What is a hormone?
An hormone It is a chemical substance released by an endocrine gland (for example the hypophysis or pituitary gland). For purists, a hormone should only be called a compound that meets the following characteristics: that it is released by specialized cells of an endocrine gland, that it carries a message to an organ or effector cells and that a response or effect to this stimulus is evident. I make this clarification because there are substances that are also considered hormone-like or paracrine factors, as is the case of IGF 1, which is synthesized in the liver (which is evidently not an endocrine gland) when stimulated by the growth hormone.
In short, just as I explain to my patients in consultation, A hormone is a messenger, which carries an instruction to an organ., so that it is fulfilled and a series of processes are generated (metabolic or catabolic, energetic, etc.) that will result in well-being for the patient.
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Control of hormone production in men
Hormone production in men is regulated by a complex feedback system involving the hypothalamus, pituitary gland and testes. This system is called the hypothalamic-pituitary-gonadal axis.
El hypothalamus produces gonadotropin-releasing hormone (GnRH)), which stimulates the pituitary gland to release luteinizing hormone (LH) and FSH hormone or follicle-stimulating hormone into the bloodstream. LH and FSH then travel to the testicles, where they stimulate the production of testosterone and sperm.
La testosterone, in turn, has a negative feedback effect on the hypothalamus and pituitary gland, which helps regulate the amount of LH and FSH released. When testosterone levels are high, they inhibit the release of GnRH and LH, which reduces testosterone production. When testosterone levels are low, this negative feedback loop is weakened, allowing for increased testosterone production.
This feedback loop helps maintain hormonal balance in the body, which is essential for optimal sexual function, fertility, and overall health in men. Disorders or diseases affecting any part of the hypothalamic-pituitary-gonadal axis can disrupt this delicate balance and lead to problems with hormone production, sexual function, and fertility.
Male Hormones and Their Function
In order to attribute one hormone to men and another to women we must first understand other hormones in the male hormone cycle that we must measure in blood in the evaluation of the endocrinological axis to have an adequate diagnostic approach, and that are essential to achieve the response of the gonads, these are FSH and LH.
FSH
FSH stands for follicle stimulating hormone, which is a hormone produced by the pituitary gland in both men and women. In men, FSH plays a key role in regulating sperm production by the testicles.
When FSH levels in men are high, may indicate a problem in the testicles or in the hypothalamic-pituitary-gonadal axis (the hormonal system that regulates sexual function and fertility). Low FSH levels in men may also indicate a problem with this axis or with the pituitary gland itself.
La FSH It is the follicle-stimulating hormone, and It is released in both men and womens to send the message that the pituitary gland wants to reach the gonads (ovaries and testicles) in men it stimulates the production of sperm and in women it stimulates the growth of eggs.
LH
LH stands for luteinizing hormone, which is a hormone produced by the pituitary gland in both men and womenIn men, LH plays a crucial role in regulating testosterone production by the testes.
LH stimulates the Leydig cells of the testes to produce testosterone, which is important for the development of male reproductive tissues, muscle mass and bone density, as well as regulating sexual desire and mood.
The low levels of LH hormone In men, they may indicate a problem with the hypothalamic-pituitary-gonadal axis or the pituitary gland itself. High levels of LH in men may indicate a problem with the testicles or the hypothalamic-pituitary-gonadal axis.
La LH on the other hand stimulates the testicle specifically in the Leydig cells for the production of testosterone, and in the women modulates the menstrual cycle, stimulates the release of eggs, ovarian maturation, and stimulates the corpus luteum (to produce progesterone to sustain the implanted egg).
Testosterone
La testosterone As we have mentioned in several articles, it is the leading hormone in men, and balanced blood values allow a wide range of physical and cognitive advantages. And it is that Testosterone increases muscle mass, with persistence of tone and volume, bone metabolism, increased HDL, cardiovascular health, less peripheral fat, optimal libido and sexual function, as for mood, it is related to better mental health, decreasing anxiety rates, Stress, depression, among others. There are many people who have a testosterone deficiency, also known as hypogonadismIf you suspect you have, we recommend you take this brief online testosterone test and in 5' get rid of doubts.
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It is also appropriate to mention their cognitive level functions, It is vital for the growth, maturation and differentiation of neuronal brain tissue, so much so that throughout the structure of neurons we find aromatase to convert testosterone as a precursor to estrogen, glial cells are capable of producing their own steroid hormones given the urgent need for them and we have hormone receptors in such important brain structures as the pituitary gland, hypothalamus, amygdala, hippocampus, gray matter, basal cortex of the frontal lobe, cerebellum, locus coeruleus, and raphe nuclei.
About Hormones
By definition, hormones are not exclusive to men or women. It is clear that testosterone predominates in men and estrogen in women, but both require at least a certain amount in the blood for their proper functioning. For example, men require minimum levels of female hormones (estrogen) to have adequate bone metabolism, distribution of body fat, decreased blood pressure and consequently decreased cardiovascular risk. This explains why women before menopause have a lower risk of heart attack, cerebrovascular disease, etc.
