Testosterone: The Complete Guide for Utah Men
By Arsenal Men's Health | Medically Reviewed by Courtney LaSumner Bass, NP | Updated December 2024 | 15 min read
Testosterone is often called the "master male hormone" for good reason. This powerful steroid hormone influences virtually every aspect of men's health—from your energy levels and mental clarity to your muscle mass, sexual function, and even your cardiovascular health. Yet despite its importance, many men know surprisingly little about what testosterone actually does, what happens when levels decline, and what treatment options exist.
At Arsenal Men's Health, we believe knowledge is power. This comprehensive guide will give you a deep, evidence-based understanding of testosterone—the science behind it, the symptoms of deficiency, how it's diagnosed, and the treatment options available through our Utah-based telehealth clinic.
What Is Testosterone?
Testosterone is the primary male sex hormone (androgen) produced predominantly in the Leydig cells of the testes, with smaller amounts produced by the adrenal glands. Women also produce testosterone in their ovaries and adrenal glands, though at significantly lower levels.
From a biochemical standpoint, testosterone is a steroid hormone derived from cholesterol. The production pathway begins when cholesterol is converted to pregnenolone through the enzyme cytochrome P450 side-chain cleavage (P450scc). Through several enzymatic steps, pregnenolone is eventually converted to testosterone—a process that takes place primarily in the testes under the influence of hormonal signals from the brain.
The Hypothalamic-Pituitary-Gonadal Axis
Your testosterone production is controlled by a sophisticated feedback system called the hypothalamic-pituitary-gonadal (HPG) axis. Understanding this system helps explain why testosterone levels fluctuate and how various treatments work:
Hypothalamus: This brain region releases gonadotropin-releasing hormone (GnRH) in pulses every 1-3 hours
Pituitary Gland: GnRH stimulates the anterior pituitary to release luteinizing hormone (LH) and follicle-stimulating hormone (FSH)
Testes: LH signals Leydig cells to produce testosterone, while FSH supports sperm production in Sertoli cells
Feedback Loop: High testosterone levels signal the hypothalamus and pituitary to reduce GnRH and LH production, maintaining balance
This feedback mechanism is why external testosterone supplementation can temporarily suppress natural production—a key consideration in treatment planning that our providers at Arsenal Men's Health carefully manage.
The Critical Functions of Testosterone
Testosterone's influence begins in the womb and continues throughout life. During fetal development (around week 7), testosterone drives the formation of male reproductive organs. During puberty, it triggers the development of secondary sexual characteristics. In adulthood, it maintains numerous vital functions.
Sexual and Reproductive Health
Testosterone is essential for libido (sex drive), erectile function, and sperm production (spermatogenesis). Research published in the Journal of Clinical Endocrinology & Metabolism demonstrates that testosterone plays a direct role in the production and maturation of sperm, the maintenance of libido, and the physiological mechanisms that enable erections. Low testosterone is strongly associated with reduced sexual desire and erectile dysfunction.
Body Composition and Physical Performance
Testosterone has powerful anabolic effects, meaning it promotes the building of tissue—particularly muscle. Studies show that testosterone increases muscle protein synthesis, leading to greater muscle mass and strength. Simultaneously, testosterone influences fat distribution, and lower levels are associated with increased visceral (abdominal) fat. Research from the American Journal of Physiology has shown that older men respond to testosterone's anabolic effects similarly to younger men, suggesting age doesn't diminish the muscle-building potential of adequate testosterone levels.
Bone Health
Testosterone maintains bone mineral density through both direct effects and its conversion to estradiol (a form of estrogen). Men with low testosterone have an increased risk of osteoporosis and bone fractures. Clinical trials have demonstrated that testosterone therapy can increase bone mineral density, particularly in the spine and hip—areas most vulnerable to age-related bone loss.
Energy and Metabolism
Testosterone supports mitochondrial function—the cellular "powerhouses" responsible for energy production. It also stimulates red blood cell production (erythropoiesis), improving oxygen delivery throughout the body. This explains why men with low testosterone often report profound fatigue and low energy that doesn't improve with sleep or rest.
Cognitive Function and Mood
The brain contains numerous testosterone receptors, and research has linked testosterone to cognitive functions including memory, spatial ability, and verbal fluency. Testosterone also influences neurotransmitters like dopamine, which affects motivation and mood. Studies have associated low testosterone with increased risk of depression, anxiety, and cognitive decline. A systematic review published in Cureus (2025) confirmed that testosterone therapy can significantly reduce depressive symptoms in hypogonadal men.
