Hormone Guide · Spoke 19

Sport and Testosterone: What Strength Training Really Does

Strength training raises testosterone briefly. That spike feels like a reward, but it says little about what counts. The real lever is slower and less spectacular. It is called body reshaping. And at the extreme end, too much training can even lower testosterone.

Shukri Jarmoukli · Physician, Integrative Medicine · ViveCura Berlin
My starting point

In the gym I often hear the same sentence: "I train for my testosterone." The idea behind it makes sense. You grind it out at the bar, then your level rises, so masculinity is built. Sadly it is not that simple. The brief hormone spike after training is real, but short-lived and overrated. What supports your hormone balance long term is not the surge after the session. It is the slow reshaping of your body over months. This article separates the myth from what the data actually show.

Perhaps you know the feeling after a hard strength session. You feel strong, alert, a little unbeatable. And you have read somewhere that right now your testosterone is shooting up. That is even true. After intense exercises with a lot of muscle mass, testosterone rises measurably. The interesting question is only: does this brief rise actually do anything? And what happens when you overdo the training?

In this spoke we look closely. We separate the acute effects directly after training from the chronic adaptations over weeks and months. We clarify what strength training and high-intensity interval training really do, why the hormone spike matters less for muscle building than long believed, and from what point too much endurance can lower testosterone. The result is a sober, usable picture rather than a promise.

Acute versus chronic: two completely different stories

When it comes to sport and testosterone, two things are constantly confused. One is the short-term response directly after training. The other is the long-term adaptation of your body. Both have to do with testosterone, but they tell completely different stories. Whoever mixes them up quickly draws the wrong conclusions.

Acute means: in the minutes after the session. Here testosterone often rises, especially after intense strength training with large muscle groups. But this wave ebbs away quickly. Chronic means: over weeks, months, years. Here it is not so much the resting value of testosterone itself that changes, but the body around it, that is, muscle, fat, and insulin sensitivity.

Study · Meta-analysis, men

Sport raises testosterone acutely, especially at higher intensity

Meta-analysis, 48 studies, 569 men Settimio D'Andrea, Daniele Santi and colleagues analyzed 48 studies with 126 trials in 2020 in the Journal of Endocrinological Investigation. Physical exertion acutely raised both total testosterone and free testosterone. Intensity was decisive: after moderate and high load testosterone rose, after light load it did not. Important for context: the rise was measurable directly after training and within the first half hour, not afterward. The authors aptly describe this brief, transient rise as endogenous, that is, the body's own, transient doping.

D'Andrea S, Spaggiari G, Barbonetti A, Santi D. J Endocrinol Invest. 2020;43(10):1349-1371. doi:10.1007/s40618-020-01251-3 · PMID: 32297287

So this brief wave is well supported. But now comes the real question. If testosterone is elevated for only half an hour after training and then falls back, what does that even do? This is exactly where research has taken a surprising turn in recent years.

Reframe

The brief testosterone spike after training is no proof that the training permanently turns up your hormone system. It is more a stress response of the body to the load, comparable to the brief rise in cortisol or growth hormone. Spectacular, but fleeting. The real value of sport for your hormones lies elsewhere, namely in what happens to your body over months.

The myth of the hormone spike: why muscle grows differently

For a long time a simple logic held. Strength training triggers a testosterone spike, testosterone builds muscle, so the spike builds muscle. This idea sounds plausible and still sits in many training guides. Only it does not hold up to closer scrutiny. Several controlled studies tested the link directly and came to a different result.

Study · Trained young men

The acute hormone spikes did not predict muscle gain

Training study, n=49 Robert Morton and Stuart Phillips followed 49 strength-trained young men over twelve weeks of whole-body training in 2016 in the Journal of Applied Physiology. They measured not only strength and muscle gain, but also the acute rises in testosterone and other anabolic hormones after training. The result was clear: there was no relationship between the size of the acute hormone spike and the later gain in muscle mass or strength. In men who already train, the brief systemic hormone wave does not predict training success.

Morton RW, Oikawa SY, Wavell CG, et al. J Appl Physiol (1985). 2016;121(1):129-138. doi:10.1152/japplphysiol.00154.2016 · PMID: 27174923

But if not the hormone spike, what then drives muscle growth? Here a look into the muscle itself is worthwhile. One study checked whether the hormone spikes measured in the blood even arrive in the muscle tissue.

