex life.
  4. Impact on mood and cognitive function: Testosterone influences mood and cognitive abilities in men. Low testosterone levels have been associated with symptoms such as fatigue, irritability, decreased motivation, and difficulty concentrating. Maintaining optimal testosterone levels can contribute to better mood, mental clarity, and overall cognitive function.
  5. Regulation of red blood cell production: Testosterone stimulates the production of red blood cells in the bone marrow. Sufficient red blood cell production is crucial for delivering oxygen to the body's tissues and organs. Adequate testosterone levels help maintain proper oxygenation and support overall energy levels.

Symptoms of Low Testosterone

Low testosterone, also known as hypogonadism, can cause a variety of symptoms in men. These symptoms can vary in severity and may include:

  1. Reduced libido (sex drive): One of the most common symptoms of low testosterone is a decrease in sexual desire and a reduced interest in sexual activity.
  2. Erectile dysfunction: Low testosterone levels can contribute to difficulties in achieving or maintaining erections, leading to problems with sexual performance.
  3. Fatigue and decreased energy levels: Men with low testosterone may experience persistent fatigue, lack of energy, and a general sense of low vitality.
  4. Decreased muscle mass and strength: Testosterone is crucial for the maintenance of muscle tissue, so low levels can result in a loss of muscle mass, reduced strength, and difficulty building or retaining muscle.
  5. Increased body fat: Low testosterone can contribute to an increase in body fat, particularly in the abdominal area. This can lead to the development of a more "pear-shaped" body.
  6. Mood changes: Some men with low testosterone may experience mood swings, irritability, or feelings of sadness and depression.
  7. Decreased bone density: Testosterone helps maintain bone health, so low levels can lead to a decrease in bone density, making men more susceptible to osteoporosis and fractures.
  8. Reduced cognitive function: Low testosterone levels have been associated with decreased cognitive abilities, including difficulties with memory, concentration, and mental clarity.
  9. Sleep disturbances: Some men with low testosterone may experience sleep disturbances, such as insomnia or increased sleepiness during the day.
  10. Decreased motivation and lack of enthusiasm: Low testosterone can contribute to a decrease in motivation, drive, and overall enthusiasm for life.

What Causes Low Testosterone?


Stress can have a significant impact on hormone levels, including testosterone. When the body is under stress, it triggers a complex hormonal response, primarily involving the release of cortisol, commonly referred to as the "stress hormone." This hormonal response can interfere with the production and regulation of testosterone in several ways:

  1. Suppression of Hypothalamic-Pituitary-Gonadal Axis: Chronic stress can disrupt the normal functioning of the hypothalamic-pituitary-gonadal (HPG) axis, which is responsible for regulating testosterone production. Stress activates the hypothalamus, leading to increased secretion of corticotropin-releasing hormone (CRH), which, in turn, stimulates the release of adrenocorticotropic hormone (ACTH) from the pituitary gland. Elevated ACTH levels can impair the release of luteinizing hormone (LH) from the pituitary gland, ultimately leading to decreased testosterone production.
  2. Reduced Testosterone Synthesis: Chronic stress can directly inhibit testosterone synthesis in the testes. Stress-induced activation of the hypothalamic-pituitary-adrenal (HPA) axis results in increased cortisol release. Elevated cortisol levels can interfere with the Leydig cells in the testes, which are responsible for producing testosterone, and reduce their responsiveness to LH stimulation, leading to decreased testosterone synthesis.
  3. Increased Testosterone Conversion: Stress-related increases in cortisol levels can stimulate the enzyme aromatase, which converts testosterone to estrogen. This increased conversion can further decrease testosterone levels relative to estrogen levels, leading to an imbalance between these hormones.
  4. Disruption of Gonadotropin-Releasing Hormone (GnRH): Stress can also affect the release and regulation of gonadotropin-releasing hormone (GnRH), which plays a vital role in stimulating LH secretion. Dysregulation of GnRH can contribute to decreased LH levels and subsequent reductions in testosterone production.


