When we talk about men's health, few things influence overall well-being as much as hormonal balance. Sex hormones regulate everything from sexual desire and daily energy levels to mood, muscle mass, and fertility. However, many men don't really know how these substances work or what signs indicate that something is wrong.
Book your first medical consultation now
and discuss your case with one of our medical specialists, no strings attached.
What are sex hormones?
Sex hormones are chemical messengers produced primarily by the gonads (in men, the testicles) and, to a lesser extent, by the adrenal glands. They travel through the bloodstream and act on various tissues and organs, regulating processes as diverse as genital development, sperm production, sexual desire, and body fat distribution.
Although we often associate the term with testosterone, there is actually a whole set of hormones that work in a coordinated way. Each one fulfills a specific function, but they are all interconnected within what is known as the reproductive hormonal axis.
Why are they important in man?
In the male body, sex hormones not only determine reproductive capacity, but also influence aspects often not directly related to sexuality: muscle strength, bone density, mental concentration, and even sleep quality. Therefore, when a hormonal imbalance occurs, the symptoms can be highly varied and, sometimes, difficult to identify at first glance.
Maintaining these hormones at adequate levels is key not only for fertility, but for overall quality of life, both in youth and in later stages.
How they work within the body
Sex hormones act through a very precise communication system. They are released into the bloodstream and bind to specific receptors present in various tissues: muscle, bone, brain, skin, and fat, among others. By binding to these receptors, they activate or deactivate certain cellular processes, which explains why their effects are so widespread.
This system also works through feedback mechanisms: when hormone levels rise or fall, the brain detects this and adjusts production accordingly. It's a dynamic balance that constantly adapts to the body's needs.
Where are male sex hormones produced?
Most male sex hormones are produced in the testes, specifically in structures called Leydig cells. However, there is also secondary production in the adrenal glands, located above the kidneys, which contribute a small proportion of androgens and other related hormones.
Androgens and regulatory hormones
Androgens are the group of hormones responsible for male sexual characteristics. Testosterone is the primary androgen, but it doesn't act alone: there are regulatory hormones, such as LH and FSH, produced in the pituitary gland, whose function is precisely to stimulate the testes to produce testosterone and sperm. Without this prior signal, testicular hormone production would not be activated correctly.
What are the main male sex hormones?
Several hormones are involved in men's sexual and reproductive health. Each has a distinct role, although they are all interconnected.
Dihydrotestosterone or DHT
DHT is a derivative of testosteroneDHT, which is much more potent in terms of biological activity, is formed by an enzyme called 5-alpha-reductase, which transforms some of the circulating testosterone into DHT. This hormone is especially relevant during genital development in the fetal stage and during puberty, and is also involved in processes such as the growth of body hair or, in some cases, male pattern baldness.
Testosterone
It is the most well-known sex hormone and the one most often associated with masculinity. It is primarily produced in the testicles and performs functions that extend far beyond sexuality: it plays a role in muscle development, red blood cell production, bone health, and mood. Its levels fluctuate throughout the day and also throughout life, gradually declining after the age of 30 or 40.
LH and FSH
Luteinizing hormone (LHLuteinizing hormone (LH) and follicle-stimulating hormone (FSH) are produced in the pituitary gland, located at the base of the brain. LH stimulates Leydig cells to produce testosterone, while FSH acts on Sertoli cells, promoting sperm production. Both are essential for the normal functioning of the male reproductive system.
Estradiol in men
Although often considered a female hormone, estradiol is also present in men, albeit at much lower concentrations. It is produced in part from the conversion of testosterone by an enzyme called aromatase. Estradiol contributes to bone health, the regulation of sex drive, and certain cognitive processes. Both an excess and a deficiency can cause symptoms.
Inhibin B
This hormone is produced in Sertoli cells and its main function is to inform the brain about the status of sperm production. When sperm production decreases, inhibin B levels typically drop, leading to a compensatory increase in FSH. For this reason, it is sometimes used as a fertility marker.
