Testosterone is usually wrongly reduced to the sex drive. Nevertheless, it plays an essential role in countless processes of our body.
In this article, I will explain why every person – regardless of sex – should be concerned if they experience apparent symptoms of low testosterone.
What Do Symptoms of Low Testosterone Mean?
Testosterone is a hormone found in both men and women. The latter is a surprising fact for many people.
Although most people associate the chemical messenger exclusively with men, women produce testosterone as well.
Low Testosterone Symptoms in Women
Many people think that estrogen and testosterone are arch enemies fighting an endless hormone war.
Some women even fear that weight lifting and eating meat will cause too much testosterone and result in an overly masculine appearance.
The truth is that testosterone is also vital in the female body, where it has essential tasks to perform. Hence, women produce most of their testosterone in the ovaries.
The female body produces the rest in fat and skin tissue in response to steroid hormones:
- Dehydroepiandrosterone (DHEA) from the adrenal glands
- And androstenedione from the ovaries
Just like testosterone, the female body produces most estrogen in the ovaries as well. And the production of the female sex hormone, in turn, requires testosterone.
For this reason, DHEA and androstenedione are precursors of these sex hormones. Therefore, they are known as prohormones.
Although testosterone is considered the male hormone, women would be guaranteed to notice if testosterone suddenly disappeared from their bodies.
Thus, when testosterone is too low in a woman, it can result in the following consequences (Tyagi et al. 20171):
- Decreased estrogen production
- Weakened libido
- Loss of muscle mass
- Decreased bone density
- Impaired body fat distribution
- Decreased cognitive health
- Mood swings
Accordingly, testosterone’s hormonal balance is essential for both men and women, although it does not occur to the same degree in different sexes.
Low Testosterone Symptoms in Men
On the other hand, men produce testosterone mainly in the testes and a small amount in the adrenal glands.
During puberty in boys, testosterone is responsible for physical changes, such as a deeper voice, hair-, and general growth.
Later on, the male body needs testosterone for healthy sexual reproduction, among other roles.
But after puberty, testosterone’s work is far from done. Throughout life, testosterone plays a vital role in a man’s health.
However, testosterone levels begin to decline with age. Starting around age 30, it drops by about one percent each year.
With this in mind, researchers estimate that about 39% of all men over the age of 45 who present to a primary care physician already have testosterone deficiency (Rivas et al. 20142).
As our population continues to age, these low testosterone levels will continue to worsen and affect the following characteristics of the male body (Bain 20073):
- Erectile function
- Sperm production
- Muscle mass
- Bone density
And this list is far from exhaustive. Before we take a closer look at the effects that can occur when testosterone is too low, let’s find out how you can recognize a testosterone deficiency.
While the symptoms of low testosterone may sometimes be obvious, they can be tough to recognize as well.
Symptoms of Low Testosterone
As we have already explained, low testosterone symptoms manifest themselves in more than one-third of middle-aged men.
Therefore, if you recognize any of the following testosterone deficiency symptoms, you are not alone.
Nevertheless, it would help if you didn’t rush to self-diagnose. Since these symptoms can also occur with other health conditions, you should get professionally tested instead.
Ultimately, it’s far more purposeful to visit your trusted doctor and get a complete blood count than to try to raise testosterone levels on your own.
Your physician can treat low testosterone with synthetic or bioidentical testosterone therapy or help you improve the following symptoms naturally.
1. Low Sex Drive Due to Lack of Testosterone
Testosterone plays a crucial role in the libido of both men and women, as we have already learned.
Besides the regular age-related decrease in libido, low testosterone can significantly reduce the desire for sex.
When low testosterone is the reason for a decrease in sex drive, it can manifest itself more obviously than when a decreased libido occurs with age.
With this in mind, researchers have found that as testosterone levels increase, sex drive in postmenopausal women also improves significantly (Davis et al. 20084).