As men age, it is natural for testosterone levels to gradually decline. This decrease in testosterone production is a normal part of the aging process and is commonly referred to as age-related or late-onset hypogonadism. Several factors contribute to the age-related decline in testosterone levels:

  1. Leydig Cell Function: Leydig cells in the testes are responsible for producing testosterone. As men age, the Leydig cells become less efficient in testosterone production. This age-related decline in Leydig cell function leads to reduced testosterone synthesis.
  2. Decreased Testicular Size: With aging, the testes tend to shrink in size. This decrease in testicular volume correlates with a decline in testosterone production.
  3. Altered Hormonal Regulation: The hypothalamus and pituitary gland play a crucial role in regulating testosterone production. With age, the feedback loop between the hypothalamus, pituitary gland, and testes becomes less sensitive and efficient. This can result in reduced secretion of luteinizing hormone (LH) and follicle-stimulating hormone (FSH), which are necessary for stimulating testosterone production.
  4. Increased Sex Hormone-Binding Globulin (SHBG) Levels: SHBG is a protein that binds to testosterone, rendering it inactive. As men age, SHBG levels tend to increase, leading to a greater proportion of testosterone being bound and unavailable for use by the body.
  5. Lifestyle and Health Factors: Aging is often accompanied by lifestyle and health changes that can contribute to lower testosterone levels. Factors such as increased body fat, sedentary lifestyle, poor nutrition, chronic illnesses, and certain medications can all impact testosterone production and contribute to age-related testosterone decline.


A poor diet can have a negative impact on testosterone levels in several ways:

  1. Nutrient Deficiencies: Testosterone production requires various nutrients, including vitamins, minerals, and essential fatty acids. A poor diet lacking in these nutrients can result in deficiencies that may hinder testosterone synthesis. For example, zinc, magnesium, vitamin D, and vitamin K2 are essential for testosterone production, and inadequate intake of these nutrients can potentially lower testosterone levels.
  2. Increased Body Fat: A diet high in processed foods, unhealthy fats, and excess calories can contribute to weight gain and increased body fat. Excess body fat, particularly visceral fat (fat around the abdomen), has been linked to lower testosterone levels. Adipose tissue (fat cells) can convert testosterone into estrogen through the enzyme aromatase, leading to a hormonal imbalance and lower overall testosterone levels.
  3. Insulin Resistance: Consuming a diet high in refined carbohydrates, sugary foods, and beverages can lead to insulin resistance, a condition where the body becomes less responsive to the hormone insulin. Insulin resistance has been associated with lower testosterone levels. Elevated insulin levels can reduce sex hormone-binding globulin (SHBG) production, leading to increased estrogen levels and decreased free testosterone available for use by the body.
  4. Inflammation: A poor diet characterized by high intake of processed foods, unhealthy fats, and sugary beverages can promote chronic inflammation in the body. Chronic inflammation has been linked to lower testosterone levels. Inflammation disrupts the normal hormonal regulation and can impair testosterone production.
  5. Disruption of Gut Health: The health of the gut microbiome plays a role in overall health, including hormone regulation. A poor diet lacking in fiber and rich in processed foods can negatively affect the diversity and balance of gut bacteria, potentially impacting testosterone levels. Some gut bacteria are involved in the metabolism and breakdown of hormones, including testosterone.

Negative Effects of Low Testosterone

Non Life Threatening

  1. Reduced libido and sexual dysfunction: Low testosterone can decrease a man's desire for sex and can lead to erectile dysfunction, affecting intimate relationships and mental well-being.
  2. Decreased muscle mass and strength: Testosterone plays a crucial role in building and maintaining muscle mass. Low levels can lead to a reduction in muscle mass and physical strength, impacting overall physical performance and body composition.
  3. Increased body fat: A decrease in testosterone can alter body composition, leading to increased body fat, particularly in the abdominal area. This can increase the risk of obesity and related health conditions.
  4. Bone density loss: Testosterone helps in maintaining bone density. Low levels can lead to thinner, weaker bones (osteoporosis), increasing the risk of fractures and injuries.
  5. Fatigue and low energy levels: Men with low testosterone often report a significant drop in energy levels, leading to fatigue and a decrease in motivation to engage in physical and daily activities.
  6. Mood swings and mental health issues: Testosterone influences mood and mental capacity. Low levels have been linked to depression, irritability, lack of focus, and reduced cognitive abilities.
  7. Sleep disturbances: Low testosterone can contribute to sleep disorders, including insomnia and changes in sleep patterns, which can affect overall health and well-being.
  8. Changes in hair growth: Testosterone plays a role in hair production, and low levels can lead to a loss of body and facial hair.
  9. Reduced semen volume and fertility issues: Testosterone aids in the production of semen, and reduced levels can lead to a decrease in semen volume, potentially affecting fertility.

