Men with low testosterone levels are at higher risk of mortality: Study

The health risks of low testosterone levels in men include low sex drive, erectile dysfunction, reduced concentration, insomnia and depression

Low levels of testosterone make one susceptible to metabolic disorders like diabetes and obesity, which increase the risk of cardiac conditions.

A systematic review found that men with low serum testosterone levels were at increased risk of all-cause and cardiovascular mortality. The research published in the journal Annals of Internal Medicine reviewed 11 studies comprising over 24,000 participants, aiming to clarify previous inconsistent findings regarding the influence of sex hormones on health outcomes in aging men.

What were the study parameters?

The researchers used individual participant data (IPD) to summarize the association between baseline concentrations of different hormones — which included testosterone, sex hormone-binding globulin (SHBG), luteinizing hormone (LH), dihydrotestosterone and estradiol — and the relative risk of cardiovascular conditions and cardiac deaths as well as all-cause mortality. The participant variables included age, body mass index, marital status, alcohol intake, smoking, physical activity, conditions like diabetes and hypertension, usage of lipid medications and the ratio of total to high-density lipoprotein (HDL) cholesterol.

What did the study reveal?

The IPD analysis found that men with testosterone levels below 7.4 nmol/L (nanomoles per liter), LH concentrations above 10 IU/L (international units per liter) and estradiol concentrations below 5.1 pmol/L (picomoles per liter) had a higher risk of all-cause mortality. Additionally, those with testosterone levels below 5.3 nmol/L were highly susceptible to cardiovascular death.

Low testosterone levels (also called hypogonadism) don’t have a direct influence on mortality. Decreased testosterone concentrations can cause fat accumulation, especially in the abdominal area. This increases the risk of metabolic disorders like obesity and type 2 diabetes, making one susceptible to cardiovascular issues and stroke that can turn fatal.

Other ill-effects of low testosterone levels

A dip in testosterone levels can adversely affect one’s cognitive abilities and mood, giving rise to symptoms like reduced concentration, depression and fatigue. Additionally, it may also lead to decreased libido and erectile dysfunction. For some, it can cause sleep disturbances, which can lead to insomnia.

More research is required

Cases of low testosterone levels in men are not unusual, with many opting for testosterone replacement therapy (TRT) to address the same. Making generalized statements may be quite tricky, as the meta-analysis suggests that there’s an increased chance of mortality only when the testosterone levels are very low.

Moreover, it doesn’t explore if TRT can improve heart health in men, reducing the risk of death. Unless more research is done to substantially confirm a direct connection between low testosterone levels and cardiovascular conditions, it is difficult to assume that hormone replacement therapy will reduce the risk of the same.

 




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