Why Hormone Health Should Be A Standard Part Of Men’s Healthcare

Hormone health is something we don’t talk about enough when it comes to men’s care. Low testosterone is often brushed off as just a normal part of aging or attributed to stress, ignoring the fact that it is a medical condition that can have a real impact on how a man feels and is easily treatable. We hear from members regularly that tell us they knew something was wrong, they no longer felt like themselves, yet their healthcare provider never suggested low testosterone could be the issue, let alone test testosterone levels. 

I’ve had one patient who was in his early 40s and started feeling “off” after a series of medical procedures. He was constantly exhausted, losing muscle and feeling unusually low. Despite visiting his doctor multiple times over the years, he was never screened for testosterone deficiency. When he eventually requested the test himself, his levels came back dangerously low. He had felt that something was night right for years, yet testing his testosterone level was never mentioned at any clinical visit. By the time a diagnosis was made, he had unnecessarily been coping with unexplained symptoms for nearly a decade.

Unfortunately, this story is not uncommon. Testosterone deficiency is prevalent in men over 40, yet it often goes unrecognized. Many men don’t know they should be screened and others may feel uncomfortable initiating the conversation. In some cases, even when patients ask for testing, they run into challenges, whether it’s insurance hurdles, scheduling delays or not being taken seriously. All of these factors can impede receiving proper care.

Understanding testosterone deficiency

Testosterone deficiency, or hypogonadism, affects an estimated 10% to 40% of men over the age of 40, depending on diagnostic criteria and populations studied. This condition is characterized by a decline in testosterone production with age, which typically begins in a man’s  30s. Common symptoms include fatigue, low libido, mood changes, reduced muscle mass and difficulty sleeping.  These symptoms are vague and often confused as the effect of a busy, stressful lifestyle. The end result, unfortunately, is often a patient who doesn’t recognize there is a bigger problem or a provider who does not feel comfortable prescribing testosterone.

Another patient, who is in his 50s, previously underwent cancer treatment. He’d been on hormone therapy for quite a time and doing well, but when insurance issues caused an interruption to his therapy regimen for a number of months, he just didn’t feel like himself anymore. He felt completely drained as though he didn’t have the energy or emotional steadiness to get through the day. Once testosterone therapy was reinitiated, things started to shift. His symptoms improved, reminding us how deeply hormones influence physical and mental functioning.

Barriers to diagnosis

Although the symptoms of low testosterone  are  common, only about 4% of men with low testosterone symptoms say they’ve actually been tested. Most doctors don’t routinely check testosterone levels, with screenings only occurring when patients request it. But why should patients be the ones figuring out what tests they need?

Men are historically less likely to seek medical care proactively. Cultural expectations around masculinity can contribute to this trend, leading men to delay or avoid medical attention due to embarrassment, stigma or the belief that they should “tough it out.”  Lack of awareness further complicates things as many don’t know that hormonal issues could be the source of what they’re feeling.

Cost is a huge barrier to treatment. Without insurance or with a plan that doesn’t offer much coverage, tests, appointments and prescriptions can quickly become unaffordable. Some patients may skip testing or treatment due to financial concerns, which may exacerbate symptoms and make a difficult situation even harder to manage in the long run.

The case for routine screening 

Testosterone levels naturally drop as men age. Sometimes that decline is so gradual, it doesn’t really cause any noticeable changes. But for others, it can hit harder, impacting things like energy, mood, motivation and even how they feel in their own skin. Men with a history of testicular cancer, chronic illness, metabolic issues or certain surgeries are especially at risk, and for them, regular screening can make a big difference.

If we started treating testosterone testing like any other part of preventive care, especially for men in those higher-risk groups, we’d likely catch deficiencies sooner and get people the help they need before symptoms start affecting their everyday life.

Benefits and considerations of treatment

Hormone replacement therapy (HRT) for men most commonly involves testosterone replacement therapy (TRT). Depending on the patient, it can be delivered as gels, injections, patches or long-acting pellets.

When used appropriately, testosterone therapy can help boost energy, mood, sex drive and muscle mass in men with confirmed low levels. Some patients also report better sleep, clearer thinking and more emotional stability. Recently, I had a patient confirm that TRT made him finally feel  “consistent” again; more even-keeled, able to show up for his job and more present in his relationship with his partner. Others say they feel more motivated, more able to exercise and more engaged in their daily lives. 

There’s also growing evidence that testosterone therapy might support metabolic health, bone strength and cardiovascular markers. While more research is still needed, these findings highlight the importance of early diagnosis, thoughtful prescribing and ongoing monitoring.

Like any treatment, hormone therapy has to be individualized per case. For the right patients, HRT can be a powerful way to bring back that sense of energy, focus and stability that’s been missing. When it’s done thoughtfully and with the right support, hormone therapy can really help someone feel more like themselves again. 

A path forward

Testosterone deficiency deserves the same attention we give to any other age-related health concern. Providers can play a big role here by starting the conversation when a patient brings up things like low energy, mood changes or reduced sex drive. For men over 40, and particularly those dealing with chronic illness, recovery from surgery or metabolic concerns, routine hormone screening can be a valuable part of preventive care.

On the other hand, men should feel comfortable addressing  hormone health with their doctors, especially if they’ve noticed lasting changes in their mood, energy or physical performance. Honest conversations, timely testing and tailored treatment plans can certainly positively impact a person’s life. 

The bottom line is that men deserve to know about available HRT and have access to care that could be life altering.

Photo: 3283197d_273, Getty Images

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