Male Hypogonadism Exercise Prescription: What the Evidence Actually Says

What resistance training does to testosterone

A review of resistance-exercise research found that testosterone and growth hormone were elevated during the 15 to 30 minutes after a session when the stimulus was adequate; this does not establish the same response in men diagnosed with hypogonadism [1]. Protocols that are high in volume, moderate to high in intensity, use short rest intervals and stress a large muscle mass tend to produce the greatest acute hormonal elevations [1]. The review also notes that many studies found no significant change in resting hormone concentrations during training, even though strength and muscle size increased [1].

Does weight loss raise testosterone?

In a meta-analysis of 24 studies of weight loss in obese men, both low-calorie diets and bariatric surgery were associated with a rise in total testosterone, with a larger rise after bariatric surgery [2]. The amount of weight lost was the strongest determinant of the testosterone rise (B=2.50±0.98, P=0.029) [2]. The meta-analysis addressed obesity-associated hypogonadotropic hypogonadism and evaluated diet and bariatric-surgery studies rather than exercise, and notes that few randomized studies have examined diet and physical activity in obese men, with conflicting results [2].

Can endurance training lower testosterone?

A review describes an exercise-hypogonadal male condition in men with long-standing endurance training in whom basal free and total testosterone are significantly and persistently reduced [3]. The mechanism is unclear, the time course and the amount of training needed to produce it are unresolved, and few studies have examined whether the hormonal change harms anything [3].

When is low testosterone a diagnosis?

The AUA uses a total testosterone below 300 ng/dL measured in the morning on two separate occasions, plus symptoms or signs [4]. The Endocrine Society requires symptoms and signs plus consistently low fasting morning total testosterone, confirmed by repeating the test [5]. FDA-approved testosterone products are for men with low testosterone and an associated medical condition [6]. For men with age-related low testosterone, the ACP suggests clinicians not start testosterone to improve energy, vitality, physical function or cognition (conditional recommendation, low-certainty evidence) [7].