December 14, 2025, 6:43 am | Read time: 7 minutes
Starting around age 40, many men notice the first physical changes that may be related to their hormone levels: Energy wanes more quickly, sleep is less restful, and waistlines often expand. These are just a few possible signs of hormonal changes. A hormone check can help interpret these changes. Our FITBOOK expert Dr. Pies, a specialist in urology, provides insight.
How does the male hormone status change?
“As early as the mid-30s, the body’s testosterone production begins to slowly decline. This gradual decrease is called andropause and is a natural development that men experience very differently,” explains Dr. Pies. “Unlike women, who undergo a relatively abrupt hormonal change during menopause, men’s hormone levels change very gradually. As a result, many symptoms go unnoticed for a long time or are prematurely attributed to other causes. A hormone check can provide clarity. It shows whether hormonal changes, a disease, or your lifestyle are the actual triggers.”
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When is a disease behind the testosterone decline?
“Andropause describes the natural decline of testosterone over the years. It becomes medically relevant only when this decline is measurable and associated with significant symptoms. In this case, specialists refer to it as late-onset hypogonadism. This clearly defined testosterone deficiency usually occurs from middle age, can be diagnosed, and is well treatable,” says Dr. Pies.
Is a low testosterone level dangerous?
“Testosterone is a good barometer for overall health. Studies even suggest a link between increased mortality rates and low testosterone levels. According to an observational study in Mecklenburg-Vorpommern, men with low testosterone are more likely to die from cardiovascular diseases. Connections with high blood pressure and diabetes were also demonstrated in this long-term study,” explains Dr. Pies.
When should men get a hormone check?
A hormone check is advisable when noticeable changes occur over several weeks or months that can no longer be clearly explained by stress, lack of sleep, or everyday burdens.
Physical signals
If you notice that your usual performance is declining, you should take a closer look. Typical signs include decreasing muscle mass despite regular training, a persistent increase in abdominal fat, or overall reduced physical resilience. Sleep disturbances, poorer recovery after exercise, or changes in hair and beard growth can also indicate a hormonal imbalance. Some men also notice that they are more frequently injured or that bones and joints are more sensitive. This can be a possible indication that bone density is slightly decreasing.
Emotional signals
Hormones also affect your psyche. If you feel more easily irritated, experience mood swings, or your stress resistance decreases, there may be more to it. The feeling of reduced mental resilience and increased depressive moods can also be a signal.
Changes in sexuality
A declining libido, less frequent or absent morning erections, and erectile dysfunction are typical indicators that should be medically clarified. They often accompany a declining testosterone level and are the reason many men first have their hormone status checked.
7 possible signals at a glance
- Loss of muscle mass
- Increase in abdominal fat
- Sleep disturbances
- Poor recovery and resilience
- Changes in hair and beard growth
- Mood swings and reduced stress resistance
- Decreasing libido
Which hormones are tested?
“A meaningful hormone check includes much more than just the testosterone level. While testosterone plays a central role in energy, libido, muscle maintenance, and mood, only in conjunction with other hormones does a complete picture emerge,” says Dr. Pies.
Testosterone
“First, total testosterone is measured, which indicates how much testosterone is circulating in the blood overall. Even more informative, however, is the so-called free or bioavailable testosterone. This is the portion that the body can actually use. For calculating these values, the sex hormone-binding globulin (SHBG) is also relevant, a protein that binds testosterone and thus influences its effect,” explains Dr. Pies.
Estrogen
Determining the estradiol level is also worthwhile, as men need a small but stable amount of estrogen, for example, for bone health and mood stability. With an increase in abdominal fat, the enzyme aromatase converts testosterone into estrogen, which in turn promotes further weight gain.
Additional markers
In addition, the hormones relevant for sperm production, LH (luteinizing hormone) and FSH (follicle-stimulating hormone), provide clues as to whether the cause of a disorder lies more in the testes or the pituitary gland. A look at DHEA-S (dehydroepiandrosterone sulfate), the stress hormone cortisol, and the thyroid hormones TSH (thyroid-stimulating hormone), fT3 (free triiodothyronine), and fT4 (free thyroxine) rounds out the check, as they significantly influence how energetic and resilient you feel.
Procedure of the hormone check
The first point of contact is often your general practitioner, who can perform basic diagnostics or refer you to specialists such as urologists, endocrinologists, or andrologists. A detailed discussion of symptoms, lifestyle, and medical history forms the starting point. This is followed by a blood sample, ideally taken in the morning between seven and ten o’clock, as hormone levels fluctuate throughout the day. After the lab analysis, the doctor discusses the results, interprets them, and recommends treatment if necessary.
Cost of the hormone check
The costs vary depending on the scope of the check. A simple testosterone test can be determined for as little as about 25 euros, while a comprehensive hormone status can cost between 150 euros and 350 euros. Depending on the symptoms, the health insurance may cover certain portions of the costs.
Can you check your hormone levels yourself?
“There are now numerous self-tests that generally work via saliva samples at home. However, these tests do not provide the same accuracy as a medical lab analysis. Some values, such as LH or FSH, are also more difficult to determine from your saliva. Self-tests are therefore only suitable for getting a sense of your own hormone status. If symptoms exist, a medical evaluation should always follow,” advises Dr. Pies.
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Treatment of hormonal disorders
The treatment always depends on the cause and severity of your symptoms. Often, slight hormonal changes can be improved with targeted lifestyle adjustments. If there is a medically relevant testosterone deficiency and your symptoms are significantly pronounced, testosterone replacement therapy may be considered.
What is testosterone replacement therapy?
In testosterone replacement therapy, or TRT, the treating physician administers testosterone to the patient in the form of gels, injections, patches, or depot injections. The goal is to bring your testosterone level back to a physiological range and thereby stabilize energy, mood, libido, and muscle strength.
Possible risks of testosterone replacement therapy
“With a correctly adjusted therapy, you can benefit from more vitality, an improved body feeling, and a more balanced mood. At the same time, TRT is not prescribed lightly. It is a medical measure that must always be accompanied by specialists. Blood values, cardiovascular risks, and blood count must be regularly monitored, as side effects such as acne, water retention, or changes in blood viscosity can occur,” says Dr. Pies. “Self-medication, as sometimes practiced in the fitness sector, is dangerous and can lead to serious health risks.”
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How men can support their hormonal balance
Strength and endurance training
Regular strength training can increase the body’s testosterone production. Moderate endurance training also positively affects your hormonal system without lowering testosterone levels through overtraining.
Adequate sleep
If you consistently sleep too little or suffer from sleep disturbances, you risk a faster hormone decline, as your body produces testosterone mainly at night, especially during deep sleep phases.
Nutrition
A balanced diet rich in proteins, healthy fats (omega-3, olive oil, avocado), and micronutrients like vitamin D, zinc, and magnesium supports your hormone production. Highly processed foods and sugar, on the other hand, have a negative impact.
Stress management
Chronic stress increases cortisol, which counteracts testosterone. Rely on relaxation techniques, short breaks in everyday life, meditation, or sports to stabilize hormonal balance.
Healthy body weight
Overweight, especially abdominal fat, directly negatively affects testosterone production.