Low Testosterone
Origins
Low testosterone, diagnosed as hypoandrogenism, typically occurs in older men "due to aging testis losing the ability to produce adequate levels of T (testosterone), despite normal or unchanged levels of LH (luteinizing hormone)." For younger adults & even adolescents, however, this diagnosis presents more of a challenge as they do not experience the same range of symptoms (Cohen et al., 2020). Why is testosterone so low?
highlights that despite accounting for factors like smoking, obesity, age, physical activity & alcohol use, the total testosterone in American men has declined significantly over the last several decades, across all age groups.
However, as explained in How to Use Cold Plunge Therapy to Boost Testosterone, Naturally, men are not the only victims of low testosterone either (although most commonly associated with this issue). As clarified in Ice Baths & Women's Testosterone, testosterone is also the most dominant sex hormone in women's bodies. Lab reports compare testosterone & estrogen in different chemical units, with testosterone reported as nanograms per deciliter (ng/dL) & estrogen concentration reported as picograms per milliliter (pg/mL). Yet when comparing them in identical units by multiplying the testosterone numbers by ten, it becomes clear that women have two to three times more testosterone concentration than estrogens (i.e., estrone, estradiol, and estriol) in their bloodstream. Although a healthy woman will still only create one tenth of the testosterone of a healthy man, it is just as crucial to women's health to maintain proper testosterone balance.
Mechanisms
Testosterone, the primary male sex hormone & anabolic steroid, serves two functions for the body. One function includes promoting muscle building due to its anabolic effects. Another function involve its effects on androgen, responsible for male traits such as deep voices & facial hair. While it is produced mainly by testicles in the adult human, it is also produced by the gonad (ovarian) tissue in women, with the rest coming from the adrenal glands (Burger 2002), fat cells, and the skin (Chen et al. 2002). For men, it regulates their appearance & sexual development, stimulates sperm production & regulate's sex drive, including semen volume. It can also help to build muscle & bone mass in either sex. In women, testosterone & androgen must be balanced properly to ensure the ovaries function normally, as androgens also play an important role in normal brain function including mood, sex drive & cognitive functions (Omona, 2020).
Symptoms
Common symptoms for older men suffering from low testosterone are erectile dysfunction & decreased libido. Younger men often do not display these same symptoms, but instead complain of low energy levels (Cohen et al., 2020). Other symptoms of low testosterone may include reduced body & facial hair, loss of muscle mass, reduced sperm count, increased breast size, hot flashes, irritability, poor concentration, depression, loss of body hair & brittle bone structure (Omona, 2020). What Happened to My Testosterone After Using Ice Baths for My Prostate explains how low testosterone can also result in prostate inflammation & in extreme cases, it can even lead to increased risk of major depression, decreased quality of life, increased mortality & prostate cancer.
Ice Baths & Women's Testosterone describes how insufficient testosterone levels in women can cause heart deficits, depressive symptoms, muscle deterioration, low libido, cognitive impairments & reduced overall well-being (Al-Azzawi and Palacious 2009). However, on the opposite end of the spectrum, a study by Rohr (2002) suggests that higher than normal testosterone levels can also create hyperandrogenic states, causing hirtuism (excessive hair growth), acne, polycystic ovarian syndrome (PCOS) & irregular menstrual cycles.
Often times, low testosterone is treated through testosterone replacement therapy (TRT) or by supplementation. However, as written in Do Ice Baths Increase Testosterone?, these treatments may result in adverse side effects such as aggression, hypersexuality & cholestatis. In those who are prone to coronary artery disease, testosterone supplementation therapy may be at risk for especially dangerous outcomes, such as myocardial infarctions, stroke & death (Lee & Tillman, 2016). Even with these risks involved, there are also some studies that suggest testosterone supplementation is ineffective in treating erectile dysfunction & is not consistent in effecting libido. Along with this, studies have shown testosterone supplemenatation having no consistent benefits on cardiovascular health, sexual function, mood, behavior or cognition (Huo et al, 2016). While this form of treatment may be most commonly recognized, it may leave people feeling limited in options without risk or significant testosterone improvement during long term use.
