Why testosterone levels decrease with age

By Mandy Armitage, MD

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Low energy, diminished strength and endurance, poor memory and concentration, reduced sexual function–we tend to take these signs as inevitabilities of aging. And while they can all have multiple causes, they can also share a single culprit: a decrease in testosterone production.

While men rarely experience the kind of huge hormonal drop that women see in menopause, after age 30 their testosterone levels can begin to decrease by about 1.5% per year. At this rate, by age 70, testosterone production can be at about 30% below its peak.

How is testosterone normally produced? 

In a normally functioning body, testosterone is produced in the testes by Leydig cells. The pituitary gland, situated at the base of the brain, secretes a hormone called luteinizing hormone (LH), which then signals the Leydig cells to make testosterone. Systems like this tend to work as feedback loops to keep hormone levels in balance. 

What happens as we age?

Unfortunately, as we grow older, studies have shown that our Leydig cells can become less responsive to LH (possibly because of an increased concentration of blood vessels), and the actual number of Leydig cells can also decrease. On top of that, the hormonal signal that leads to LH secretion has also been shown to go down over time, affecting the entire feedback loop. 

And that’s not all. In addition to all of the above, other medical conditions such as type 2 diabetes, erectile dysfunction, obesity, sleep apnea, and hypertension–all of which become more common with age–can also affect these hormones and their regulation. No wonder you might be feeling off!

Okay, so what now?

The good news is that the medical community continues to learn more about not just the causes, but also the treatments for low testosterone. While it’s important to undergo testing to rule out other potential medical causes and ensure you meet the proper criteria, testosterone replacement therapy can be a safe and effective option. 

At Vault, we take a comprehensive approach to low testosterone and emphasize an optimal patient experience. We offer access to thorough testing, customized treatment plans, and your medical team.

This article was reviewed by Aaron Grotas, MD