Therefore, before you immediately reach for supplements, you should still always talk to your trusted doctor if you notice a change in your sexual desire.
Ultimately, testosterone can be low at any age and for various reasons. Plus, it’s not the only possible reason for an impaired libido.
2. Erectile Dysfunction as a Symptom of Low Testosterone
Although testosterone levels are not the primary factor in erection, difficulty getting or maintaining an erection might indicate too little testosterone in the body.
After the hormone stimulates receptors in the brain that produce nitric oxide, erectile dysfunction can result from testosterone being too low.
Nitric oxide is a chemical that triggers a chemical reaction to get or maintain an erection (Cartledge et al. 20015).
The lower the testosterone level, the more difficult it becomes for a man to get an erection.
It is not only when free testosterone is too low that erectile dysfunction can occur. Additionally, several health reasons can make it challenging to get or maintain an erection.
These include alcohol consumption, smoking, psychological stress, depression, or diabetes.
Therefore, even in this context, it is essential to talk to the doctor first and find out the real cause, instead of resorting to a dietary supplement.
3. Underdevelopment of Sexual Organs
Testosterone plays a key role when it comes to the growth of the male body.
In contrast to normal testosterone levels, low levels of the hormone can contribute to the underdevelopment of the testicles or even the penis.
Since there can be various reasons, insufficient growth of sexual organs does not always have to be a symptom of testosterone deficiency.
4. Low Sperm Volume Due to Lack of Testosterone
Testosterone also plays a role in the production of sperm. Therefore, men who experience low testosterone levels often notice a decrease in the volume of their semen during ejaculation.
Moreover, researchers studying infertile couples have found that low testosterone levels can lead to abnormal sperm morphology and lower live birth rates (Trussell et al. 20196).
5. Low Testosterone Can Make You Tired
Many men who have low testosterone levels in their bodies complain of fatigue and a decrease in energy levels regularly.
With this in mind, researchers treated HIV-positive men suffering from hypogonadism – gonad dysfunction in the testes – with testosterone.
In this case, increasing testosterone levels also increased energy levels in about 80% of the participants (Wagner et al. 19987).
For this reason, you could be suffering from a testosterone deficiency if you continuously feel listless despite getting enough sleep.
6. Insufficient Sleep Due to Hormonal Imbalance
Not only fatigue but also lack of sleep can be due to low testosterone levels.
It’s no secret that millions of people have trouble getting the recommended amount of about eight hours of sleep every night.
When you add low testosterone levels to the mix, it makes the situation much more difficult. Taking testosterone, however, can help.
In contrast, external testosterone can also worsen sleep problems if taken for the wrong reason (Wittert 20148).
Therefore, even if you experience sleep problems, you should first talk to your doctor and get tested for low testosterone before reaching for supplements.
7. Low Testosterone Can Cause Hair Loss in Females
Hair loss is another symptom of low testosterone associated with aging.
However, it is difficult to diagnose low testosterone based on hair loss alone. Furthermore, hair loss is a complex issue.
In addition to testosterone deficiency, researchers associate increased testosterone conversion to dihydrotestosterone (DHT) with progressive hair loss (Ustuner 20139).
Conversely, more DHT means less free testosterone. Nevertheless, your body can also produce DHT from dehydroepiandrosterone (DHEA), another hormone that is more abundant in women.
With this in mind, a study involving 285 women found low testosterone levels in those who already suffered from hair loss.
The scientists treated the participants with testosterone directly on the scalp and hairline. Due to the testosterone treatment, not a single participant had to complain about hair loss anymore.
Against this background, the scientists concluded that testosterone has an anabolic effect on hair growth (Glaser et al. 201210).
8. Testosterone May Be Too Low if You Have Anemia
Doctors have linked testosterone deficiency to an increased risk of anemia, the reduction of red blood cells.
In addition to sleep problems, symptoms of anemia include dizziness and difficulty concentrating.