Cardiovascular Health
The relationship between testosterone and cardiovascular health is complex. Testosterone supports endothelial function (the health of blood vessel linings) and may have beneficial effects on cholesterol profiles. However, the cardiovascular effects of testosterone therapy have been debated. Current evidence suggests that maintaining testosterone within normal physiological ranges is associated with cardiovascular health, while both very low and supraphysiological (abnormally high) levels may increase risk. This is why careful monitoring during treatment is essential.
Normal Testosterone Levels: What the Numbers Mean
The American Urological Association (AUA) defines low testosterone (testosterone deficiency) as a total testosterone level below 300 nanograms per deciliter (ng/dL), combined with symptoms of deficiency. However, understanding testosterone measurement requires knowing about different forms of the hormone:
Total vs. Free Testosterone
Total Testosterone: The complete amount of testosterone in your blood, including testosterone bound to proteins (primarily sex hormone-binding globulin/SHBG and albumin) plus free testosterone. Normal range: 300-1,000 ng/dL
Free Testosterone: The unbound, biologically active form available for your body to use (about 2-3% of total). This is what actually enters cells and produces effects
Bioavailable Testosterone: Free testosterone plus albumin-bound testosterone (which can easily release and become active)
Some men have total testosterone in the "normal" range but experience symptoms because their SHBG is elevated, leaving less free testosterone available. This is why comprehensive testing and clinical correlation are essential—and why "normal" lab values don't tell the whole story.
How Testosterone Levels Change With Age
After age 30-40, testosterone levels naturally decline by approximately 1-2% per year. However, this decline varies significantly between individuals and isn't inevitable. Lifestyle factors, overall health, and genetics all influence the rate of decline. The AUA emphasizes that aging alone doesn't automatically cause testosterone deficiency requiring treatment—symptoms must be present alongside low levels.
It's also important to note that testosterone levels fluctuate throughout the day, typically peaking in the early morning and declining by evening. This is why guidelines recommend testing be performed before 10 AM for the most accurate results.
Recognizing Low Testosterone: Signs and Symptoms
The symptoms of testosterone deficiency can be subtle at first and are often attributed to "getting older" or stress. However, when multiple symptoms occur together—especially in younger men—low testosterone should be considered. According to the AUA and Endocrine Society guidelines, symptoms of testosterone deficiency include:
Sexual Symptoms
Reduced sex drive (libido)
Erectile dysfunction (difficulty achieving or maintaining erections)
Fewer spontaneous erections (especially morning erections)
Reduced fertility or low sperm count
Physical Symptoms
Decreased muscle mass and strength
Increased body fat, particularly around the abdomen
Gynecomastia (breast tissue development)
Decreased bone density
Hair loss (body and facial hair)
Hot flashes or night sweats
Cognitive and Emotional Symptoms
Persistent fatigue not relieved by rest
Difficulty concentrating or "brain fog"
Depression or depressed mood
Irritability or mood changes
Decreased motivation or drive
Memory problems
"Many men I treat describe feeling like a shadow of their former selves—they know something is wrong but often attribute it to age or stress. When we identify and treat testosterone deficiency, the transformation can be remarkable." — Courtney LaSumner Bass, NP, Arsenal Men's Health
Causes of Low Testosterone
Understanding what causes testosterone deficiency helps guide treatment decisions. Hypogonadism (the medical term for testosterone deficiency) is classified into two main categories:
Primary Hypogonadism
This occurs when the problem originates in the testes themselves—they don't produce adequate testosterone despite receiving proper signals from the brain. Causes include genetic conditions (such as Klinefelter syndrome), testicular injury or infection, chemotherapy or radiation, undescended testicles, and mumps orchitis.
Secondary Hypogonadism
This occurs when the problem is in the hypothalamus or pituitary gland—the testes are capable of producing testosterone but don't receive adequate hormonal signals. Causes include pituitary disorders or tumors, obesity, certain medications (especially opioids and corticosteroids), chronic illness, HIV/AIDS, hemochromatosis (iron overload), and inflammatory diseases.
Contributing Factors
Several lifestyle and health factors can contribute to declining testosterone:
Obesity: Strongly associated with low testosterone; excess fat tissue converts testosterone to estrogen
Sleep Disorders: Testosterone is primarily produced during deep sleep; sleep apnea is particularly detrimental
Chronic Stress: Elevated cortisol suppresses testosterone production through the HPG axis
Type 2 Diabetes: Strong bidirectional relationship with low testosterone
Alcohol: Excessive consumption suppresses testosterone production
Medications: Opioids, corticosteroids, and some antidepressants can lower testosterone
How Low Testosterone Is Diagnosed
Proper diagnosis of testosterone deficiency requires both laboratory confirmation AND clinical symptoms. According to AUA guidelines, the diagnosis should include:
Laboratory Testing
Two Separate Morning Blood Tests: Total testosterone should be measured on two different days, with blood drawn before 10 AM when levels are highest
Fasting Sample: Recommended for most accurate results
CLIA-Certified Laboratory: Ensures quality and accuracy of results
Additional Testing May Include
Free Testosterone: Especially if total testosterone is borderline
LH and FSH: To distinguish between primary and secondary hypogonadism
Prolactin: Elevated levels can suppress testosterone and may indicate pituitary issues
Complete Blood Count (CBC): Baseline for monitoring during treatment
PSA: Prostate-specific antigen baseline for men over 40
Metabolic Panel: To assess overall health and identify contributing factors
At Arsenal Men's Health, we make testing convenient with at-home lab kits processed by CLIA-certified laboratories. Your results are reviewed by our licensed medical providers who will discuss findings and treatment options during your telehealth consultation.