Life Threatening

Low testosterone in men, beyond influencing physical appearance and sexual function, can also have profound implications on more serious and potentially life-threatening health conditions. Two significant health risks associated with low testosterone levels are cardiovascular disease and diabetes, which are detailed below:

Accelerated aging process

Low testosterone—a condition referred to as hypogonadism, in fact—may influence the body in several different ways that might actually add to the acceleration of aging in men. These factors are literal, including both physical and mental aspects.

Decrease in Muscle Mass and Strength: Testosterone is extremely necessary for muscle mass and strength. Its decrease can bring about a decrease in muscle mass and physical strength, both qualities usually associated with old age.

Reduced Bone Density: Testosterone helps in the production and strengthening of bones. In fact, men with low testosterone levels are likely to experience reduced bone density, which in a way pre-exposes them to osteoporosis and for that matter, fractures, which is quite rampant during old age.

Increased body fats: Low levels of testosterone can lead to the increase in body fats, especially in the tummy area. This is due to the change in body composition. He may become obese due to this change, and associated health-related problems with obesity include type 2 diabetes and cardiovascular diseases, commonly observed in the geriatric population.

Fatigue and Reduced Energy Levels: Greatly reduced energy levels coupled with complete fatigue, whereby one feels way too old for their age, and as a result, they have much less zeal to do things they previously used to be excited about, have been reported by men with low levels of testosterone.

Mood: Testosterone plays a big part in mood and the mental capacity. Low levels of testosterone could cause a man to feel depressed and irritable, and even lose interest in the things that used to bring him joy. It may also affect overall life quality perception and may cause one to feel that he is aging faster.

Drop in testosterone: Evidence indicates that low levels of testosterone may be linked to a decline in the cognitive abilities involving memory and concentration, comparable with the changes taking place during aging.

Testicular problems: Testosterones are very essential for sexual health. The inadequate level of testosterones may cause some problems, like decreased sex drive and erectile dysfunction, and sexual health problems mainly thought to occur in old ages.

Skin changes—low levels of testosterone weaken the skin, causing it to be thin, less elastic, and more predisposed to wrinkling.

Cardiovascular Disease

Low testosterone levels have been linked to an increased risk of cardiovascular diseases, including heart disease and stroke. The mechanisms through which low testosterone might influence heart health include:

  • Endothelial Dysfunction: Testosterone is thought to play a role in the health of the endothelium, the inner lining of blood vessels. Low levels can lead to dysfunction of the endothelium, which can reduce the flexibility of blood vessels, impairing their ability to dilate and increasing the risk of atherosclerosis (buildup of plaque in the arteries).
  • Lipid Profile Changes: Testosterone can influence lipid metabolism. Low levels of testosterone are often associated with unfavorable changes in lipid profiles, including increased levels of low-density lipoprotein (LDL) cholesterol and triglycerides, and decreased levels of high-density lipoprotein (HDL) cholesterol. These changes can contribute to the development of atherosclerosis.
  • Inflammation: Low testosterone is linked to increased levels of inflammatory markers, such as C-reactive protein (CRP). Chronic inflammation is a known risk factor for cardiovascular diseases.


The relationship between low testosterone and type 2 diabetes has been extensively studied, and there is evidence to suggest that low testosterone levels may increase the risk of developing type 2 diabetes. Possible mechanisms include:

  • Insulin Resistance: Testosterone plays a role in insulin sensitivity. Low levels of testosterone can lead to increased insulin resistance, a condition where the body's cells do not respond effectively to insulin. Insulin resistance is a key feature of type 2 diabetes.
  • Fat Distribution: Men with low testosterone levels tend to have increased fat, particularly visceral fat, which is the fat stored around the abdominal organs. Visceral fat is a significant risk factor for insulin resistance and type 2 diabetes.
  • Inflammatory Pathways: Similar to its role in cardiovascular disease, low testosterone can contribute to increased inflammation, which is implicated in the pathogenesis of type 2 diabetes.