Prolactin
Prolactin is produced in the pituitary gland and, although it is usually associated with breastfeeding in women, it is also present in men. Under normal conditions, its levels are low, but when it rises abnormally, it can interfere with testosterone production and cause symptoms such as decreased libido or erectile dysfunction.
SHBG
Sex hormone-binding globulin, known as SHBG, is a protein that transports testosterone in the blood. Only a small fraction of testosterone circulates "free," meaning it is available to act on tissues; the rest travels bound to SHBG or albumin. Levels of this protein can be altered by age, body weight, or certain medical conditions, which directly influences the amount of active testosterone.
Differences between male and female hormones
Although we usually talk about "male" and "female" hormones, the biological reality is more nuanced.
Men also produce estrogen
As mentioned earlier, the male body produces estradiol, although in much smaller quantities than in women. This hormone plays important roles related to bone and cardiovascular health.
Women also produce testosterone
Similarly, the female body produces testosterone, primarily in the ovaries and adrenal glands. It contributes to libido, muscle mass, and overall well-being, although at much lower concentrations than in men.
The difference lies in the concentration and hormonal function
What truly distinguishes the male from the female hormonal profile is not the presence or absence of a specific hormone, but rather the proportions in which they are found and the predominant role they play in each organism. This difference in concentrations is what determines the development of the sexual and reproductive characteristics specific to each sex.
Male hormonal axis
Proper hormonal function depends on a highly organized communication system, known as the hypothalamus-pituitary-gonadal axis.
From the brain to the testicles
The entire process begins in the brain. The hypothalamus sends signals to the pituitary gland, which in turn stimulates the testicles to produce testosterone and sperm. It is a hierarchical chain of command in which each structure depends on the one before it to activate correctly.
The role of the hypothalamus and the GnRH hormone
The hypothalamus releases gonadotropin-releasing hormone, known as GnRH, in a pulsatile manner, meaning in small bursts throughout the day. This pulsatile release is essential: if GnRH were released continuously instead of intermittently, the system would cease to function normally.
How the pituitary gland releases LH and FSH
Upon receiving the signal from GnRH, the pituitary gland releases LH and FSH into the bloodstream. These two hormones travel to the testes, where each acts on a different cell type to perform its specific function.
Leydig cells
Leydig cells, located between the seminiferous tubules of the testes, are responsible for producing testosterone in response to LH stimulation. They are, therefore, the main source of testosterone in the male body.
Sertoli cells
Sertoli cells, for their part, respond to FSH and play an essential role in sperm production and maturation. They also secrete inhibin B, which participates in the hormonal feedback system.
The feedback system that maintains hormonal balance
When testosterone or inhibin B levels are sufficient, the brain reduces the release of GnRH, LH, and FSH, thus decreasing testicular stimulation. Conversely, if levels drop, the brain increases the signal to try to restore balance. This self-regulating mechanism is what allows hormone levels to remain relatively stable over time, although it can be disrupted by various factors.
What functions do sex hormones perform?
Male sex hormones are involved in a large number of processes, far beyond the reproductive sphere.
Development of the genitals
During fetal development, testosterone and its derivative, DHT, are responsible for the differentiation and development of male genitalia. Without adequate exposure to these hormones at the appropriate time, genital development would not occur normally.
Changes during puberty
During puberty, the increase in testosterone causes very visible changes: growth of body and facial hair, deepening of the voice, muscle development, growth of the genitals, and increased height, among others. It is one of the periods of greatest hormonal activity in a man's life.
Sexual desire, arousal, and quality of erections
Testosterone has a direct relationship with libido and sexual responsiveness. Adequate levels promote both desire and the quality of erections, while low levels can lead to decreased sexual interest or difficulty maintaining a firm erection.
Sperm production
Spermatogenesis, the process of sperm production, depends on the combined action of FSH and testosterone on Sertoli cells. Any disruption in this balance can affect both the quantity and quality of semen.
Male fertility
Beyond sperm production, male fertility depends on a set of hormonal factors that must be well-coordinated. An imbalance in testosterone, LH, FSH, or prolactin can make conception difficult, even when other semen parameters appear normal.