In men with low testosterone, treatment with a testosterone gel increased hemoglobin levels in the blood.
Based on the magnitude of the changes and the decrease in anemia, the researchers concluded that the result could be clinical-grade (Roy et al. 201711).
9. Decreased Bone Density Is a Symptom of Low Testosterone
Osteoporosis is the thinning of bone mass – a condition primarily associated with women. Nevertheless, men can also be affected by bone loss.
Researchers studying osteoporosis in men have found that testosterone has a direct effect on it.
Among other indirect effects, testosterone stimulates osteoblasts and protects against bone loss (Golds et al. 201712).
10. Testosterone Deficiency Promotes Muscle Loss
If you suffer from low testosterone for an extended time, it can harm muscle mass.
According to studies, testosterone plays an essential role in building and maintaining lean mass but does not necessarily contribute to increased performance (Huo et al. 201613).
11. Low Testosterone Can Cause Weight Gain
Men who suffer from low testosterone levels have trouble building muscle mass and gain body fat more efficiently.
If testosterone levels drop, the balance to estrogen is compromised. As a result, fatty tissue can grow on the chest. This condition is also known as gynecomastia (Swerdloff et al. 201914).
Since low testosterone levels favor it, researchers conclude that an increase in men’s hormones precisely results in abdominal fat loss (Rebuffe-Scrive et al. 199115).
12. Diabetes Is Supported by Low Testosterone Symptoms
Another reason why the decrease in testosterone levels may cause weight gain is the accompanying decrease in insulin sensitivity.
Accordingly, researchers found that insulin sensitivity increases with testosterone levels. As a result, the risk of developing insulin resistance and type 2 diabetes drops.
However, even in this case, it is not wise to reach for a supplement since these can negate the positive effect by worsening HDL cholesterol levels.
According to this study, metabolic issues are more likely to be favored by testosterone supplementation than the other way round (Emmelot-Vonk et al. 200816).
13. Testosterone Deficiency Causes Mood Swings
A recent study suggests that testosterone plays a more prominent role in the relationship with mood and mental health than previously believed. And this is true for both men and women.
Accordingly, researchers associated higher testosterone levels with more energy and well-being and less anger and irritability (Tyagi et al. 201717).
14. Low Testosterone May Impair Cognition
As we just noted, testosterone also plays a role in mental health—unfortunately, testosterone levels and memory function decline with age.
With this in mind, researchers reviewed the effects of testosterone therapy on memory function in older men. They concluded that the treatment could acutely improve the men’s cognitive function.
However, whether such treatment can have a positive long-term effect on memory function remains unclear in their opinion (Cherrier et al. 200118).
Causes of Low Testosterone Symptoms
It is not only the passage of time that causes a decrease in testosterone levels in the body. Lifestyle also plays a significant role in the natural balance of your hormone levels.
In this sense, four major lifestyle factors can lower your testosterone levels to dangerous levels:
1. Excessive Alcohol Consumption
Not just when it comes to testosterone, alcohol is a double-edged sword.
Contrary to popular belief, small amounts can have positive effects, while overconsumption is harmful to your health.
That’s why, in the context of testosterone, doctors often advise to keep alcohol within moderate limits.
Accordingly, researchers have found that small amounts of alcohol can increase testosterone levels in women and men (Sarkola et al. 200319).
Since there is no clear quantity guideline in this context, we have to fall back on the general health effects.
Research has shown that 12.5 grams of alcohol per day pose the lowest risk to women’s health and 25 grams to men’s health (Corrao et al. 200020).
This optimum corresponds to approximately 90 milliliters of red wine for a woman and 180 milliliters of red wine for a man per day.
2. Prescription Drugs
Also, other legal drugs can bring testosterone-lowering side effects.
- Cholesterol-lowering statins
- Beta-blockers and antihypertensives
- Analgesics with opioids
- Antidepressants and mood elevators
- Glucocorticosteroids such as cortisone (synthetic cortisol)
If you notice low testosterone symptoms and take one of these testosterone killers, you should immediately talk to your doctor.
