Understanding testosterone and the gonads in Males

Testosterone is a hormone secreted mainly from the testes in males. It is produced in a smaller quantity from the adrenal glands. Lack of testosterone has been blamed for a number of symptoms seen in the general population. However unlike women who go through menopause, there is no similar male equivalent (andropause). Levels of testosterone do decline over time as we age. That does not always imply that supplementation is required

What is testosterone?

This is a steroid hormone which comes into prominence at the time of puberty. The pituitary gland (situated at the base of the brain) wakes up and secretes stimulatory hormones (FSH and LH) into the blood This wakes up the testes, hair follicles, and skin organs ( eg sebaceous glands – leading to oily skin).  The testes starts to enlarge in size and starts to produce testosterone and later sperm. At the same time, there is considerable increase in body hair, particularly facial hair.

What happens if we replace testosterone to boost testosterone levels?

  1.  With the first dose, there is a rise in testosterone and testosterone transport. There is likely to be an increase in energy and libido ( This may be a placebo effect). Many of the symptoms start to improve
  2. By the end of the first week, there is a decline in pituitary stimulatory hormones ( FSH and LH) and there is a reduction in testicular testosterone production and sperm production.
  3. by the end of two weeks, there is almost complete shutdown in testosterone production and levels start to decline back to previous levels. With this there is a recurrence of symptoms
  4. You might then start to think, that the dose is not correct. However the more you raise your dose, the less your own production becomes

What is the cause for low testosterone levels?

  • My testosterone is low….

Testosterone like other hormones respond to support your body appropriately. When there is any adverse situation/ circumstance, the body recognizes that the person is not in the right physical state for reproduction

    • Inadequate Sleep – This tends to leave you with a permanent “hangover”. Your body and hormones do not reset and this leaves you with a disrupted circadian rhythm ( Internal clock). Testosterone levels will be low.
    • Obesity – Obesity induces a state in the body akin to infection / inflammation. Even without diabetes, the body experiences rise in inflammation, elevated levels of uneliminated waste products. This is particualrly the case if there is increase in visceral fat ( fat deposited around internal organs)
    • Stress. Stress is a matter of life and death for the body. It cannot differentiate between an invasion by bacteria, facing a tiger , war or danger to life or a bad day at the office. Attempting reproduction, when there is a tiger nearby is not conducive to a long life.
    • Poor vascular and metabolic health. If the body is not healthy, your blood vessels and nerves are unlikely to respond to stimulation. This means that despite your best intentions, sexual thoughts and imagery are unlikely to progress further to an erection.
    • smoking – This causes a lack of responsiveness of blood vessels, This is a requirement for increased blood flow to the brain and penis during
    • Alcohol – Alcohol is a brain suppressant. It causes inhibition of your internal imagery and auto erotic climb towards a sustained erection
    • Tiredness – If you are tired, it is likely that you will not be able to remain “in the zone”. This is a brain construct, where all external stimuli and input is temporarily suppressed, and there is complete focus in the moment.

  •  But my problems have come so suddenly.

      • This is quite a common scenario. It is likely that a number of factors come together and we tend to attribute this to an illness, a medication or injury.
      • It is likely that there has been a number of factors playing in the background, over a period of time

  • I have taken testosterone, but I feel no different

    • Testosterone is a permissive hormone. It does not change you as a person or change you into a person who is having a constant erection.  It merely makes erection and intercourse more likely.  A lot of factors will have to come together for libido and erections to occur. If  testosterone has not worked, it is likely that there are other factors at play.

 What can I do to improve my sex life?

  • Understanding factors that might be contributory
  • practice getting “into the zone” – taking time
  • Taking the pressure off – start with non penetrative intercourse
  • Exercise and vascular health
  • Correcting physical issues ( eg low testosterone, diabetes control, medications)
  • Timetabling it
  • Understanding refractory period.
  • support and understanding

 

  • Can pornography help?

Pornography can be counter productive as it feeds very powerful images into the brain. These are  images and videos, which  are readily available online. Viewing pornography, however is counterproductive as it tends to hinder the build up towards erection and ejaculation This process is based on auto-eroticism. This is where your brain builds up the level of arousal internally. Like all rewards, the anticipation is what builds your brain up to the plateau, from which orgasm can occur . Pornography short circuits this process.