Hormone Balancing in Men

By: Arturo Portales, DO


Hormone balancing in men starts with testosterone. Testosterone is the dominant male hormone. When men are deficient in testosterone, they feel it.

Common symptoms are fatigue, weight gain, poor exercise tolerance, low libido, poor sexual function, erectile dysfunction, brain fog, poor memory, lack of ambition or drive, loss of muscle mass, increased cardiovascular disease, and joint aches, to name a few. In a nutshell, men just don’t feel as manly as they used to.

Testosterone helps with maintaining lean body mass, improving metabolism, helping brain function, increasing endurance, improving mental alertness, libido, and sexual function, and even helping memory and improving mental sharpness. 

Men also have estrogen. However, men have roughly 1/10th the amount of estrogen as ladies. Too much estrogen in a man can increase cardiovascular disease, increase the risk of gynecomastia, and increase moodiness and emotional lability. Too little estrogen can result in hyper aggressiveness. 

Another hormone to consider is the thyroid. The thyroid regulates the body’s metabolism. When thyroid function is low, metabolism is low. Symptoms include fatigue, thinning hair, dry skin, cold intolerance, joint aches, poor focus, constipation, weight gain, and sluggishness. 

If a man’s testosterone is at optimal levels, but his thyroid is not functioning well, he will still not feel quite right. Optimizing thyroid function is very key in optimizing hormone functions. 

Hormone testing in men includes the following:

  • Total and free testosterone, estradiol, TSH, free T3, total T4, PSA, CBC, CMP, HgA1c, vitamin D3 level. Other tests such as a lipid panel may also be checked prior to starting testosterone therapy. 

Once therapy is initiated, labs will need to be rechecked periodically and regularly. This assures that a safe level has been reached. 

Potential side effects of testosterone treatment may include water retention, hair loss, mood swings, and acne. The different methods of therapy can produce their own side effects. For example, with topical testosterone, transference is a potential problem. Transference is when the testosterone cream rubs off on you onto someone else. 

Injectable testosterone may lead to pain at the injection site, moodiness depending on the frequency of injections, and increased estrogen levels. The moodiness comes as a roller-coaster effect which happens as a result of high levels after the injection followed by low levels before the next one. 

Pellet testosterone therapy has the potential for pain at the pellet site, possible infection of the site, the expulsion of the pellet, and possible infection at the insertion site. These are rare occurrences and the benefit far outweighs the risk.

*All information subject to change. Images may contain models. Individual results are not guaranteed and may vary.