In most cases, you can use alternatives that do not affect hormone balance.
3. Estrogen-Like Chemicals
Other agents that can harm healthy testosterone levels are xenoestrogens or estrogen-like chemicals.
These are the following industrial chemicals that disrupt the hormonal system and can cause adverse health effects at high doses (Roy et al. 200924):
- Bisphenol A (BPA)
- Dichlorodiphenyltrichloroethane (DDT).
- Polybrominated biphenyls (PBBs)
- Polychlorinated biphenyls (PCBs)
- Phthalate esters
Every time you use plastic products that contain BPA, such as plastic drinking bottles, you increase your exposure to xenoestrogens.
You can also find estrogen-like chemicals in canned foods, food packaging, dental fillings, or toiletries, such as shampoos, creams, and deodorants.
4. Too Much Stress
As I mentioned earlier, cortisol is a natural antagonist of testosterone. If cortisol increases, testosterone decreases and vice versa.
Therefore, over-exercising can also be bad for testosterone levels in the long run since too much exercise can induce severe stress on the body.
As long as the hormones are in balance, they complement each other well. While cortisol can promote muscle loss and weight gain, testosterone counteracts by improving muscle gain and fat loss.
However, when cortisol takes over due to chronic stress, it cannot be easy to maintain normal testosterone levels.
That’s why meditation, a wellness weekend, or appropriate exercise can help you keep cortisol low and testosterone high.
Effect of Low Testosterone Symptoms
Already the symptoms of low testosterone levels make a variety of adverse health aspects transparent.
Moreover, many people wonder whether the following indirect effects and diseases can be caused by low testosterone.
Can Low Testosterone Promote Alzheimer’s Disease?
As we have already heard, testosterone production is a factor in cognitive health. Unfortunately, however, both functions decline as we age.
However, as evidenced by one study, older men with low testosterone levels are at a significantly higher risk of developing Alzheimer’s disease.
According to researchers, high testosterone levels in older men significantly reduce the risk of developing Alzheimer’s disease (Chu et al. 201025).
Can Low Testosterone Cause Anxiety?
Testosterone also plays a supporting role in the mood and overall mental health of men and women. Additionally, it’s a natural antagonist of cortisol, the stress hormone.
For this reason, testosterone deficiency is consistently associated with nervousness, depression, and anxiety (Tyagi et al. 201726).
With this in mind, researchers studied women who suffered from a social anxiety disorder. They found that a single dose of 0.5 milligrams of testosterone was sufficient to significantly improve anxiety disorder symptoms (Enter et al. 201627).
In this sense, there seems to be a negative correlation between testosterone and anxiety. Accordingly, low testosterone levels may promote anxiety, and higher levels may reduce it.
Can Testosterone Deficiency Lead to Cardiovascular Disease?
Cardiovascular disease is responsible for an unprecedented proportion of deaths in the Western world.
Research has a clear opinion regarding the effect of low testosterone on the risk of cardiovascular disease. Accordingly, testosterone deficiency supports the following adverse health effects (Webb et al. 201728):
- Endothelial dysfunction
- Cardiac repolarisation
In contrast, opinions divide when it comes to exogenous testosterone treatment.
While some studies view taking testosterone supplements as a remedy for heart disease, others suggest that testosterone therapy may exacerbate cardiovascular disease (Vigen et al. 201329).
Do Low Testosterone Symptoms Promote Mortality?
That one cannot take testosterone deficiency lightly is shown by a study conducted on 858 men who were 40 or older.
In this study, men with low testosterone levels’ mortality rate were significantly higher than those with normal levels.
Even adjusting for other significant factors, such as age and obesity, concluded that testosterone deficiency significantly increased the risk of overall mortality (Shores et al. 200630).