Muscle mass and strength
Testosterone promotes muscle protein synthesis, which explains why men generally have more muscle mass than women. Low levels of this hormone can lead to a loss of strength and muscle mass, especially after a certain age.
Body fat distribution
Sex hormones also influence how and where body fat accumulates. Low testosterone levels are frequently associated with increased abdominal fat, while adequate levels promote a more balanced body composition.
Bone density and metabolic health
Both testosterone and estradiol contribute to maintaining bone mineral density. A prolonged decline in these levels, especially in older men, can increase the risk of osteoporosis and fractures. Furthermore, there is a close relationship between hormone levels and metabolic parameters such as insulin sensitivity and lipid profile.
Mood, concentration
Testosterone receptors are present in various brain areas, which explains why this hormone influences mood, motivation, and concentration. Men with low levels often report increased irritability, apathy, or difficulty maintaining attention.
Memory and sleep
A relationship has also been observed between hormone levels and sleep quality, as well as with certain aspects of memory. Poor sleep quality can also reduce testosterone production, creating a self-reinforcing cycle.
How testosterone changes throughout the day
There is, however, a clear daily rhythm: testosterone levels typically peak in the morning, shortly after waking, and gradually decline throughout the day. This circadian variation is why testosterone tests are usually recommended in the morning.
Factors that alter hormones
Multiple factors can disrupt hormonal balance:
- Chronic stress
- Lack of sleep
- Overweight
- Excessive alcohol consumption
- Certain medications
- Chronic diseases
- Genetic factors
- Age.
How male hormones change with age
From the age of 30 or 40, total testosterone levels gradually decline at a rate of approximately 1% per year, although this percentage can vary from person to person. Free testosterone levels tend to decrease somewhat more significantly, partly because SHBG levels tend to increase with age.
Andropause and hypogonadism
When this hormonal decline is accompanied by obvious symptoms, it is sometimes referred to as andropause, although the more medically accurate term is hypogonadism of late onset. Unlike female menopause, it is not a sudden cessation of hormonal function, but a slow and progressive process that not all men experience with the same intensity.
You may also like: male hormone cycle.
Levels of male sex hormones
Interpreting a hormonal analysis correctly requires taking into account several nuances.
Total, free and bioavailable testosterone
Total testosterone includes all the hormone present in the blood, both protein-bound and free. Free testosterone is the fraction not bound to proteins, while bioavailable testosterone includes both free testosterone and testosterone weakly bound to albumin. Many specialists believe that free or bioavailable testosterone provides a more accurate picture of actual hormonal activity, as it is the fraction that can act directly on tissues.
As a general guideline, various laboratories place the normal range for total testosterone in young adult men at around 264-916 ng/dL, with a gradual decline starting around age 40-50. These are always indicative values that should be interpreted in conjunction with age, symptoms, and other analytical parameters.
What time should a testosterone test be performed?
Since testosterone levels follow a circadian rhythm, it's best to have your blood drawn between 7:00 and 10:00 a.m., on an empty stomach, as this is when levels are highest and most representative. Testing in the afternoon can produce lower values than the actual levels, which could lead to misinterpretations.
What do LH, FSH, estradiol, and prolactin indicate?
These parameters complement the information provided by testosterone. Elevated LH and FSH levels along with low testosterone usually indicate a testicular problem; conversely, if LH and FSH are low along with low testosterone, the origin is likely in the hypothalamus or pituitary gland. Estradiol and prolactin help to complete the diagnosis, especially when symptoms such as decreased libido or gynecomastia are present.
Why do reference values change?
Reference ranges can vary between laboratories depending on the analytical method used, the reference population, or even the unit of measurement (ng/dL or nmol/L). This is why it is so important that any laboratory test be interpreted by a medical professional, who can contextualize the result according to each specific case.
Male hormonal imbalance
An imbalance in sex hormones can manifest itself in very different ways depending on the hormone affected.
