The word 'testosterone' tends to conjure a specific image — and it's almost always male. That's a problem, because testosterone is a critical hormone for both sexes, and suboptimal levels are a significant driver of the fatigue, cognitive fog, reduced motivation, and diminished body composition that bring many patients through our door.
Testosterone in Men: Beyond the Libido Narrative
In men, testosterone plays a central role in muscle protein synthesis, bone density, fat distribution, cognitive function, mood regulation, and cardiovascular health. The age-related decline — roughly 1–2% per year after age 30 — is well-documented. Many men in their 40s and 50s experience clinically meaningful symptoms at levels that technically fall within 'normal' range.
Total testosterone is only part of the picture. Free testosterone (the biologically active fraction) and SHBG must be measured to understand what's actually available to your tissues. A total testosterone of 500 ng/dL with high SHBG may leave a patient with less biologically active hormone than someone at 350 with low SHBG.
Testosterone in Women: Overlooked and Under-Tested
Women produce testosterone in the ovaries and adrenal glands. While the quantities are smaller than in men, testosterone is equally important for female energy, libido, mood, body composition, and bone density. Low testosterone in women is associated with persistent fatigue, brain fog, difficulty building or maintaining muscle, and low libido — symptoms frequently attributed to 'stress' or 'just getting older.'
When Optimization Makes Sense
Testosterone optimization isn't appropriate for everyone — and at M Health, we don't recommend it without comprehensive lab evaluation and a detailed clinical picture. When it is appropriate, options include bioidentical testosterone therapy, addressing lifestyle factors that suppress testosterone, and nutritional support for testosterone biosynthesis. The goal is always optimal function, not supraphysiologic levels.