Natural Remedies Can Improve Low Testosterone Symptoms
Many physical and psychological effects of testosterone deficiency for both men and women are unknown and readily underestimated.
While low testosterone levels result in various adverse health effects, treatment with exogenous testosterone is not a panacea.
While a natural increase in testosterone levels can be a guarantor of better health, testosterone treatments often show opposite results.
For example, exogenous testosterone can worsen heart disease, while enhancing testosterone levels naturally brings improvements.
Therefore, it makes sense to address low testosterone where it originates – in an unhealthy lifestyle.
For this reason, I’ll be taking a closer look at how you can fight low testosterone through stress reduction, diet, and exercise in a future article.
Low Testosterone Symptoms FAQ
What is free testosterone?
Free es testosterone is not bound to other molecules. Testosterone in the blood is predominantly bound to proteins.
What is bioavailable testosterone?
Bioavailable testosterone includes free testosterone and testosterone bound to non-specific proteins. It excludes testosterone, which is attached to sex hormone-binding globulin (SHBG).
What are the causes of low testosterone?
Stress, medications, estrogen-like chemicals, and excessive alcohol consumption can lower testosterone levels.
1Tyagi V, Scordo M, Yoon RS, Liporace FA, Greene LW. Revisiting the role of testosterone: Are we missing something?. Rev Urol. 2017;19(1):16-24. doi: 10.3909/riu0716. PubMed PMID: 28522926; PubMed Central PMCID: PMC5434832.
2Rivas AM, Mulkey Z, Lado-Abeal J, Yarbrough S. Diagnosing and managing low serum testosterone. Proc (Bayl Univ Med Cent). 2014 Oct;27(4):321-4. doi: 10.1080/08998280.2014.11929145. Review. PubMed PMID: 25484498; PubMed Central PMCID: PMC4255853.
3Bain J. The many faces of testosterone. Clin Interv Aging. 2007;2(4):567-76. doi: 10.2147/cia.s1417. Review. PubMed PMID: 18225457; PubMed Central PMCID: PMC2686330.
4Davis SR, Moreau M, Kroll R, Bouchard C, Panay N, Gass M, Braunstein GD, Hirschberg AL, Rodenberg C, Pack S, Koch H, Moufarege A, Studd J. Testosterone for low libido in postmenopausal women not taking estrogen. N Engl J Med. 2008 Nov 6;359(19):2005-17. doi: 10.1056/NEJMoa0707302. PubMed PMID: 18987368.
5Cartledge J, Minhas S, Eardley I. The role of nitric oxide in penile erection. Expert Opin Pharmacother. 2001 Jan;2(1):95-107. doi: 10.1517/146565220.127.116.11. Review. PubMed PMID: 11336572.
6Trussell JC, Coward RM, Santoro N, Stetter C, Kunselman A, Diamond MP, Hansen KR, Krawetz SA, Legro RS, Heisenleder D, Smith J, Steiner A, Wild R, Casson P, Coutifaris C, Alvero RR, Robinson RB, Christman G, Patrizio P, Zhang H, Lindgren MC. Association between testosterone, semen parameters, and live birth in men with unexplained infertility in an intrauterine insemination population. Fertil Steril. 2019 Jun;111(6):1129-1134. doi: 10.1016/j.fertnstert.2019.01.034. Epub 2019 Apr 12. PubMed PMID: 30982604; PubMed Central PMCID: PMC6557574.
7Wagner GJ, Rabkin JG, Rabkin R. Testosterone as a treatment for fatigue in HIV+ men. Gen Hosp Psychiatry. 1998 Jul;20(4):209-13. doi: 10.1016/s0163-8343(98)00024-3. PubMed PMID: 9719899.
8Wittert G. The relationship between sleep disorders and testosterone in men. Asian J Androl. 2014 Mar-Apr;16(2):262-5. doi: 10.4103/1008-682X.122586. Review. PubMed PMID: 24435056; PubMed Central PMCID: PMC3955336.
