Testosterone Deficiency and the Mature Male
Dr. Maureen Sweeney has worked with men for over 20 years. The assessment tools and guidance she provides are grounded in deep clinical experience, combined with up-to-date knowledge of men’s health and testosterone’s role in male aging. Hormone health doesn’t stand alone; it must be understood within the broader context of general health, lifestyle factors, and individual risks. Personalized assessment and care are fundamental to the Age Management Programs she offers.
Why Talk About Testosterone?
In the last decade, men’s health has moved from hushed conversations to mainstream media—from social media “T-level” memes to longevity podcasts.
Yet this flood of headlines often mixes myth with fact.
Testosterone deficiency (TD) is a medically recognized condition that can:
• Sap energy
• Lower mood and motivation
• Reduce sexual function
• Negatively impact long-term health
Why Is Testosterone Important?
Low testosterone affects how a man feels and functions in pivotal ways.
• Lower sex drive
• Lost or weaker morning/night-time erections
• Erectile difficulties
• Reduced genital sensation or orgasm intensity
• Persistent fatigue or “loss of drive”
• Depressed mood or irritability
• Brain fog or slower thinking speed
• Reduced motivation to exercise
• Decreased muscle mass or strength
• Increased abdominal fat or gynecomastia (breast tissue)
• Low bone density or unexplained fractures
• Mild anemia (low red blood cell production)
• Smaller or softer testes
Note: These symptoms often overlap with thyroid disorders, sleep apnea, depression, or metabolic disease—another reason a holistic assessment matters.
A thorough evaluation combines clinical assessment with lab testing:
- Timing matters: Total testosterone is measured before 11 a.m. Levels below 10–12 nmol/L (≈ 300–350 ng/dL) are generally considered low.
- Free and bioavailable testosterone: These fractions reflect the hormone truly available to cells and can reveal deficiency even if total levels appear “normal.” Dr. Sweeney recommends measuring both to guide diagnosis and monitoring.
- Pituitary hormone testing: To evaluate signaling from the brain.
- Context is key: Symptoms, exam findings, and health history guide interpretation—a lab number alone doesn’t tell the whole story
First-line strategies target reversible factors:
• Prioritize restorative sleep
• Engage in strength training and interval exercise
• Lose excess weight (if overweight)
• Limit alcohol and recreational substances
• Review medications (some drugs suppress testosterone or mimic TD symptoms)
When lifestyle measures aren’t enough—or when symptoms are severe—Dr. Sweeney may recommend a trial of Testosterone Therapy (TTh), tailored to your goals and health status.
• Relieve distressing symptoms and improve quality of life
• Restore testosterone to healthy physiologic levels (not supraphysiologic)
• Reduce risks linked to testosterone deficiency (e.g., osteoporosis, metabolic disease)
• Preserve fertility when desired (using adjunctive or alternative treatments)
• Monitor benefits and potential side effects regularly
Controversies & Common Questions
Large observational studies suggest restoring low testosterone may reduce cardiovascular events, though randomized trials show mixed results. Current consensus: in men without recent heart attack or stroke, monitored TTh is unlikely to increase risk and may improve cardiometabolic markers. Research continues to refine recommendations.
Modern evidence does not support the outdated fear that testosterone “feeds” prostate cancer. Men with treated localized cancer or on active surveillance can often use TTh safely with specialist supervision. Regular PSA testing and prostate exams remain essential.
Testosterone naturally converts (aromatizes) to estradiol. Moderate increases are expected when testosterone is restored.
Normal estradiol levels are beneficial for:
• Cognition
• Libido
• Bone density
• Body-fat distribution, including helping reduce visceral (belly) fat
Suppressing estradiol with aromatase inhibitors should be reserved only for confirmed high-estradiol side effects—not used routinely.
While testosterone supports sexual function, erections depend on vascular, neurologic, metabolic (e.g., diabetes), and psychological factors. Many men require additional treatment (such as PDE-5 inhibitors, lifestyle changes, or cardiometabolic evaluation) even when testosterone is optimized.
Your Next Step
If you recognize yourself in these symptoms—or simply want clarity—an assessment at Live Young Medical may be the right path.
Dr. Maureen Sweeney’s Age Management Programs draw on over two decades of experience, combining evidence-based care and learned clinical insight. Her goal is to help you understand how hormones, lifestyle, and health intersect—and create a personalized plan to improve your function, vitality, and healthspan.