Treatment Options for Low Testosterone
Once testosterone deficiency is confirmed, several treatment approaches are available. The FDA has approved testosterone products for men with confirmed hypogonadism due to medical conditions affecting the testes or hypothalamus/pituitary. Treatment decisions are individualized based on symptoms, overall health, and patient preferences.
Testosterone Replacement Therapy (TRT)
TRT directly supplements the body with testosterone to restore levels to the normal range. It does not work overnight—gradual improvements typically begin within a few weeks as hormone levels stabilize. Administration methods include:
Injections: Typically administered intramuscularly every 1-2 weeks, or subcutaneously; provides reliable testosterone delivery
Topical Gels/Creams: Applied daily to the skin; provides steady absorption; requires precautions to prevent transfer to others
Patches: Applied daily; may cause skin irritation in some men
Pellets: Implanted under the skin; releases testosterone over 3-6 months
Fertility Considerations
An important consideration: TRT suppresses sperm production by disrupting the normal hormonal signals needed for spermatogenesis. For men concerned about fertility, alternative approaches such as enclomiphene citrate or hCG (human chorionic gonadotropin) may stimulate the body's own testosterone production while preserving fertility. These medications work by stimulating the HPG axis rather than replacing testosterone directly. Research has shown enclomiphene can effectively raise testosterone levels while maintaining or improving sperm parameters.
Benefits of Treatment
Clinical studies and systematic reviews have demonstrated that testosterone therapy in appropriately selected hypogonadal men can provide:
Improved sexual function and libido
Increased muscle mass and strength
Improved bone mineral density
Enhanced mood and reduced depressive symptoms
Increased energy and reduced fatigue
Improved body composition with reduced fat mass
Potential Side Effects and Monitoring
Like any medical treatment, testosterone therapy requires careful monitoring. Potential side effects include acne, oily skin, fluid retention, breast tenderness, sleep apnea worsening, and increased red blood cell count (polycythemia). Regular monitoring ensures treatment remains safe and effective, with adjustments made as needed.
The AUA recommends patients be evaluated at 3-6 months after initiating therapy and annually thereafter, with monitoring including testosterone levels, hematocrit, and PSA for appropriate candidates. At Arsenal Men's Health, we maintain ongoing monitoring throughout your treatment to ensure optimal outcomes.
Natural Strategies to Support Healthy Testosterone
While lifestyle changes alone may not correct clinically low testosterone, they play an important role in supporting overall hormonal health and may enhance the effectiveness of treatment:
Exercise
Resistance training and high-intensity interval training (HIIT) have been shown to temporarily boost testosterone levels and improve body composition, which can support healthy testosterone long-term. However, overtraining can have the opposite effect, so balance is key.
Sleep Optimization
The majority of testosterone is produced during deep sleep. Poor sleep quality significantly impairs testosterone production. Prioritize 7-9 hours of quality sleep and address sleep disorders like sleep apnea.
Nutrition
Key nutrients for testosterone production include:
Zinc: Found in pumpkin seeds, nuts, and legumes
Vitamin D: Sunlight exposure, fatty fish, and fortified foods
Healthy Fats: Avocados, olive oil, nuts (testosterone is made from cholesterol)
Research suggests the Mediterranean diet may support healthy testosterone levels. Avoid ultra-processed foods, which are associated with poorer reproductive health.
Weight Management
Maintaining a healthy weight is one of the most impactful factors for testosterone. Excess body fat—particularly visceral fat—converts testosterone to estrogen through aromatization. Weight loss in overweight men often leads to improved testosterone levels.
Stress Management
Chronic stress elevates cortisol, which directly suppresses the HPG axis and testosterone production. Effective stress management through exercise, meditation, or other techniques can support hormonal balance.
Limit Alcohol
Excessive alcohol consumption is associated with lower testosterone. Following moderate drinking guidelines (up to two drinks per day for men) supports hormonal health.
Common Questions About Testosterone
Does testosterone therapy cause prostate cancer?