9Ustuner ET. Cause of androgenic alopecia: crux of the matter. Plast Reconstr Surg Glob Open. 2013 Oct;1(7):e64. doi: 10.1097/GOX.0000000000000005. eCollection 2013 Oct. PubMed PMID: 25289259; PubMed Central PMCID: PMC4174066.
10Glaser RL, Dimitrakakis C, Messenger AG. Improvement in scalp hair growth in androgen-deficient women treated with testosterone: a questionnaire study. Br J Dermatol. 2012 Feb;166(2):274-8. doi: 10.1111/j.1365-2133.2011.10655.x. Epub 2012 Jan 9. PubMed PMID: 21967243; PubMed Central PMCID: PMC3380548.
11Roy CN, Snyder PJ, Stephens-Shields AJ, Artz AS, Bhasin S, Cohen HJ, Farrar JT, Gill TM, Zeldow B, Cella D, Barrett-Connor E, Cauley JA, Crandall JP, Cunningham GR, Ensrud KE, Lewis CE, Matsumoto AM, Molitch ME, Pahor M, Swerdloff RS, Cifelli D, Hou X, Resnick SM, Walston JD, Anton S, Basaria S, Diem SJ, Wang C, Schrier SL, Ellenberg SS. Association of Testosterone Levels With Anemia in Older Men: A Controlled Clinical Trial. JAMA Intern Med. 2017 Apr 1;177(4):480-490. doi: 10.1001/jamainternmed.2016.9540. PubMed PMID: 28241237; PubMed Central PMCID: PMC5433757.
12Golds G, Houdek D, Arnason T. Male Hypogonadism and Osteoporosis: The Effects, Clinical Consequences, and Treatment of Testosterone Deficiency in Bone Health. Int J Endocrinol. 2017;2017:4602129. doi: 10.1155/2017/4602129. Epub 2017 Mar 16. Review. PubMed PMID: 28408926; PubMed Central PMCID: PMC5376477.
13Huo S, Scialli AR, McGarvey S, Hill E, Tügertimur B, Hogenmiller A, Hirsch AI, Fugh-Berman A. Treatment of Men for “Low Testosterone”: A Systematic Review. PLoS One. 2016;11(9):e0162480. doi: 10.1371/journal.pone.0162480. eCollection 2016. PubMed PMID: 27655114; PubMed Central PMCID: PMC5031462.
14Swerdloff RS, Ng CM. Gynecomastia: Etiology, Diagnosis, and Treatment. [Updated 2019 Jul 7]. In: Feingold KR, Anawalt B, Boyce A, et al., editors. Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc.; 2000-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK279105/
15Rebuffé-Scrive M, Mårin P, Björntorp P. Effect of testosterone on abdominal adipose tissue in men. Int J Obes. 1991 Nov;15(11):791-5. PubMed PMID: 1778664.
16Emmelot-Vonk MH, Verhaar HJ, Nakhai Pour HR, Aleman A, Lock TM, Bosch JL, Grobbee DE, van der Schouw YT. Effect of testosterone supplementation on functional mobility, cognition, and other parameters in older men: a randomized controlled trial. JAMA. 2008 Jan 2;299(1):39-52. doi: 10.1001/jama.2007.51. PubMed PMID: 18167405.
17Tyagi V, Scordo M, Yoon RS, Liporace FA, Greene LW. Revisiting the role of testosterone: Are we missing something?. Rev Urol. 2017;19(1):16-24. doi: 10.3909/riu0716. PubMed PMID: 28522926; PubMed Central PMCID: PMC5434832.
18Cherrier MM, Asthana S, Plymate S, Baker L, Matsumoto AM, Peskind E, Raskind MA, Brodkin K, Bremner W, Petrova A, LaTendresse S, Craft S. Testosterone supplementation improves spatial and verbal memory in healthy older men. Neurology. 2001 Jul 10;57(1):80-8. doi: 10.1212/wnl.57.1.80. PubMed PMID: 11445632.