Symptoms of low testosterone in men
Among the most common signs are:
- Decreased sex drive
- Difficulty maintaining erections
- persistent fatigue
- Loss of muscle mass
- Increased body fat
- Mood swings
- Decreased concentration
- Reduction of body hair
What happens when testosterone is too high?
Although this scenario is discussed much less, excessively high levels of testosterone, generally associated with the unsupervised use of anabolic steroids, can also cause problems:
- Acne
- mood swings
- Increased cardiovascular risk
- Decreased natural sperm production
- Testicular atrophy
High or too low estradiol
Excessive estradiol in men can be associated with fluid retention, increased breast tissue, or mood changes. Conversely, excessively low levels can negatively affect bone health and sex drive.
High prolactin and decreased sex drive
Hyperprolactinemia can inhibit testosterone production and cause a significant decrease in libido, erectile dysfunction, and even, in more severe cases, visual disturbances if the origin is a benign pituitary tumor.
LH and FSH abnormalities
Abnormal levels of these hormones are usually the first clue to locating the origin of a hormonal problem, whether at the testicular level or at the central level, in the hypothalamus or the pituitary gland.
Causes that should be investigated by a specialist
Among the most frequent causes of hormonal imbalance are natural aging, obesity, type 2 diabetes, alcohol or substance use, chronic stress, some medications, genetic disorders such as Klinefelter syndrome, or pituitary gland problems. A specialist should evaluate each case individually to determine the exact cause.
The symptoms of a hormonal imbalance can be grouped into three main categories:
- Sexual and reproductive: decreased libido, erectile dysfunction, reduced ejaculate volume, fertility difficulties.
- Physical and metabolic: fatigue, loss of muscle mass, increased body fat, decreased bone density, abnormal sweating.
- Cognitive and emotional: irritability, apathy, difficulty concentrating, sleep disturbances, low mood.
Book your first medical consultation now
and discuss your case with one of our medical specialists, no strings attached.
Libido, erection and male fertility
The relationship between hormones and sexual function is one of the aspects that most concerns men.
Does testosterone control sex drive?
Testosterone is undoubtedly one of the main regulators of sexual desire, but it is not the only factor involved. Psychological, emotional, and relational aspects also decisively influence libido, so normal hormone levels do not always guarantee a high sex drive, and vice versa.
Low testosterone and erectile dysfunction
Although erectile dysfunction often has a vascular or psychological origin, low testosterone levels can contribute to or worsen the problem, especially when combined with other risk factors such as hypertension, diabetes, or smoking.
How hormones are involved in semen production
As explained previously, FSH and testosterone are essential for Sertoli cells to properly carry out spermatogenesis. An imbalance in these hormones can reduce both the quantity and quality of sperm produced.
Hormonal imbalances that can hinder fertility
Conditions such as hypogonadism, hyperprolactinemia, or thyroid disorders can interfere with male fertility, even in the absence of other obvious symptoms. For this reason, a comprehensive hormonal evaluation is usually part of the routine assessment for couples trying unsuccessfully to conceive.
When to request a male hormone test
It is recommended to request a hormonal evaluation when there are persistent symptoms such as decreased libido (or low libido), erectile dysfunction, unexplained fatigue, mood swings without apparent cause, loss of muscle mass, or difficulty conceiving. It may also be recommended for men of a certain age as part of a general health check-up.
How to maintain hormonal balance naturally
In addition to medical treatment when necessary, there are lifestyle habits that help maintain a healthy hormonal profile.
Sleep well and respect the body's rhythms
Quality sleep is one of the most crucial factors in testosterone production, as a large portion of this hormone is synthesized during the deepest stages of sleep. Regularly sleeping less than the recommended amount has been linked to significant decreases in hormone levels.
Strength training and physical activity
Exercise, especially strength training, promotes testosterone production and helps maintain a healthier body composition. A sedentary lifestyle, on the other hand, is associated with lower hormone levels.
Body weight and abdominal fat
Excess body fat, particularly abdominal fat, promotes the conversion of testosterone into estrogen via the aromatase enzyme, which can disrupt hormonal balance. Maintaining a healthy weight is therefore one of the most effective ways to protect hormonal health.