Study · Trained men, crossover

High hormone levels in the blood do not mean high hormone levels in the muscle

Crossover, n=6 Felipe Vechin, Jakob Vingren and colleagues had trained men perform the same arm exercise once with and once without an additional, hormone-raising leg exercise in 2023 in Frontiers in Endocrinology. In the blood, cortisol rose under the more intense condition. In the muscle itself, however, the steroid concentrations did not change measurably. This suggests that the systemic hormone wave after training does not simply flow into the muscle. The local stimulus in the muscle, that is, mechanical tension and fiber loading, appears to be more important for growth.

Vechin FC, Vingren JL, Telles GD, et al. Front Endocrinol (Lausanne). 2023;14:1081056. doi:10.3389/fendo.2023.1081056 · PMID: 37077354

Common misconception

"I have to schedule my training so the testosterone spike is maximal." You can let this worry go. The data suggest that the muscle responds above all to the local mechanical stimulus, not to the brief hormone wave in the blood. Good training comes from sufficient load, sensible progression, and enough recovery. You do not have to optimize it for hormone surges. That takes a lot of pressure out of training planning.

How sport acts at the cell level: the four PNI lenses

In clinical psychoneuroimmunology, or PNI for short, we look not just at a single hormone value, but at four interwoven levels. On the topic of sport and testosterone, each lens explains a part of why movement takes effect, and often in a different way than one might think. Together they form a clearer picture.

Nervous system and signal transmission

The acute testosterone spike after training is a stress response. Through the nervous system and the higher control center in the brain, more signal is briefly sent to the testes. At the cell level, however, the muscle responds above all to the mechanical stimulus itself. The tension of the fiber sets off local signaling pathways that initiate building, largely independent of the brief hormone wave in the blood. That explains why the spike stays fleeting, while the stimulus in the muscle takes lasting effect.

Immune system and repair

Training creates small, controlled damage in the muscle that calls the immune system into action. Inflammatory cells clear up and initiate repair. At the cell level this short-term inflammatory stimulus is desirable, because it is part of building. It only becomes a problem when recovery is missing and the stimulus does not subside. Then the healing stress can turn into a silent chronic inflammation that burdens the hormone system instead of supporting it.

Metabolism and insulin

Here lies the strongest long-term effect of sport. Strength training and interval training improve insulin sensitivity and build muscle that takes up sugar. At the cell level the muscle cells respond better to insulin again, and less belly fat means less conversion of testosterone into estrogen through the enzyme aromatase. Through this reshaping, not through the acute spike, sport most likely supports the male hormone system.

Hormone system and recovery

The sex hormone system and the stress system share the control center in the brain. With enough recovery, the balance of testosterone and cortisol stays stable. With sustained load and no rest, cortisol can stay high and push testosterone down. At the cell level the body then prioritizes survival over building. That is why recovery is not the opposite of training but part of the stimulus. Without it, the hormone ratio tips over.

These four lenses show why the simple formula "more training equals more testosterone" falls short. The benefit comes through metabolism, muscle, and a stable hormone ratio. And exactly these mechanisms tip over when the load gets too high and recovery too short.

The other side: when sport can lower testosterone

So far sport sounded like a pure gain for hormones. Over wide stretches that is true. But there is a flip side that is rarely mentioned. At the extreme end of the training spectrum, sport can lower testosterone rather than raise it. This does not affect the normal recreational athlete, but men with very high endurance volume over a long time.

Study · Review, endurance athletes

The exercise-hypogonadal male condition

Review Anthony Hackney of the University of North Carolina described a state in 2005 in Current Trends in Endocrinology that he calls the exercise-hypogonadal male condition. Men who train very high endurance volumes over years can show persistently lower resting values of free and total testosterone, without the regulatory hormones rising in response. The proposed mechanism is an adaptation or disturbance in the higher control center in the brain. Hackney stresses that this is not a common phenomenon and mainly affects chronically heavily loaded endurance athletes, not the recreational runner.

Hackney AC, Hackney ZC. Curr Trends Endocrinol. 2005;1:101-106. PMID: 31723314

A later assessment by Amy Lane and Anthony Hackney in 2014 in the Journal of Endocrinology and Diabetes rounds out the picture. They point out that the persistently low values in some affected men can also impair sperm production, which is relevant when there is a wish to have children (doi:10.15226/2374-6890/1/2/00108, PMID: 29657961). Often a low energy availability plays a part, meaning too little food relative to high expenditure. But why does the system tip over at all? An important clue comes from research on overtraining.