19Sarkola T, Eriksson CJ. Testosterone increases in men after a low dose of alcohol. Alcohol Clin Exp Res. 2003 Apr;27(4):682-5. doi: 10.1097/01.ALC.0000060526.43976.68. PubMed PMID: 12711931.
20Corrao G, Rubbiati L, Bagnardi V, Zambon A, Poikolainen K. Alcohol and coronary heart disease: a meta-analysis. Addiction. 2000 Oct;95(10):1505-23. doi: 10.1046/j.1360-0443.2000.951015056.x. PubMed PMID: 11070527.
21Schooling CM, Au Yeung SL, Freeman G, Cowling BJ. The effect of statins on testosterone in men and women, a systematic review and meta-analysis of randomized controlled trials. BMC Med. 2013 Feb 28;11:57. doi: 10.1186/1741-7015-11-57. Review. PubMed PMID: 23448151; PubMed Central PMCID: PMC3621815.
22Rosen RC, Kostis JB, Jekelis AW. Beta-blocker effects on sexual function in normal males. Arch Sex Behav. 1988 Jun;17(3):241-55. doi: 10.1007/BF01541742. PubMed PMID: 2900627.
23Rubinstein AL, Carpenter DM. Association Between Commonly Prescribed Opioids and Androgen Deficiency in Men: A Retrospective Cohort Analysis. Pain Med. 2017 Apr 1;18(4):637-644. doi: 10.1093/pm/pnw182. PubMed PMID: 27516365; PubMed Central PMCID: PMC5410969.
24Roy JR, Chakraborty S, Chakraborty TR. Estrogen-like endocrine disrupting chemicals affecting puberty in humans–a review. Med Sci Monit. 2009 Jun;15(6):RA137-45. Review. PubMed PMID: 19478717.
25Chu LW, Tam S, Wong RL, Yik PY, Song Y, Cheung BM, Morley JE, Lam KS. Bioavailable testosterone predicts a lower risk of Alzheimer’s disease in older men. J Alzheimers Dis. 2010;21(4):1335-45. doi: 10.3233/jad-2010-100027. PubMed PMID: 21504130.
26Tyagi V, Scordo M, Yoon RS, Liporace FA, Greene LW. Revisiting the role of testosterone: Are we missing something?. Rev Urol. 2017;19(1):16-24. doi: 10.3909/riu0716. PubMed PMID: 28522926; PubMed Central PMCID: PMC5434832.
27Enter D, Terburg D, Harrewijn A, Spinhoven P, Roelofs K. Single dose testosterone administration alleviates gaze avoidance in women with Social Anxiety Disorder. Psychoneuroendocrinology. 2016 Jan;63:26-33. doi: 10.1016/j.psyneuen.2015.09.008. Epub 2015 Sep 9. PubMed PMID: 26402923.
28M Webb C, Collins P. Role of Testosterone in the Treatment of Cardiovascular Disease. Eur Cardiol. 2017 Dec;12(2):83-87. doi: 10.15420/ecr.2017:21:1. Review. PubMed PMID: 30416559; PubMed Central PMCID: PMC6223354.
29Vigen R, O’Donnell CI, Barón AE, Grunwald GK, Maddox TM, Bradley SM, Barqawi A, Woning G, Wierman ME, Plomondon ME, Rumsfeld JS, Ho PM. Association of testosterone therapy with mortality, myocardial infarction, and stroke in men with low testosterone levels. JAMA. 2013 Nov 6;310(17):1829-36. doi: 10.1001/jama.2013.280386. PubMed PMID: 24193080.
30Shores MM, Matsumoto AM, Sloan KL, Kivlahan DR. Low serum testosterone and mortality in male veterans. Arch Intern Med. 2006 Aug 14-28;166(15):1660-5. doi: 10.1001/archinte.166.15.1660. PubMed PMID: 16908801.