Current evidence does not support a link between testosterone therapy and the development of prostate cancer in men without existing prostate disease. The AUA guidelines state there is no evidence that testosterone therapy causes prostate cancer. However, testosterone therapy is not recommended for men with untreated prostate cancer.
Is testosterone therapy safe for the heart?
The relationship between testosterone therapy and cardiovascular health has been extensively studied. While the FDA issued a warning in 2015 about potential cardiovascular risks, subsequent research has provided more nuanced understanding. The AUA notes that clinicians should inform patients that low testosterone is itself a risk factor for cardiovascular disease. The key is appropriate patient selection, proper dosing to physiological ranges, and ongoing monitoring.
How long does it take to see results from TRT?
Different symptoms improve at different rates. Some men notice improved energy and mood within a few weeks. Sexual function often improves within 3-6 weeks. Changes in body composition (muscle gain, fat loss) typically require 3-6 months of consistent treatment. Full benefits may take 6-12 months to achieve.
Can I stop TRT once I start?
Yes, testosterone therapy can be discontinued, though it should be done under medical supervision. Natural testosterone production typically resumes, though recovery time varies. The AUA recommends discussing cessation with patients who achieve normal testosterone levels but don't experience symptom improvement after 3-6 months of treatment.
Take the First Step: Get Tested
If you're experiencing symptoms of low testosterone, knowledge is the first step toward feeling like yourself again. At Arsenal Men's Health, we've made it simple for Utah men to get answers:
Free Consultation: Book a confidential telehealth consultation with our licensed medical providers
Convenient Testing: Comprehensive lab testing from the comfort of your home or a local lab
Personalized Treatment: If eligible, receive a customized treatment plan tailored to your specific needs
Ongoing Support: Regular monitoring and adjustments to optimize your results
Remember: Testosterone deficiency is a medical condition, not a character flaw or inevitable consequence of aging. With proper diagnosis and treatment, most men experience significant improvement in their symptoms and quality of life.
Ready to get started? Contact Arsenal Men's Health today at (385) 666-6292 or visit arsenalmenshealth.com to schedule your free consultation.
Medical Disclaimer: This article is for educational purposes only and does not constitute medical advice. All treatment decisions are made by a licensed medical provider based on individual clinical appropriateness and patient history. Individual results may vary.
References
Nassar GN, Leslie SW. Physiology, Testosterone. StatPearls Publishing; 2023. PMID: 30252384
Mulhall JP, Trost LW, Brannigan RE, et al. Evaluation and Management of Testosterone Deficiency: AUA Guideline. J Urol. 2018;200(2):423-432.
Bhasin S, Brito JP, Cunningham GR, et al. Testosterone Therapy in Men With Hypogonadism: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2018;103(5):1715-1744.
Yassin AA, et al. Testosterone and men's health: An in-depth exploration of their relationship. UroPrecision. 2025. doi:10.1002/uro2.115
Tyagi V, Scordo M, Yoon RS, et al. Revisiting the role of testosterone: Are we missing something? Rev Urol. 2017;19(1):16-24.
Traish AM, Miner MM, Morgentaler A, Zitzmann M. Testosterone deficiency. Am J Med. 2011;124(7):578-587.
Rastrelli G, Corona G, Maggi M. Testosterone and sexual function in men. Maturitas. 2018;112:46-52.
Benefits of Testosterone Hormone in the Human Body: A Systematic Review. Cureus. 2025;17(2). doi:10.7759/cureus
Wiehle RD, Fontenot GK, Wike J, et al. Enclomiphene citrate stimulates testosterone production while preventing oligospermia. Fertil Steril. 2014;102(3):720-727.
Bhasin S, Woodhouse L, Casaburi R, et al. Older men are as responsive as young men to the anabolic effects of graded doses of testosterone on the skeletal muscle. J Clin Endocrinol Metab. 2005;90(2):678-688.
Zitzmann M, Nieschlag E. Testosterone levels in healthy men and the relation to behavioural and physical characteristics. Eur J Endocrinol. 2001;144(3):183-197.
Canadian Urological Association guideline on testosterone deficiency in men: Evidence-based Q&A. Can Urol Assoc J. 2021;15(5):E334-E348.
Tags: testosterone, low testosterone, TRT, testosterone replacement therapy, men's health, hormone therapy, hypogonadism, Utah men's health, telehealth, Arsenal Men's Health
SEO Meta Description: Complete guide to testosterone for Utah men. Learn what testosterone does, symptoms of low T, how it's diagnosed, and treatment options at Arsenal Men's Health. Evidence-based information with peer-reviewed references.
Featured Image Alt Text: Utah man feeling energetic and confident after testosterone optimization treatment
