Fuel of masculinity

Testosterone is the main male sex hormone. It is necessary and responsible for the masculine appearance, for hair and muscle mass, for sperm formation and libido.

They can be admired in the bodybuilding studio: the muscular, men who feel particularly male. Testosterone from the group of androgens, i.e. the male sex hormones, is also a synonym for exaggerated male behavior: for dominant-aggressive macho behavior and for supposedly high sexual activity. In fact, testosterone is also the “fuel of masculinity”, explains Dr. Manfred Ventz, hormone specialist at the Berlin Charité.

“Testosterone is the most important male sex hormone, it is formed in the testes and also in small numbers in the adrenal gland, it is the hormone that is practically necessary for development, that is to say when it is fetish, so that it becomes a male infant at all it plays a vital role during puberty, and later it is there to maintain male habit. ” 

Testosterone is necessary and responsible for the male appearance, hair and muscle mass, sperm formation and libido. The hormone also influences drive, stamina, willingness to take risks or competitive behavior. For muscles and bone stability, testosterone also occurs in women, but to a much lesser extent.

“And in women of fertile age this is partly formed in the ovaries, but also in the adrenal glands, so it is converted from precursors, for example in the adipose tissue or in the skin.” 

Only a small part of the testosterone circulates freely in the blood and is therefore normally usable. In women, an excess of testosterone in the blood can lead to “masculinization”, which can be seen, for example, in beard growth. 

How much testosterone a man needs varies. The amount of hormones fluctuates seasonally and throughout the day – it is highest in the morning. In addition, the testosterone level drops after hard physical work, also as a result of, for example, stress or alcohol consumption.

If the testicles are underactive, called “hypogonadism”, there is a permanent testosterone deficiency. The deficiency can also be caused by various diseases. Doctor Ventz: 

“There are congenital diseases, for example when there are no testicles, but the best known is Klinefelter syndrome, which is where the chromosomes XXY are. They have small testicles, and initially, testosterone may be enough, but later there is a testosterone deficiency. But of course, there are also acquired cases: operations after tumors on the testicles or after operations on the inguinal canal, sometimes damage can occur if the testicles do not move into the scrotum at all. ”

The testosterone deficiency leads to a “feminization” of the affected men: they develop a female-looking breast, have no male hair, muscles and bone structure become weaker. However, disease-related deficiency of this hormone is rare overall. 

However, “quite normal” is that testosterone levels decrease with age. Some doctors speak of the Climacterium virile – of male menopause. The term is controversial because the testosterone breakdown differs from the female climacteric. Professor Wolfgang Harth, dermatologist and head of the center for men’s medicine at the Vivantes Clinic Berlin-Spandau:

“From the age of 40, testosterone decreases continuously by one to one and a half percent a year. It is not like overnight with women that these hormone changes lead to menopausal symptoms, for men it is a slow process. ” 

Nevertheless, this can also lead to massive health problems in men, mostly from the age of 60.

“Frequent need for sleep or that you can no longer get going in the morning, have a profuse sweating, up to psychological changes: irritability, mood swings, depression, or that you suddenly become anxious, and of course sexual disorders, there First and foremost is the loss of pleasure, loss of potency, a multitude of complaints, which must be discussed individually with the patient and doctor. “

Only if signs of illness and measured low testosterone levels occur together, hormone replacement therapy may be considered. Artificial testosterone is often offered for sale as “anti-aging” and potency aid, is required by older men of creation, and is uncritically prescribed by some doctors. Certain underlying diseases, especially the adrenal glands, must be excluded beforehand. If the substitution really makes sense, you should proceed step by step, says the dermatologist and andrologist – “male doctor” – Professor Harth:

“What you can do is that you usually start with short-term replacement therapies, i.e. the gel form, because if side effects should occur, you only have side effects for a short time, and if this initial phase has been successfully completed, you can also take injections change, which must first be given after six weeks, later only every three to four months. ” 

But here too, there is no effect without side effects, says the Charité hormone expert Doctor Manfred Ventz. 

“Testosterone was sometimes traded as a fountain of youth, but there are also side effects. For example, especially in the elderly, when there are cells that develop into prostate cancer, you can stimulate them, including prostate hyperplasia, which means enlargement. ”

In addition to prostate cancer, damage to the heart and blood vessels or mental illnesses can also result from unduly medically undisclosed excessive testosterone intake. Precise weighing is therefore necessary. 

The greatest risk to health, however, is taking testosterone as an anabolic steroid, as a muscle-building supplement in all kinds of sports and in bodybuilding. There seems to be no problem getting something like this on the black market. And the risk of excessive dosing is particularly high here.

“So there are a large number of men who take this to achieve increased performance and muscle building. And this too much testosterone can have an impact on the psyche, i.e. making it more aggressive, for example, or increasing libido in the beginning, but this usually adjusts again in the area of ​​the psyche and this excess remains in the area of body. ” 

anabolic-doping is therefore permanently dangerous, Professor Wolfgang Harth, Director emphasized the center for Men medicine at Vivantes Klinikum Berlin-Spandau.

“This means that too much blood is created, for example. Muscles may continue to grow so excessively that there are problems with the heart muscles, and we have always had reports that competitive athletes who did doping died very early. In young men, this leads to a limitation in the number of sperm. “