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Testosterone: More than sex, muscle and masculinity - Baylor College of Medicine Blog Network
Testosterone may be one of the most important biomarkers of men's overall health, often signaling underlying conditions long before symptoms become severe.
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Testosterone is often associated with sex, muscles and masculinity. But after more than two decades of treating men with low testosterone, I have come to appreciate that testosterone is more than a sex hormone and can be a window into a man’s overall health.
Testosterone plays an essential role in sexual function, but its effects extend far beyond the bedroom. Bone health, muscle mass, red blood cell production, energy levels and overall physical well-being all are related to testosterone levels. Low testosterone can affect obesity, diabetes, metabolic syndrome, depression, heart disease and other chronic medical conditions.
In many ways, I view testosterone as a barometer of men’s health. When testosterone levels are low, I ask ‘why.’ Sometimes the answer is obesity, poor sleep, stress, untreated sleep apnea or metabolic disease. Identifying these conditions may be just as important as addressing the testosterone deficiency itself.
Unfortunately, testosterone has suffered from decades of misconceptions and controversy. Some believe testosterone therapy causes prostate cancer or heart attacks. Others dismiss low testosterone as an inevitable consequence of aging that men should simply accept. The science tells a more nuanced story.
I was fortunate to serve on the steering committee for the landmark TRAVERSE trial, which provided important reassurance about heart health in men with higher-than-normal testosterone levels. In 2025, the FDA removed boxed-warning language about increased cardiovascular risks from testosterone products, although blood pressure warnings remain. These developments should encourage us to reconsider how we approach men’s hormonal health.
Recent national interest in testosterone screening has brought this conversation into the spotlight. I believe this represents an important opportunity to improve men’s overall health. A low testosterone result does not automatically mean a man needs testosterone therapy. Diagnosis requires appropriate testing, clinical evaluation and consideration of symptoms. Treatment should always be individualized. But we cannot address a problem if we never look for it.
Men deserve accurate information, access to appropriate testing and evidence-based treatment without unnecessary stigma or outdated misconceptions. I believe we should move toward more proactive testosterone assessment in men, particularly beginning in midlife, while recognizing that universal screening remains an area of medical debate. The goal should be to identify men who may benefit from further evaluation and earlier intervention.
By Dr. Mohit Khera, professor of urology at Baylor College of Medicine
