Testosterone is the primary male sex hormone that is responsible for regulating fertility, muscle mass, fat distribution, and red blood cell production. This article will review what testosterone is, normal levels, imbalances, and treatments. If you have any concerns about your testosterone levels, talk to your primary care provider or visit your local men’s health clinic.

What is Testosterone

Testosterone is the primary male hormone that is responsible for the development of male sex characteristics. Females also produce testosterone, but in much smaller quantities. Testosterone is produced primarily in testicles within cells called the Leydig cells. Levels are controlled by the brain and pituitary gland and carried by the blood. The primary responsibility of testosterone is sperm production, which is why inadequate amounts lead to infertility. Testosterone is also responsible for a host of other tasks including sex drive, bone mass, fat distribution, muscle size and strength, and red blood cell production. Testosterone in women assists with bone density, muscle strength, and sex drive.

Testosterone Levels

Normal testosterone levels in males range between 270 to 1,200 nanograms per deciliter (ng/dL), with an average level of 679 ng/dL. An ideal level in a healthy male is between 400 and 600 ng/dL. Testosterone levels increase to induce puberty and sexual maturity.Levels peak at around 20 years of age and then slowly declines with increased age, when reproduction is no longer the primary driving force. In normal, healthy men, testosterone levels may drop by one to two percent a year starting in the 40s. In women, normal testosterone levels are much lower, ranging from 20 to 75 ng/dL.

Testosterone Imbalances

Both high and low levels of testosterone can cause dysfunction in the areas of the body that are regulated by the hormone.

Low Levels

Reduced levels of testosterone can be caused by testicular injury or infection. Chronic use of opiate analgesics reduces testosterone levels. Pituitary issues or high prolactin levels can also cause a decrease in testosterone. Major causes are chronic medical diseases such as type 2 diabetes, kidney or liver disease, obesity, HIV/AIDS, Klinefeter syndrome, Prader-Willi syndrome, hemochromatosis, Kallman syndrome, or myotonic dystrophy.

When a man has low levels of testosterone he may experience erectile dysfunction, reduced sex drive, low sperm count or infertility, and enlarged breast tissue. Signs of low testosterone levels may manifest as loss of body hair, decreased muscle tone and strength, depression, hot flashes, and increased body fat. Chronic low testosterone levels can lead to osteoporosis, mood swings, reduced energy, or shrinking testicles.

High Levels

Increased levels of testosterone is a much rarer condition and can cause an early onset of puberty in young boys. High testosterone levels are linked to acne and aggression. High blood pressure and high red blood cell count (polycythemia). Infertility is also a concern with high levels of testosterone.

Women may experience higher than normal testosterone levels caused by hirsutism, polycystic ovarian syndrome, acne adrenal hyperplasia. An excess level of testosterone in women can also cause infertility and male pattern baldness. In addition, it can increase the size of the clitoris and decrease breast size. Deepening of voice, increased muscle mass, and excessive body hair are common signs of higher than normal testosterone levels in women. Overly high levels can cause irregular menstrual cycles, low libido, and mood swings.


To reduce testosterone levels medications such as glucocorticosteroids, metformin, spironolactone can be used. For women, taking female hormones or oral contraceptives may be enough to reduce testosterone levels. All of these medications are available by prescription only. Natural ways to alter testosterone levels include diet and exercise programs to reduce weight. Treating chronic disease such as diabetes can help to correct hormone levels.

Low levels of testosterone can be treated with testosterone replacement therapy (TRT). The benefits of TRT are an increase in bone strength and hemoglobin levels. Prohormone supplements are a sort of steroid used for weight loss and muscle-building.

If you are experiencing signs or symptoms of low testosterone levels, it can easily be confirmed with a simple blood test. At Charleston Men’s Clinic, we offer evaluation and lab testing. If diagnosed with low testosterone, we offer a variety of treatment options that you can discuss with the provider who does your initial evaluation. We also treat erectile dysfunction, premature ejaculation, and Peyronie’s Disease. Call and schedule an appointment today!