The liver further metabolizes testosterone into inactive forms that are excreted in the urine and bile. 5-alpha reductase converts testosterone into dihydrotestosterone (DHT), a more potent androgen that binds to androgen receptors with higher affinity. These enzymes transform testosterone into different biologically active forms, influencing a range of physiological outcomes. The hypothalamus releases gonadotropin-releasing hormone (GnRH), which signals the pituitary gland to release luteinizing hormone (LH) and follicle-stimulating hormone (FSH). The production and regulation of testosterone are controlled by the hypothalamic-pituitary-gonadal (HPG) axis. Testosterone is primarily produced in the testes in men and in smaller amounts in the adrenal glands and ovaries in women.
However, it is crucial to consult with a qualified healthcare professional before considering TRT. Common side effects may include acne, fluid retention, and changes in mood or libido. It can also improve overall well-being, mood, and cognitive function.
Serious side effects may include liver toxicity, heart disease (though a randomized trial found no evidence of major adverse cardiac events compared to placebo in men with low testosterone), and behavioral changes. It is unclear if the use of testosterone for low levels due to aging is beneficial or harmful. Attention, memory, and spatial ability are key cognitive functions affected by testosterone in humans. Conflicting results have been obtained concerning the importance of testosterone in maintaining cardiovascular health. In people who have undergone testosterone deprivation therapy, testosterone increases beyond the castrate level have been shown to increase the rate of spread of an existing prostate cancer. Testosterone does not appear to increase the risk of developing prostate cancer. The brain is also affected by this sexual differentiation; the enzyme aromatase converts testosterone into estradiol that is responsible for masculinization of the brain in male mice.
In fact, as men age, testosterone levels drop very gradually, about 1% to 2% each year — unlike the relatively rapid drop in estrogen that causes menopause. Women with high testosterone levels, due to either disease or drug use, may experience a decrease in breast size and deepening of the voice, in addition to many of the problems men may have. Part of this may be due to the difficulty defining "normal" testosterone levels and "normal" behavior. When testosterone levels rise too high, the brain sends signals to the pituitary to reduce production. Even moderate alcohol consumption suppresses SHBG, stresses liver function, disrupts sleep architecture, and blunts testosterone production. It requires understanding how sleep, nutrition, body composition, stress, and physical activity interact with hormonal physiology.
During this time, the brain, immune system and metabolism continue to be shaped, and nutrition matters greatly. The most important metabolic intervention may begin even before pregnancy. A baby’s metabolic heath does not start after delivery occurs, but while in the womb. Science shows that metabolism begins developing before birth, changes dramatically during puberty and older adulthood, and can be influenced throughout a person’s life. Stay on top of latest health news from Harvard Medical School. Sign up for HEALTHBeat and receive trusted health information delivered right to your inbox.

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