Food, alcohol and habits
A balanced diet, rich in quality protein, healthy fats, vitamins, and minerals, contributes to proper hormonal function. Excessive alcohol consumption, on the other hand, can negatively affect testosterone production and disrupt estradiol metabolism.
Chronic stress
Prolonged stress raises cortisol levels, a hormone that can interfere with testosterone production. Incorporating stress management strategies, such as exercise, adequate rest, or relaxation techniques, can have a positive impact on hormonal balance.
Supplements to increase testosterone
Numerous supplements on the market promise to naturally raise testosterone levels. While some micronutrients, such as zinc or vitamin D, may be helpful in cases of deficiency, evidence supporting most of these products is limited. Before taking any supplement, it's best to consult a healthcare professional, who can assess whether a deficiency exists and determine the most appropriate option.
It may interest you: 15 foods to increase testosterone.
Frequently Asked Questions (FAQs)
How does cholesterol affect sex hormones?
Cholesterol is the raw material from which the body synthesizes testosterone and other steroid hormones. Excessively low cholesterol levels, generally associated with very restrictive diets or the use of certain medications, can limit hormone production. At the same time, excess cholesterol is linked to cardiovascular problems, which can also indirectly affect hormonal health.
What are the 5 male hormones?
Although several hormones are involved in male sexual health, the five most frequently highlighted are testosterone, dihydrotestosterone (DHT), LH, FSH, and estradiol. Other relevant hormones, such as prolactin, inhibin B, and SHBG, complete the male hormonal picture.
What are the symptoms of low testosterone in a man?
The most frequent symptoms include decreased sex drive, difficulty maintaining erections, persistent fatigue, loss of muscle mass, increased body fat, mood swings, difficulty concentrating, and, in some cases, decreased body hair.
What are normal testosterone levels according to age?
As a general guideline, total testosterone levels in young adult men typically range from approximately 264 to 916 ng/dL, while after age 50 the range tends to shift slightly towards lower values. These ranges may vary depending on the laboratory and should always be interpreted in conjunction with the patient's symptoms and medical judgment.
Can low testosterone cause erectile dysfunction or infertility?
Yes, low testosterone levels can contribute to both erectile dysfunction and fertility problems, although they are not the only possible cause in either case. Therefore, if these symptoms are present, a comprehensive evaluation is recommended, including not only testosterone levels but also other hormonal parameters and an assessment of overall health.
Take the first step to restore your hormonal well-being
Have you noticed changes in your energy, libido, mood, physical performance, or overall well-being? These symptoms can be related to various factors, including a possible hormonal imbalance. Low T Center You can request a specialized assessment of male hormonal health, with a personalized approach based on your particular situation.
Featured services include:
- Online Testosterone Test, where we will evaluate with this quick and free test if you have low testosterone or high testosterone in men with this simple, convenient test without leaving home.
- Testosterone Replacement Therapy (TRT), indicated in cases of primary hypogonadism o secondary hypogonadism, helps you regain your vitality, sexual energy and overall well-being.
Take the first step to better understand your health, resolve your doubts, and receive professional guidance on the most suitable options for you. Request your appointment and start taking care of your hormonal well-being and quality of life today.
Book your first medical consultation now
and discuss your case with one of our medical specialists, no strings attached.
Conclusion
Male sex hormones extend far beyond the purely reproductive sphere: they influence daily energy levels, mood, muscle mass, bone health, and overall quality of life. Understanding how this system works, what factors can disrupt it, and what signs to watch for allows for timely intervention in the event of any imbalance.
Maintaining healthy habits—getting enough sleep, exercising regularly, eating a balanced diet, and managing stress—is fundamental to preserving good hormonal balance. Even so, when persistent symptoms appear, it's best to consult a specialist who can assess the situation individually through a comprehensive hormonal evaluation, thus avoiding self-diagnosis and ensuring a safe and effective approach.
0 comments