Study · Long-distance runners, training camp

Overtraining halved the ratio of testosterone to cortisol

Cohort, n=13 Tohru Ishigaki and colleagues followed thirteen male long-distance runners through an eight-day, very intense training camp with on average more than 280 kilometers run, in a Japanese study in 2005. After the camp, cortisol had risen markedly and testosterone had fallen markedly. The ratio of testosterone to cortisol, a marker for the balance of building and breakdown, halved. The authors interpreted this as a sign of an overtraining state. It shows how quickly high load without enough recovery can tip the hormone ratio.

Ishigaki T, Koyama K, Tsujita J, et al. J Physiol Anthropol Appl Human Sci. 2005;24(6):573-578. doi:10.2114/jpa.24.573 · PMID: 16377941

And now you know why more is not automatically better. The hormone system does not distinguish between stress from work and stress from training. Both count on the same account. When recovery is missing, the ratio of testosterone and cortisol tips over, and the body switches into saving mode.

What the data show for the average man

After all this one might feel unsettled. The spike does little, too much endurance harms, so is sport not worth it at all? On the contrary. For the vast majority of men, movement is one of the best levers there is, just through a different route than thought. The route runs through body composition, and that is exactly what controlled studies show in men who do not train at the extreme end.

Study · Overweight men, RCT

More moderate movement raised testosterone and sexual function

RCT, n=90 Joan Khoo and colleagues compared two training volumes over 24 weeks in 90 overweight, sedentary men in 2013 in the Journal of Sexual Medicine, both combined with a slight calorie reduction. The group with the higher volume of moderate movement, that is, over 200 minutes per week, showed a markedly stronger rise in testosterone and sexual function, as well as a greater reduction in weight, waist circumference, and fat mass, than the group with less movement. The hormone gain therefore ran through fat loss and the reshaping of the body.

Khoo J, Tian HH, Tan B, et al. J Sex Med. 2013;10(7):1823-1832. doi:10.1111/jsm.12154 · PMID: 23635309

Strength training itself is also worth a closer look. A controlled study by Juha Ahtiainen and colleagues in 2015 in Experimental Gerontology examined over twelve months how strength training affects testosterone metabolism in younger and older men. The resting value of testosterone barely changed through the training, the system stayed remarkably stable. The acute response after a session was smaller in the older men than in the younger ones (doi:10.1016/j.exger.2015.06.010, PMID: 26079649). This fits the picture: the value of the barbell lies not in raising resting testosterone, but in preserving muscle and metabolism.

The question of whether the type of training makes a difference is also interesting. A randomized study by Shane Schwanbeck and colleagues in 2020 in the Journal of Strength and Conditioning Research compared free weights with machines. In the men, free testosterone rose more immediately after training with free weights than with machines. The muscle and strength gain after eight weeks, however, was similar in both groups (doi:10.1519/JSC.0000000000003349, PMID: 32358310). Again the same pattern: the acute hormone response differs, the outcome at the end barely does.

And for older men with low testosterone too, movement remains a sensible lever, especially in combination with other measures. A randomized study by Giulia Gregori, Dennis Villareal and colleagues in 2021 in the American Journal of Clinical Nutrition examined older, overweight men with hypogonadism. An intensive lifestyle program with movement improved important functions, and the combination of training and medically supervised testosterone therapy showed additional effects on mental performance (doi:10.1093/ajcn/nqab253, PMID: 34375393). A broader review by Jakob Vingren and William Kraemer in 2010 in Sports Medicine places the role of testosterone in strength training in context and describes testosterone as an important but only one of several factors for muscle growth (doi:10.2165/11536910-000000000-00000, PMID: 21058750).

Three levers for training that supports your system

From all of this no ready-made training plan can be derived, because the right volume is individual. But three directions can be noted that fit what the data show. They are a beginning, not a plan. The individual path is best found with expert guidance.

1

Rely on strength training for body reshaping

Because the long-term benefit runs through muscle and insulin sensitivity, regular strength training is a strong lever. It is not about maximizing the hormone spike, but about setting demanding yet manageable stimuli and progressing slowly. More muscle and less belly fat may ease the burden on the male hormone system over months, quite independent of what happens in the blood directly after the session.

2

Treat recovery as part of training

Since the hormone ratio of testosterone and cortisol can tip over with too much load, recovery is no luxury. Sleep, rest days, and enough energy from nutrition are part of the stimulus, not its opposite. If you feel persistently exhausted, listless, and poorly recovered, that is a signal to ease off. More training then brings not more, but less.

