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Low Testosterone in Men: Can Exercise Boost This Hormone?

For men who are experiencing low testosterone, Dr. Vaynkof explores the role of exercise—the type, frequency, and duration—needed to raise your hormone levels to normal.

Testosterone is a steroid hormone known for stimulating the development of male secondary sexual characteristics, and it is considered a potent androgen. While this sex hormone is produced mostly in the testes, it is also released to a lesser extent by the ovaries as well as other organs, including the adrenal glands in both men and women. 

The stimulus for testosterone production comes primarily from the hypothalamus and pituitary gland, which are responsible for sending signals to the testes from hormones such as GnRH (gonadotropin-releasing hormone), LH (luteinizing hormone) and FSH (follicle -stimulating hormone). 

If you have low testosterone, the best next step is to get a diagnosis so you can treat it right.

"When you think about the two major functions of the male testes: production of sperm and testosterone, the term hypogonadism refers to a problem when either or both of those functions are impaired," says Yevgeniy "Eugene" Vaynkof, MD, a family physician providing care at the Medical Offices of Manhattan in New York City.

Having a low level of testosterone can arise from a disorder when there is a hormone failure of the testes, known a primary hypogonadism, or the problem can be due to faulty signals that go to the testicle, mainly from the brain, which can lead to other problems such as sperm production and/or testosterone production, called secondary hypogonadism. 

The array of causes for secondary hypogonadism is quite large, ranging from a side effect of glucocorticoid treatment commonly due to long-term treatment for asthma, chronic obstructive pulmonary disease, sarcoidosis, extended opioid administration for chronic pain, as well as conditions like anorexia, diabetes, obesity, and sleep apnea,  just to name a few. 

The physiological functions that rely on testosterone are numerous, some are well proven, while others are still being intensely studied. In both men and women, elevated levels of sexual arousal are usually matched with an increase in testosterone levels.1

Interestingly, there has been speculation that testosterone levels vary between the sexes early on in a relationship—decreasing in men and increasing in women—which some think can contribute to behavioral differences during that time.1

What is a bit more clear is a direct correlation with higher levels of testosterone and aggressive behavior in men, leading to a heightened competitive state. This has been shown in competitive sports, such as bodybuilding among others, where the competitive state is always high.2-4 Increased testosterone levels, especially when in excess, have also been associated with increased risk-taking behaviors and criminality, as some studies have shown increased testosterone levels in men who have been incarcerated.5

“Regarding the exogenous (supplemental) testosterone, whenever you put something into your body that was not produced by your own cells,” Dr. Vaynkof tells EndocrineWeb, “you’ll want to consider the potential side effects and risks that may occur when these substances are found above the normal range since the body was not designed to handle more than a set range."6-8 

Side Effects of High Testosterone Supplementation

The popularity of supplemental testosterone, especially the use of exogenous testosterone in the form of anabolic steroids, has found its way into competitive sports and has created a lot of interest in the role of testosterone and some of its positive effects among non-athletes.10-11

In general, study results have shown a direct association with increased muscle size and strength, aerobic endurance, faster recovery, and even decreased fat mass.9,10 The mechanism behind this, and how it relates to brain function and other hormones such as leptin (the satiety hormone) and cortisol (the stress hormone) is still not completely clear, says Dr. Vaynkof.

When testosterone supplements are taken, men might also raise the risk for:

  • gynecomastia, or enlarged breasts,
  • severe acne
  • high blood pressure
  • blood clots
  • cardiac events (eg, heart failure, heart attack, stroke)
  • certain cancers, specifically of the prostate  

Before you make a decision to take exogenous (supplemental) testosterone, it is best to consider the full picture so you are aware of the other factors that have been shown to affect testosterone levels first. For example, age is a factor (testosterone levels gradually decline with age), sleep (an increase in sleep can lead to elevated levels), an imbalance in levels of vitamins and minerals such as vitamins A, D, and zinc (changes testosterone levels).6,8,11-17 In addition, exercise and weight loss can affect testosterone levels.9,10

“Before you begin taking testosterone pills or injections with the risk of potentially harmful side effects, it is best to consider and try to correct these factors without the need for a hormone first,” says Dr.  Vaynkof.