Do Ice Baths Increase Testosterone explains how mitochondria are crucial for testosterone synthesis. Testosterone is actually synthesized in the body from cholesterol. This means that without sufficient HDL (high-density lipoprotein) & LDL (low-density lipoprotein) cholesterol in the bloodstream, testosterone synthesis suffers. What many people do not yet realize is that mitochondria perform steroidogenesis, or the conversion of cholesterol to pregnenolone, the steroidal precursor necessary to synthesize testosterone (Papadopoulos et al. 2012). This makes mitochondrial health essential to maintaining
healthy testosterone.
Although there have been conflicting studies of the effects of ice baths on testosterone, the science of cold therapy for treating low testosterone has become increasingly more convincing. After adopting a regular practice of cold plunge therapy, both women and men have documented increases in total testosterone.
Do Ice Baths Increase Testosterone? reviews several case studies that show that ice baths help to support the resolution of low testosterone levels. In the case of Eloise DeSoutter, a 32 year old nulliparous (woman who has never given birth), she began self directing cold plunging to see its impacts on her fertility once her biological sister was diagnosed with PCOS (polycystic ovary syndrome). She experimented with this over 4 months, initially performing daily immersions from 2-8°C, then reducing her frequency to 2-3 times per week. Eloise saw significant endocrine & anthropometric changes, & her total testosterone increased from 0.6 to 1.1 nmol/L, showing nearly 2x her usual levels. Additionally, Eloise's estrogen levels exhibited a 3x increase, her muscle mass increased by 2% & her total fat mass decreased by 2%. While she had no other lifestyle modifications during this period, she still reported having enhanced mood, confidence, libido & energy levels.
Another case study reviewed in this article takes a look at Sean Smiley, a 43 year old male firefighter & paramedic, struggling with a history of chronic hypogonadism from a prior saddle injury sustained at 26. After unsuccessful attempts at testosterone supplementation & suffering from adverse side effects like aggression, hypersexuality & cholestatis, Sean discontinued testosterone replacement therapy & began a new approach through cold water immersion. When he was 39, he began pre-exercise cold pool swimming & eventually progressed to doing ice baths, combined with breath work. Sean saw a staggering increase within only 35-45 days. His testosterone levels increased from the low 200's ng/dL range to 595 ng/dL. Not only did his testosterone levels increase, but he reported notable improvements in his mental health, sexual function & return of nocturnal tumescence (nighttime erections). As he continued his cold water regimen, these levels only continued to improve as he reached 773 ng/dL by July 2024.
In both of these cases, ice baths proved effective at not only treating low testosterone when other treatments methods had failed, but offers hope for those still struggling from abnormal levels & the physiological impacts this can have on a person.
Uncommon Testosterone, a follow-up to Uncommon Cold, dives deeper into the science of cold plunge therapy for testosterone enhancement. It features the latest science on the mechanisms of testosterone synthesis, also including several case studies of individuals who have implemented an ice bath routine for their sexual health.
To learn more about the mechanisms of ice baths as a treatment for low testosterone, purchase a copy of Uncommon Testosterone.
References
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Al-Azzawi F, Palacios S. Hormonal changes during menopause. Maturitas. 2009 Jun 20;63(2):135-7.
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Burger HG. Androgen production in women. Fertility and sterility. 2002 Apr 1;77:3-5.
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Chen W, Thiboutot D, Zouboulis CC. Cutaneous androgen metabolism: basic research and clinical perspectives. Journal of Investigative Dermatology. 2002 Nov 1;119(5):992-1007.
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Cohen J, Nassau DE, Patel P, Ramasamy R. Low testosterone in adolescents & young adults. Frontiers in endocrinology. 2020 Jan 10;10:916.
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Huo 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 Sep 21;11(9):e0162480.
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Lee OD, Tillman K. An overview of testosterone therapy. American journal of men's health. 2016 Jan;10(1):68-72.
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Omona K. Testosterone. InReproductive Hormones 2020 Oct 5. IntechOpen.
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Papadopoulos V, Miller WL. Role of mitochondria in steroidogenesis. Best practice & research Clinical endocrinology & metabolism. 2012 Dec 1;26(6):771-90.
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Rohr UD. The impact of testosterone imbalance on depression and women's health. Maturitas. 2002 Apr 15;41:25-46.
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