If you watch TV entertainment programs, you can often see a muscular, handsome celebrity in his mid-40s proudly talking regarding his male hormone levels. His big and nice muscles are overflowing with masculinity just by looking at him, and it seems natural that the level of testosterone, the male hormone that maintains such masculinity, is higher than that of ordinary men.
If so, do all middle-aged men who do not have much muscle mass have lowered testosterone levels? What is the relationship between exercising hard, male hormone levels, and male menopause?
Testosterone deficiency syndrome, commonly referred to as male menopause, can be defined as a case in which testosterone levels decrease below a certain threshold as we age, and typical male menopause symptoms appear sexually, physically, and mentally.
◆ Male menopause-related symptoms
▽Physical change
Reduced testicular volume, reduced and lost body hair, gynecomastia, reduced lean body mass and muscle strength
Visceral obesity, decreased bone density,
▽Sexual symptoms
Decreased libido, erectile dysfunction, decreased night sleep erection, decreased semen volume
▽Cognitive, emotional, and quality-related symptoms
Changes in mood, sleep disturbances, depression, cognitive decline, decreased energy and patience
▽Related circumstances
Male factor infertility, metabolic syndrome, anemia
Although it is true that the prevalence of male menopause increases with age, older age does not necessarily indicate testosterone deficiency, and is closely related to an individual’s health status.
In the case of metabolic syndrome, which is represented by obesity such as diabetes, high blood pressure, hyperlipidemia, and increased waist circumference, testosterone deficiency is a representative disease. of course increases the risk of cardiovascular disease.
Aerobic exercise, a significant increase in testosterone levels
Male menopause can be easily treated with testosterone supplementation. Lifestyle modifications such as smoking cessation, sobriety, diet control and exercise must be performed along with such testosterone treatment.
The aforementioned exercise is one of the very important factors in the control of metabolic syndrome, and of course there is a close link with andropause, which is closely related to the metabolic syndrome.
Broadly, exercise can be divided into resistance exercise and aerobic exercise. Resistance exercise is an exercise that repeats muscle relaxation and contraction, and is beneficial to increase muscle mass and strength. It is well-known as an exercise that is more helpful in improving function.
It is for this reason that bodybuilders focus on resistance training to build muscle, and aerobic exercise is strongly recommended for obese patients. If so, what kind of exercise would be more desirable to increase the male hormone level and keep it normal?
At first glance, it would seem that building muscle through resistance training would help raise male hormone levels, but that doesn’t seem to be the case.
In this regard, I would like to introduce the results of a study that I recently published. Testosterone levels and related items were statistically analyzed by conducting body composition tests and six representative exercise abilities (cardiorespiratory fitness, flexibility, agility, sense of balance, muscular endurance, and strength) targeting 87 middle-aged men.
Before the study, it was predicted that muscle mass or strength related items would have a close correlation with testosterone levels, but rather, body fat percentage, abdominal fat percentage, and cardiorespiratory fitness were found to have a close relationship with testosterone levels.
Therefore, rather than resistance exercise, I think that aerobic exercise that can reduce fat mass and increase cardiorespiratory fitness can be more effective in increasing testosterone levels. In fact, the results of a study confirming the effect of regular aerobic exercise over one year for male menopausal patients with diabetes showed that testosterone levels were It can be seen that there is an increase in
Another study reported that testosterone levels and sexual function significantly improved as a result of performing aerobic exercise at least 200 hours a week for 6 months in 90 obese elderly people who do not exercise regularly. In addition, there is a study result showing that 12 weeks of high-intensity interval training using aerobic exercise significantly increased testosterone levels in men (average age 62) who did not exercise normally.
Of course, aerobic exercise isn’t the only thing that increases testosterone levels. Several studies have reported that resistance exercise, which strengthens muscles, can also increase testosterone levels.