3

Eat enough, especially with a lot of endurance

Because too low an energy availability can lower testosterone in men, sufficient nutrition during sport is central. This is especially true if you run or cycle a lot. Whoever trains hard and eats too little risks the body switching into saving mode. Eating enough is not a contradiction to fitness here, but the prerequisite for your hormone system to play along.

And if the symptoms remain despite good training and enough recovery, a workup that looks at the whole picture belongs to it. Fatigue, lack of drive, or loss of libido despite sport can have many causes, from overtraining to iron deficiency, thyroid issues, or a genuine hormone deficiency. A single value is rarely enough. A good assessment takes your symptoms seriously and looks for what really lies behind them.

The core

It is not the spike that counts, but the reshaping

Sport does not support your testosterone through the brief hormone wave after training. It takes effect through what happens slowly: more muscle, less belly fat, a calmer metabolism. Give your body demanding stimuli and enough recovery, and the whole system works for you. You do not have to maximize anything. You may train to be strong and alive, not to chase a number.

Frequently asked questions about sport and testosterone

Does strength training raise testosterone permanently?

Strength training raises testosterone shortly after a workout, especially after exercises involving large muscle groups and heavy loads. This acute spike lasts only minutes up to about half an hour, after which the level returns to baseline. A meta-analysis clearly confirmed this short rise. A lasting increase in the resting value through training, by contrast, is not well supported. What can change is body composition: more muscle, less belly fat. Through this indirect route, regular training may ease the burden on the hormone system, less through the brief spikes themselves. So if you are hoping for long-term effects, you should focus on consistency and body reshaping, not on single hormone surges after a workout.

Do the acute testosterone spikes after training build muscle?

For a long time the brief testosterone spike after strength training was seen as a key driver of muscle growth. More recent research paints a different picture. In a controlled study of trained young men, the acute rises in testosterone and other anabolic hormones showed no relationship with later gains in muscle or strength. Another study found that the hormone spikes measured in the blood did not translate into higher hormone concentrations in the muscle. This suggests that the local stimulus in the muscle itself, that is, the mechanical tension and the loading of the muscle fibers, may be more important for growth than the brief systemic hormone wave. The good news: you do not have to optimize your training for hormone spikes.

What is the difference between acute and chronic effects of sport on testosterone?

Acute effects are the short-term changes directly after a workout. Here testosterone often rises, especially after intense strength or interval training, and falls again within half an hour. Chronic effects are the long-term adaptations over weeks and months. They show up less in the resting value of testosterone itself and more in a changed body composition, better insulin sensitivity, and more muscle mass. This distinction is central: the brief spike is spectacular but of little significance. The slow reshaping of the body is unspectacular, but it is the route through which sport may support the male hormone system in a lasting way.

Can too much endurance sport lower testosterone?

Yes, this can happen, but it mainly affects men who train very high endurance volumes over a long period. In research it is described as the exercise-hypogonadal male condition. Men with years of high endurance volume may show persistently lower resting values of free and total testosterone, without the regulatory hormones rising to compensate. The proposed mechanism is an adaptation or disturbance in the higher control center in the brain, often together with too little energy intake relative to expenditure. The key point of context: this does not affect the recreational runner who jogs three times a week. It is a phenomenon at the extreme end of the training spectrum.

What does overtraining mean for hormones?

Overtraining describes a state in which load and recovery are persistently out of balance. At the hormonal level this often shows up as rising cortisol and falling testosterone, so that the ratio of testosterone to cortisol tips over. In a study of long-distance runners, this ratio halved after an eight-day, very intense training camp. The body then prioritizes short-term survival over building and reproduction. Overtraining is therefore not a sign of weakness but a signal that recovery is falling short. More is not automatically better in training. Rest, sleep, and enough energy are part of the stimulus, not the opposite of it.

How much sport is good for testosterone?

No exact dose can be derived from the data, but a direction can. Regular strength training with demanding but manageable stimuli, along with moderate endurance, appears to support the male hormone system, mainly through the reshaping of body composition. In a study of overweight men, a higher volume of moderate exercise over six months brought both more testosterone and better sexual function than a lower volume. At the same time, the opposite holds at the extreme end: very high endurance volume without enough recovery and energy can lower testosterone. So a middle path of stimulus and recovery makes sense, not maximizing at any cost. The volume that fits you best is something you can find with medical or expert guidance.

Is strength training or endurance better for testosterone?