It's important to recognize that these conditions are multifactorial, meaning that low testosterone is just one of many factors that can contribute to their development. Lifestyle factors such as diet, exercise, smoking status, and alcohol consumption, as well as genetic predispositions, also play significant roles.

Dementia & Alzheimers

The relationship between chronic low testosterone and the development of dementia, including Alzheimer's disease, is an area of ongoing research, with several proposed mechanisms suggesting how low testosterone might contribute to cognitive decline and dementia:

  1. Neuroprotection: Testosterone is thought to have neuroprotective effects, meaning it helps protect neurons (brain cells) from damage. It may influence the growth and survival of neurons, promote the repair of damaged neurons, and protect against the accumulation of toxic substances in the brain, such as amyloid-beta plaques, which are a hallmark of Alzheimer's disease. Lower levels of testosterone could reduce these protective effects, making the brain more susceptible to damage and the development of dementia.
  2. Inflammation: Chronic low testosterone may contribute to increased inflammation within the body and brain. Inflammation is a key factor in the pathogenesis of Alzheimer's disease and other forms of dementia. Testosterone has anti-inflammatory properties, and lower levels could lead to an increase in pro-inflammatory cytokines, contributing to neuroinflammation and neuronal damage.
  3. Vascular Health: Testosterone plays a role in maintaining vascular health by influencing blood flow and endothelial function. Reduced testosterone levels are associated with an increased risk of cardiovascular diseases, which are known risk factors for the development of vascular dementia and can also contribute to Alzheimer's disease by affecting cerebral blood flow and leading to cerebrovascular damage.
  4. Metabolic Regulation: Testosterone influences metabolism, including the regulation of insulin and glucose levels. Low testosterone levels are associated with metabolic disorders such as diabetes and obesity, which are known risk factors for Alzheimer's disease and other dementias. Insulin resistance and poor glucose metabolism can lead to brain cell damage and cognitive decline.
  5. Cognitive Reserve: Chronic low testosterone may impact cognitive reserve, the brain's ability to compensate for neural damage. By affecting cognitive functions such as memory, concentration, and executive function, low testosterone may reduce the brain's resilience against the pathological changes associated with dementia.

Testosterone Replacement Therapy

What is Testosterone Replacement Therapy?

Testosterone replacement therapy (TRT) is a medical treatment that involves supplementing testosterone levels in individuals with low testosterone. TRT is typically prescribed to men & women with clinically diagnosed low testosterone levels (hypogonadism) or those experiencing symptoms associated with low testosterone.

Benefits of Testosterone Replacement Therapy

Testosterone replacement therapy (TRT) can provide several potential benefits: (#6 is our favorite)

  1. Increased Libido and Sexual Function: TRT can improve sexual desire (libido) and address symptoms of erectile dysfunction in men with low testosterone levels. It can enhance sexual performance, increase frequency of erections, and improve overall satisfaction with sexual experiences.
  2. Improved Mood and Mental Well-being: Low testosterone levels have been associated with symptoms of depression, irritability, fatigue, and decreased motivation. TRT may help improve mood, alleviate symptoms of depression, and enhance overall well-being. It can contribute to increased energy levels, improved motivation, and a sense of mental clarity.
  3. Increased Muscle Mass and Strength: Testosterone plays a crucial role in the development and maintenance of muscle tissue. TRT can help increase muscle mass, strength, and physical performance. It may also support the recovery and repair of muscle following exercise or injury.
  4. Preservation of Bone Density: Testosterone is important for maintaining bone health in men. Low testosterone levels can contribute to decreased bone density and increase the risk of osteoporosis and fractures. TRT can help preserve bone density and reduce the risk of osteoporosis.
  5. Improved Body Composition: Testosterone plays a role in regulating fat metabolism and distribution in the body. TRT may help reduce body fat percentage, particularly visceral fat (fat around the abdomen), and promote a more favorable body composition.
  6. Enhanced Cognitive Function: TRT has positive effects on cognitive function, including memory, attention, and spatial abilities. It may improve mental processing speed and overall cognitive performance in some individuals.