The above does not mean that men should increase estrogen levels (which would be counterproductive), but that we should improve cardiovascular risk through other parameters. I encourage you to schedule a free information appointment to indicate the most appropriate tests for your personal situation.
Hormonal Reference Values
It is very important to understand several concepts in order to reach a conclusion about the “normality” or alteration of my analytical results.
When we refer to hormonal levels, the ranges of "normality" cannot be correlated with other types of blood measurements, such as electrolyte levels, in this case, saying that a normal level of sodium go of 135 to 145 mEq/dl and that by being outside these limits, with high precision, we can ensure that we will find some symptoms of disease, but this is because sodium is a final product while hormones are not, remember that they are messengers, thus, for each organism we can have different hormonal levels, which result in a specific response, however we are guided by them because we have no way to objectify these varied responses that are mostly clinical (libido, muscle mass, cognition ...). That is to say, we can find patients with symptoms of hypogonadism (low testosterone production) with hormonal levels within "normal" ranges.
How are the 5 love hormones activated?
The “love hormones” include oxytocin, dopamine, serotonin, endorphins and vasopressin. Here’s how they’re activated:
1. Oxytocin
- Physical contact: Hugs, kisses and sexual relations.
- Emotional bonds: Activities that build trust and connection, such as deep conversations.
- acts of kindness: Helping others and receiving help can increase oxytocin levels.
2. Dopamine
- Reward and achievement: Complete goals and receive praise.
- Physical activity: Regular exercise.
- Food: Eat pleasurable foods, but in moderation.
3. Serotonin
- Exposure to the sun: Sunlight helps the production of serotonin.
- Exercise: Regular physical activity.
- Food: Eat foods rich in tryptophan, such as bananas, nuts and seeds.
4. Endorphins
- intense exercise: Activities such as running, swimming or cycling.
- Laughter: Watch comedies or spend time with friends who make you laugh.
- Pleasurable activities: Eat chocolate, have sex and listen to music that you enjoy.
5. vasopressin
- Intimate relationsVasopressin is released during and after sexual intercourse.
- Long-term ties: Participate in activities that strengthen the emotional connection with a partner.
Regularly participating in activities that promote these hormones can help improve emotional well-being and personal relationships.
Can these be associated with hypogonadism?
According to the most up-to-date studies on the subject, primary hypogonadism It is a deficient function of testosterone production by the testicle, which can be confirmed by measuring: total testosterone and/or free testosterone. Thus, the European Academy of Andrology, supported by the European Society of Endocrinology, states in its clinical practice guidelines: "The exact concentration of Testosterone (total) below which a diagnosis of functional hypogonadism can be confidently made remains elusive and controversial. The harmonized lower limits of the reference range for Testosterone (total) in healthy, non-obese young men (19 to 39 years of age) were 9,2 nmol/L (264 ng/dL) and 10,5 nmol/L (303 ng/dL) using, respectively, the 2,5th and 5th percentiles.”
For their part, in a study of hypogonadism published in the New England Journal of Medicine taking the population of the European Male Aging Study (Cohort study of European men from 8 cities, one of them Santiago de Compostela, Spain), they recruited 3369 patients, finding that sexual symptoms (poor morning erections, low libido and erectile dysfunction) had an association with total T (TT) concentrations < 320 ng/dL (11 nmol/L) and free T (TL) < 64 pg / mL (220 pmol / L) (after adjusting for age).
The different medical societies conclude through meta-analysis that the patients who obtain the greatest benefit from Testosterone Replacement Therapy are those who have TT values < 8 nmol/L, and those with TL < 225 pmol / L (6,5 ng/dL or < 65 pg / mL ) are associated with hypogonadism in adult men.
For the reasons mentioned above, the other important concept to know is to identify the different units of measurement in which the results are presented, since the values change according to these (pg/ml, nmol/L, ng/dL, etc.), They depend on the measurement method used in the laboratory, for this we can take into account the following tables:
NORMAL VALUES – HORMONES IN MEN
and in the following table you will find the normal values of Total Testosterone found in men aged 20 to 44 years in a study with a cohort of 1486 participants, carried out by the Department of Urology at the University of Michigan in the United States, and published in the Journal of the American Urological Association in December 2022:
What causes hormone deficiency?
Lack of hormones, or a hormonal imbalance, can be caused by a variety of reasons. Factors that influence hormone production and regulation can be genetic, environmental, disease-related, and lifestyle-related. Below are some of the common causes that can lead to a hormonal deficiency:
1. Problems in the Endocrine Glands
Hormones are produced by various glands in the endocrine system, including the thyroid, adrenal glands, pituitary gland, testes, and ovaries. Any dysfunction or damage to these glands can result in inadequate hormone production. Examples include:
- Hypothyroidism: When the thyroid gland does not produce enough thyroid hormone.
- hypopituitarism:When the pituitary gland, the master gland, does not produce enough hormones that regulate other glands.