Taking Testosterone to Induce Desirable Weight Loss

Achieving weight loss by changing the testosterone level has drawn special interest. Some evidence suggests that a reduction in weight may lead to an increase in testosterone levels.16,17

“This seems to be related to an enzyme found mostly in our fat cells called aromatase, which converts testosterone to estradiol, one of the so-called female sex hormones,” says Dr. Yaynkof, “and while it seems logical that as the level of fat increases so does the level of aromatase activity, which can lead to more estradiol and less testosterone, hence prompting development of female secondary sexual characteristics like gynecomastia, as an example. However, a clear association between body mass index (BMI) or obesity and elevated testosterone levels has not been clearly established.”17

When looking at the impact of exercise on testosterone levels, it might come as a surprise to you but there are differences in hormone levels based on the type of activity pursued: resistance versus endurance. Some data indicate that resistance training can increase testosterone levels whereas endurance activity, such as long distance running, typically lowers testosterone levels, especially in men.2-4

“However, this relationship is complicated by other hormones such as cortisol, also known as the stress hormone, and leptin, the hormone involved in satiety (feeling full after eating) that need to be considered,” Dr. Yaynkof tells EndocrineWeb.

Simply put, he explains, you can think of these relationships between hormones are inverted. Mainly, if leptin levels go up, such as when someone gains weight, their testosterone levels are likely to drop, and if cortisol levels rise, such as at peak body stress during endurance training, or even if one is severely sleep deprived, then testosterone levels are likely to drop or remain low.  

“Remember, the variability of these hormones is influenced, at least in part, by the aromatase enzyme discussed earlier, but a direct relationship between testosterone and these other hormones has not been clearly established through well-conducted studies,” says Dr. Yaynkof.    

As for the impact of exercise, the consensus is that exercise can increase or decrease testosterone levels based on the following factors:

  • type of exercise
  • duration (hold long)
  • frequency (how often)
  • the amount of rest you get in between.

Weight (resistance) training has been shown to have a more direct impact on testosterone levels than the intensity of cardiovascular activity such as long distance running.9,10 Also, keeping your exercises short—to about 45 minutes or less, and every other day as opposed to daily—has both been shown to be more beneficial as opposed to prolonged daily strenuous exercising.

"With exercise, too little testosterone is just as much of a problem as is too much so the goal must be to achieve a balance where you exert yourself enough to break a sweat but not too the level where your body senses a high level of stress causing the release of the stress hormone cortisol, which would lead to a lower production of testosterone," he says. This is similar to the reason that conditions such as obesity, diabetes, and even PCOS (polycystic ovarian syndrome) in women can lead to low testosterone levels, whereby the production of cortisol and the dysregulation of hormones such as LH and FSH produced by the pituitary gland are out of sync. 

In effect, the benefits of exercise on testosterone levels also depend on where you start (your baseline level) and how long does it last (the rise in testosterone). If someone’s testosterone levels are borderline or low-normal to start then a reasonable result may be expected with appropriate exercise.

However, if the baseline level is moderately or severely low than you should not expect to achieve an improvement in the testosterone levels on your own, and would want to seek the guidance of a specialist (ie, an endocrinologist, or your primary physician) for possible medication options to help boost baseline levels. 

Regarding the duration of the possible testosterone rise, some studies suggest that the rise in testosterone levels is only transient, which again leads to the question of the actual benefit in any enhancement of your testosterone levels. "As you can see, further research and studies on this topic will help provide some more conclusive answers in the future," Dr. Vaynkof says.

Continue Reading
Higher Risk for Cardiovascular Events Found With Testosterone Injections Versus Gels

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