Side Effects of Testosterone Replacement Therapy

Testosterone replacement therapy (TRT) can have potential side effects, although they are generally uncommon and vary depending on the individual, the dosage, and the method of administration. Some possible side effects of TRT include:

  1. Fluid Retention: TRT can cause fluid retention, leading to bloating or an increase in blood pressure. Monitoring fluid balance and blood pressure is important during TRT.
  2. Acne and Skin Reactions: Testosterone can stimulate sebum production, which may lead to increased acne or oily skin. Some individuals may also experience skin reactions at the application site of gels, creams, or patches.
  3. Increased Red Blood Cell Production: TRT can stimulate the production of red blood cells, which may result in a higher red blood cell count (polycythemia). This can increase the risk of blood clots or other cardiovascular complications. Regular monitoring of hematocrit and hemoglobin levels is necessary to manage this potential side effect.
  4. Prostate Effects: There has been debate regarding the impact of TRT on the prostate gland. Some studies suggest that TRT may stimulate the growth of existing prostate cancer cells, although the evidence remains inconclusive. Close monitoring of prostate health through regular prostate-specific antigen (PSA) testing is essential for individuals considering or undergoing TRT.
  5. Sleep Apnea: TRT may exacerbate sleep apnea or contribute to the development of sleep apnea in individuals who are already at risk. It is important to evaluate and monitor sleep patterns during TRT.
  6. Testicular Shrinkage: TRT can lead to testicular shrinkage due to the suppression of the body's natural testosterone production. This is reversible upon discontinuation of TRT.

Preventing Negative Side Effects of Testosterone Replacement Therapy

One of the key aspects of our vision for Evolve Anti-Aging & Wellness is being a full-fledged, state of the art diagnostic laboratory. This gives us the ability to view our clients blood panel within 30 minutes. This near instant access to lab results allows us to foresee potential side effects before they become a problem.

We perform blood tests every 10-12 weeks.

All blood tests are included in your therapy protocol.

Additionally, we supply clients with customized protocols based on their panel results. Meaning, if a client has low testosterone and high estrogen, we formulate the protocols to increase testosterone while bringing estrogen levels to the desired range.

Testicular atrophy is a common side effect with TRT. To avoid this negative side effect, we provide the client with numerous options that stimulate the production of luteinizing hormone (LH) - which acts as a signal from the pituitary gland to the testicles to produce your natural testosterone and semen. This will prevent the testicles from atrophying and will help sustain its natural size and integrity.

  • Blood work

    We process your lab results in-house and have results ready in about 45 minutes. We will check the following panels:

    • Hormone Panel (Testosterone, Estrogen, Luteinizing hormone, Thyroid, HGA1C)
    • Lipid (cholesterol, HDL, LDL, Triglycerides)
    • Comprehensive Metabolic (Liver, Kidneys, Glucose, K2, Chlorid...)
    • Complete Blood Count (Hemoglobin, Hematocrit, Red blood Count, White Blood Count...)
  • Consultation

    We introduce you to our TRT program and answer any questions you may have while you blood panel results are processing.

    We will discuss possible side effects, and how we stop them from occurring and we treat them if they do occur.

  • Testosterone Replacement Protocol

    After your results have been reviewed and determined a candidate for TRT, we discuss your results with you, answer any further questions you may have and get you started. You may have your therapy administered in the clinic or you may take the protocol(s) home with you for self administration. No problem if you don't know how, we will train you!

  • Testosterone

    Testosterone is the male sex hormone that is responsible for our vitality, sexual appetite, endurance, mood regulation, focus and cognition, muscle synthesis, sleep quality and strengthening the immune system.

    Our testosterone therapy is overseen and prescribed by Benito Villanueva, MD. You can learn more about doctor Villanueva by clicking here.

  • HCg & Clomid

    Testosterone replacement therapy does have side effects. One of them being the stopping or lack of production of testosterone and semen.

    To remedy this, we prescribe either HCg (human chorionic gonadotropin) or clomid. These medications stimulate the body to continue to synthesize your natural testosterone and keep up semen production.

  • Aromatase inhibitor

    Aromatase inhibitors are used in men on testosterone replacement therapy to prevent the conversion of testosterone to estrogen, reducing the risk of side effects like breast tissue development and water retention.