However, in general, there are many results that testosterone levels increase when resistance exercise is performed vigorously in the short term, and the long-term effect of resistance exercise is not well known. According to the results of some studies, it is reported that testosterone levels increase only when the total amount of exercise is large, not all rapid resistance exercise.
The degree of increase in testosterone may vary depending on the muscle area. It is known that short-term testosterone synergism is better when large muscles are used than small muscles. Elevation of testosterone levels may be more effective when
The combined effect of male hormone replacement therapy and exercise therapy
In fact, when treating menopausal patients, there are cases where the effect is maintained well following testosterone treatment, but there are many cases where the treatment returns to the original situation following stopping treatment. I would like to introduce another study that I conducted on which parts will affect the maintenance of this effect.
We analyzed the data of regarding 150 patients who responded to the treatment at the time of testosterone treatment, and is currently on discontinuation of treatment, but can confirm whether the treatment effect is maintained. As a result of comparison between the group in which the treatment effect was maintained and the group in which the treatment effect was not maintained, it was found that the group in which the treatment effect was well maintained had a more sufficient treatment period than the group in which the treatment effect was not maintained for regarding 10 months. . It was also found that the rate of regular exercise at least 3 times a week was significantly higher than that of the group that did not maintain the treatment effect (45.8% vs 9.8%).
In other words, it can be said that it is a way to maintain the effect well even following stopping treatment to perform regular exercise at least 3 times a week while implementing sufficient male hormone supplementation therapy for more than 10 months.
In order to find out what effect physical exercise therapy has on male hormone replacement therapy, 50 male menopausal patients were divided into two groups. In the other group, male hormone replacement therapy and regular exercise therapy were administered simultaneously for 3 months, and then only regular exercise was performed without male hormone replacement therapy for 2 months.
Male menopause patients who were treated with a combination of male hormone replacement therapy and exercise therapy showed significantly better testosterone levels and improvement of male menopause symptoms than those who received male hormone replacement therapy alone, and stopped male hormone replacement therapy. However, in patients who received only testosterone replacement therapy, both serum testosterone levels and androgenic symptoms showed a tendency to return to their pre-treatment state. and improved symptoms were maintained to some extent well.
As can be seen from the results of the above study, it was found that if you exercise regularly, the effect of male hormone replacement therapy can be increased, and it is of great help in maintaining the effect even if male hormone replacement therapy is stopped. Exercise may play an important role in increasing and maintaining testosterone because it reduces insulin, oxidative stress, and aromatase, a fat cell that converts testosterone to estradiol, in muscle and serum. This is because it increases the concentration of DHT (dihydrotestosterone).
Now, it’s time to answer the questions we had in the beginning. Building muscle through resistance training can certainly help increase testosterone levels. However, considering the results of several studies, it is difficult to assert that resistance exercise alone can effectively raise and maintain testosterone levels.
Rather, there are many research results that aerobic exercise helps to increase and maintain testosterone levels, and in my own research, cardiorespiratory fitness and fat mass, which can be improved through aerobic exercise, were closely related to testosterone levels.
Therefore, in order for middle-aged men to avoid and overcome menopause, it is more effective to maintain healthy physical strength through various types of exercise rather than focusing on building muscle through resistance exercise.
Even middle-aged men can maintain normal testosterone levels and avoid male menopause if they prevent obesity through proper exercise, even if they do not build muscle like celebrities on TV.
Of course, in the case of andropause patients with severe symptoms and a marked drop in testosterone levels, it is true that it is difficult to overcome andropause with exercise therapy alone. In this case, appropriate testosterone replacement therapy along with exercise therapy can help improve symptoms and increase testosterone levels. Even following symptoms have been controlled by administering testosterone replacement therapy for a sufficient period of time, continuing exercise therapy will help maintain the therapeutic effect.
It should be borne in mind that male menopause is not a disease that can be overcome by relying on drug treatment alone, but is a disease that can be properly treated only when lifestyle changes, including exercise therapy, must be combined.
Professor Min-Goo Park, Seoul Paik Hospital, Inje University