- Adrenal Insufficiency: When the adrenal glands do not produce enough hormones such as cortisol.
2. Autoimmune disorders
Autoimmune diseases such as Hashimoto's disease (which affects the thyroid) or Addison's disease (which affects the adrenal glands) can cause the immune system to attack the endocrine glands, reducing hormone production.
3. Aging
Aging is a natural factor that can lead to a decrease in the production of certain hormones. For example, testosterone levels in men and estrogen levels in women tend to decrease with age.
4. Chronic Stress
Chronic stress can affect hormone production. High levels of cortisol (the stress hormone) can inhibit the production of other hormones, such as testosterone and estrogen.
5. Medications
Some medications can affect hormone production, i.e. they are drugs that cause impotence. For example, certain steroids, thyroid medications, chemotherapy, and antipsychotic medications can influence hormonal balance.
6. Genetic Factors
Some people are born with genetic disorders that affect hormone production. Examples include Klinefelter syndrome and Turner syndrome, which affect sexual development and hormone production.
7. Diet and Lifestyle
A nutrient-poor diet, lack of exercise, and unhealthy habits such as excessive alcohol or drug use can all contribute to hormonal dysfunction. Obesity can also disrupt hormonal balance.
8. Illnesses and Injuries
Diseases such as diabetes, heart disease, and certain types of cancer can affect the endocrine system. Injuries to the brain or areas near the endocrine glands can also cause hormonal dysfunction.
Conclusion
To understand the concepts of hormones, their values and relationship with illness or health, it is very important not only to be informed, but also to consult with a doctor who is an expert on the subject and perform the relevant analyses for your specific clinical picture. We encourage you to request a free information appointment so that you can have high-quality advice with one of our doctors who will have the pleasure of serving you.
Book your first medical consultation now
and discuss your case with one of our medical specialists, no strings attached.
BIBLIOGRAPHY/CYBERGRAPHY
- Shalender Bhasin, Juan P Brito, Glenn R Cunningham, Frances J Hayes, Howard N Hodis, Alvin M Matsumoto, Peter J Snyder, Ronald S Swerdloff, Frederick C Wu, Maria A Yialamas, Testosterone Therapy in Men With Hypogonadism: An Endocrine Society Clinical Practice Guideline, The Journal of Clinical Endocrinology & Metabolism, Volume 103, Issue 5, May 2018, Pages 1715–1744, https://doi.org/10.1210/jc.2018-00229
- Lee DM, O'Neill TW, Pye SR, Silman AJ, Finn JD, Pendleton N, Tajar A, Bartfai G, Casanueva F, Forti G, Giwercman A, Huhtaniemi IT, Kula K, Punab M, Boonen S, Vanderschueren D, Wu FC; EMAS study group. The European Male Aging Study (EMAS): design, methods and recruitment. Int J Androl. 2009 Feb;32(1):11-24. doi: 10.1111/j.1365-2605.2008.00879.x. Epub 2008 Mar 5. PMID: 18328041.
- Corona, G, Goulis, DG, Huhtaniemi, I, et al. European Academy of Andrology (EAA) guidelines* on investigation, treatment and monitoring of functional hypogonadism in males. Andrology. 2020; 8: 970– 987. https://doi.org/10.1111/andr.12770
- Wu FC, Tajar A, Beynon JM, Pye SR, Silman AJ, Finn JD, O'Neill TW, Bartfai G, Casanueva FF, Forti G, Giwercman A, Han TS, Kula K, Lean ME, Pendleton N, Punab M, Boonen S, Vanderschueren D, Labrie F, Huhtaniemi IT; EMAS Group. Identification of late-onset hypogonadism in middle-aged and elderly men. N Engl J Med. 2010 Jul 8;363(2):123-35. doi: 10.1056/NEJMoa0911101. Epub 2010 Jun 16. PMID: 20554979.
- EAU Guidelines on Sexual and Reproductive Health A. Salonia (Chair), C. Bettocchi, J. Carvalho, G. Corona, TH Jones, A. Kadioglu, JI Martinez-Salamanca, S. Minhas (Vice-chair), EC Serefoglu, P. Verze Guidelines Associates: L. Boeri, P. Capogrosso, A. Cocci, K. Dimitropoulos, M. Gül, G. Hatzichristodoulou, A. Kalkanli, LA Morgado, V. Modgil, U. Milenkovic, G. Russo, T Tharakan Guidelines Office: JA Darraugh https://uroweb.org/guidelines/sexual-and-reproductive-health/chapter/introduction
- Zhu A, Andino J, Daignault-Newton S, Chopra Z, Sarma A, Dupree JM. What Is a Normal Testosterone Level for Young Men? Rethinking the 300 ng/dL Cutoff for Testosterone Deficiency in Men 20-44 Years Old. J Urol. 2022 Dec;208(6):1295-1302. doi: 10.1097/JU.0000000000002928. Epub 2022 Oct 25.PMID:36282060. https://www.auajournals.org/doi/full/10.1097/JU.0000000000002928
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