Healthy Aging Men: Would You Like a Spot of T?

By Bren Boston, MD

Aging in men does not carry the same taboo as it does for women.  There is not the same pressure to dye your gray hair and botox your wrinkles if you are a guy. But men have the same desire for longevityand prolonging the feeling of vitalityas women.  

Healthy aging requires a whole lifestyle approach:

  • Anti-inflammatory foods that promote cellular health 
  • Exercise to increase lean muscle mass
  • Stretching to maintain elasticity 
  • Stress reduction
  • Detoxification with healthy liver & kidneys
  • Avoiding environmental toxins
  • Mood boosting with meditation, mindfulness, and altruism

As we age, these lifestyle factors become more and more important.  They need to be in place before blaming the typical middle age decline in testosterone for weight gain, depressed mood, and reduced libido. When middle age men think about andropause, the male equivalent of menopause, they think it’s all about testosterone.  Before you even think about whether hormone imbalance is causing your symptoms, you have to take a good hard look at your lifestyle.

Andropause is the name for the symptoms that men feel when their testosterone levels begin to decline.  Testosterone levels decline 1% a year after age 30.  Testosterone is made in the testicles (95%) and in the adrenal glands (5%).  Low testosterone can be due to the normal aging process or could be due to a disease called hypogonadism in which there is a problem with the testicles, pituitary gland or hypothalamus.  Environmental toxins such as phthalates have been found to decrease testosterone levels in men as well.

Testosterone is a hormone that has positive actions on many body parts:  stimulates increased lean muscle mass, bone mineral density, increased red blood cell production, improved energy, mood and libido.  Testosterone can also be converted into dihydrotestosterone (DHT) which can cause negative effects like acne, male pattern baldness, and prostate hypertrophy.

Deficiency of testosterone is related to decreased lean muscle mass, increased body fat, osteoporosis, anemia, insomnia, fatigue, depressed mood, and male sexual disorders.  

A blood test is the only way to diagnose a low testosterone level.  

For some men with symptomatic low testosterone levels, starting testosterone replacement therapy can improve their quality of life. Balancing hormones can lead to better energy, sleep, and wellbeing.  There are many benefits and risks associated with testosterone replacement therapy. Hormone replacement therapy is a big decision and should be discussed with a physician that is familiar with the safety protocols of hormone replacement.

Dr. Bren Boston, MD sees patients at the Akasha Center for Integrative Medicine in Santa Monica, California.  She educates her patients on the risks and benefits of hormone replacement.  You can make an appointment by calling 310-451-8880 or emailing us at