Testosterone is an emotional topic. It’s both a medical term and shorthand for all kinds of qualities we associate with masculinity.
As a 62-year-old exercise freak, I come to the notion with a lot of feelings (masculine-repressed feelings, naturally). Testosterone is code for a certain flavour of manliness. If a film is described as testosterone-fuelled, you have a fair idea it probably isn’t a meditation on the beauty of nature.
I suspect this hormone is used as slang for traditional manliness because it’s pseudo-scientific, men really do have more testosterone than women. However, as any man who has watched a woman give birth will know, qualities like bravery, resilience and pain tolerance are not really male at all.
A gradual decline in testosterone levels is a natural part of ageing. I have no idea what my current levels are but the peak years are 18-25 and typically the hormone, that has so much to do with drive and libido, drops one or two per cent every year once you’re in your thirties or forties. This is a very small and steady decline but “symptoms” like lack of energy, loss of libido, weight gain and muscle loss are often ascribed to hormonal causes.
The NHS website says considering this shift as some sort of “male menopause” isn’t helpful. “This label is misleading because it suggests the symptoms are the result of a sudden drop in testosterone in middle age, similar to what occurs in the female menopause. This is not true.” While some men do suffer a genuine testosterone deficiency, many may be ascribing depression, lack of exercise or a general sadness about changing roles and ageing to this most famous of hormones. This may have something to do with growth in the commercial hormone replacement boom.
A US report published last year said: “Demand for safe, convenient and highly bioavailable testosterone formulations is surging as men over 40 demand quality-of-life solutions.” US Secretary of State for Health and Human Services Robert F Kennedy Jr is a fan. Speaking on the Lex Fridman Podcast in 2023, RFK talked through his strenuous weight-training and walking regime, before explaining: “I’m on an anti-aging protocol from my doctor that includes testosterone replacement.” Figures quoted in Men’s Journal say US prescriptions for the hormone rose to 10 million in 2024. I find this interesting as I don’t think my father’s generation would have even been aware of testosterone as a factor in their health.
Nearly half of men over 50 or 60 will have low testosterone (Photo: Teri Pengilley)There is an inevitable cultural framing around this hormone. As a 60-something who works out every day, I feel much the same as I ever did, but slightly calmer. At 62, I don’t feel the need to lift more and run faster than anyone in my vicinity. I can drink alcohol for an hour or so and stop, and generally, my emotions feel more regulated. This, to me, is the positive side of ageing.
However, for some older men, this extends to exhaustion, loss of libido and gloomy low mood – inevitable and natural ageing, or a treatable hormone deficiency? Dr Jeff Foster, director of men’s health at private healthcare company Voy, says dismissing these symptoms is unfair to older men.
“There are those who see this as a normal part of ageing – you are more tired, more grumpy, less happy, less keen to have sex, less able to put on muscle and you have rising cholesterol. Over 40 per cent of men over 50 or 60 will have low testosterone; some less open-minded health professionals will see this as inevitable.”
Voy supplies testosterone replacement therapy but does so along strict ethical guidelines. In the US, many men are being prescribed testosterone on the basis of symptoms alone, but Voy will not sell you the hormone unless blood tests prove that you are deficient. Levels of the hormone will vary from man to man, so one person’s “low” testosterone isn’t always necessarily cause for concern.
Foster says there are two tests, undertaken separately; one measures total testosterone and the other free testosterone – both are important. Total testosterone can be normal but hide a shortfall in free testosterone – that which can be immediately accessed by the body for use.
“There is no such thing as topping up. If your tests are normal, you’re not getting [replacement therapy]. There could be other factors causing the symptoms – you may actually be suffering from depression, for example.”
Curiosity then leads to natural factors that preserve testosterone levels to counter the gloomy side effects of a deficiency. Scientists who recently studied a group of lifelong cyclists were surprised by their testosterone levels. Essentially, they hadn’t aged hormonally at all. Their levels of this much-discussed substance hadn’t fallen with the passage of time. If, like me, you’re a man in your sixties, this was a very interesting finding.
Dr Niharika Duggal of the University of Birmingham worked on the research and said: “It’s well documented that levels of testosterone decline with age. But we found there was no correlation with age in the cyclist’s cohort. The testosterone levels didn’t decline as they did in a comparative group that hadn’t exercised. This wasn’t one of the findings we were actually expecting.”
Actually, the cycling is probably irrelevant. Duggal and her colleagues picked the cycling club because they were an easy group to test and track. They’d been exercising all their lives consistently, they’d recorded what they’d done and they were easy to contact for follow-up studies.
High-intensity bursts have a short-term boosting effect on testosterone (Photo: Teri Pengilley)The researchers suspect the result was caused not by miles on the road but by the cyclists’ healthy and lean bodies. “With exercise, we know that they had good body composition. The body mass index levels were lower so they had better metabolic health and inflammation levels were lower too,” Duggal says.
In fact, the evidence suggests that not cycling but weight training and high-intensity bursts have a short-term boosting effect on the hormone. Having less fat and more muscle is, however, linked to a higher baseline level of testosterone, rather than a spike that lasts a few hours.
And if I do have a hormone deficiency, can I save myself money by simply going to the gym or joining a cycling club?
Voy’s Dr Jeff Foster says: “Exercise will definitely help testosterone production, but it will not help someone who has a genuinely low T picture. So if I use myself as an example, at 47, I exercise four to five times a week, and that will help maintain and maximise what my body can do naturally. But if I had a condition that meant my testosterone was significantly dropping, then all the exercise in the world would not fix that.”
Duggal’s view supports Foster’s approach. She says artificial hormone boosting can be a good idea if your base level is low, but adding to a normal level may have risks. “If you don’t know what your levels are and you start taking supplements, I have a feeling it could do more harm than good.” Testosterone is a driver of prostate cancer, for example.
“At the moment, some of the marketing is more about improving your exercise capabilities. Our research is all about healthspan (how long we can maintain good health). We are not so interested in cosmetic effects but how we can live healthier,” she says.
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Keiren Douglas, wellbeing personal trainer at Nuffield Health says: “Heavy resistance training has been tied closely to boosting testosterone levels in men over 40. It works by stimulating large muscle groups to grow, reducing visceral fat (along with good diet), increasing lean mass and reducing the conversion of testosterone into oestrogen.”
He confirms that it’s all about keeping the fat off, echoing the cycling study. “Resistance training at a moderate to high intensity three or four times a week can positively affect your testosterone levels, so long as other factors like sleep, diet and stress are all managed.” He recommends the classic compound lifts – the ones that use most of your body each time – deadlifts, squats, pull-ups.
The part of all this that fascinates me is the extent to which our father’s generation put up with a reduced lust for life in their later years or embraced the joys of the armchair with a sane acceptance of the ageing process. I’ll confess to fighting a daily battle with old man stereotypes – I find it impossible to pull on a cardigan and retreat. Part of my motivation when I exercise is fending off all the unpleasant effects of growing older, including potential testosterone deficiency. I’m going to have myself tested but I’m also going to think hard about what it is to be an old man in 2026, and resist the cultural pressure to remain eternally youthful. I wonder if there’s a good cycling club in my area…
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