Both have their place, and it depends on the dose. Strength training builds muscle and improves insulin sensitivity, both of which are closely tied to testosterone. It also reliably triggers acute hormone spikes. Moderate endurance is good for heart, circulation, and metabolism and can help reduce belly fat, which converts testosterone into estrogen through the enzyme aromatase. Only very high endurance volume over years can lower resting testosterone in men. For most men a combination makes sense: strength training as a foundation for muscle and metabolism, plus moderate endurance. It is not about either or, but about a balanced ratio with enough recovery.

Does HIIT raise testosterone more than normal training?

High-intensity interval training, or HIIT, triggers acute hormone responses just like intense strength training. A meta-analysis showed that the intensity of the load above all determines how strongly testosterone rises shortly after a workout. Moderate and high intensity led to a clear rise, light load did not. But this does not mean that HIIT raises the resting value in a lasting way. As with strength training: the acute spike is real but short, and its direct value for long-term building is questionable. HIIT can be an efficient route to improve metabolism and body composition. It is exactly through that route, not through the hormone spike, that its real value for testosterone is likely to run.

Can older men also support their testosterone with training?

Older men often show a smaller acute testosterone response after a workout than younger men, and testicular function declines somewhat with age. Even so, training can be valuable in older age, mainly through preserving muscle mass, strength, and insulin sensitivity. In a study of older, overweight men with low testosterone, an intensive lifestyle program with exercise improved important functions, and the combination of training and medically supervised testosterone therapy showed additional effects. For most older men, strength training is a safe and sensible lever to support the body. With marked symptoms, a medical assessment should come first.

When should I see a doctor about low testosterone despite sport?

If you train regularly and are still persistently tired and lacking drive, if your libido fades, or if you notice erectile problems, this should be medically assessed. This is especially true if you train a lot of endurance while eating little, as this may point to low energy availability. An unfulfilled wish to have children despite athletic fitness should also be examined, since very high training volume can affect sperm production. Many causes can lie behind such symptoms, from overtraining to iron deficiency, thyroid issues, or a genuine hormone deficiency. A single value is rarely enough. A good assessment looks at the whole picture. If you have low moods that do not pass, please seek help.

Connections to other topics

When the value stays lowUnderstanding testosterone deficiency

The deeper context of when a low value despite sport is really a deficiency and which causes can lie behind it.

When stress plays a partCortisol and the HPA axis in burnout

Why the ratio of cortisol and testosterone tips over in overtraining and how the stress axis is interwoven with your hormone system.

When energy is missingIron deficiency and iron infusions

Iron deficiency is common in athletes and can explain an exhaustion that looks like a pure hormone problem.

When the thyroid joins inFunctional thyroid underactivity

Why a borderline thyroid can influence drive, resilience, and recovery, even with good fitness.

When the other side is meantHormonal imbalance in women

How load and energy availability also reach into the hormone system in women, with many parallels to men.

When the gut is involvedGut reset: holistic gut treatment

How the gut and silent inflammation co-determine how well your body recovers from load and keeps the hormone system in balance.

SJ
Written by

Shukri Jarmoukli

Physician, Integrative Medicine, Clinical Psychoneuroimmunology · ViveCura Berlin, Skalitzer Straße 137 · Focus: male hormones as a networked system. On the topic of sport and testosterone, I consistently separate the short-term hormone spike after training from the long-term adaptations through muscle, fat, and insulin. This spoke draws on the meta-analysis of the acute testosterone rise (D'Andrea and Santi 2020, Journal of Endocrinological Investigation), on the research showing that acute hormone spikes do not predict muscle building (Morton and Phillips 2016, Journal of Applied Physiology), on the data on the exercise-hypogonadal male condition (Hackney 2005) and on overtraining (Ishigaki 2005), as well as on controlled studies on movement and testosterone in overweight and older men (Khoo 2013, Journal of Sexual Medicine; Gregori and Villareal 2021, American Journal of Clinical Nutrition). My aim is a men's consultation that places sport realistically, not as a miracle cure and not as a risk, but as one lever among several.

Sources and further reading

  1. D'Andrea S, Spaggiari G, Barbonetti A, Santi D. Endogenous transient doping: physical exercise acutely increases testosterone levels-results from a meta-analysis. J Endocrinol Invest. 2020;43(10):1349-1371. doi:10.1007/s40618-020-01251-3 · PMID: 32297287 [Meta-analysis]
  2. Morton RW, Oikawa SY, Wavell CG, et al. Neither load nor systemic hormones determine resistance training-mediated hypertrophy or strength gains in resistance-trained young men. J Appl Physiol (1985). 2016;121(1):129-138. doi:10.1152/japplphysiol.00154.2016 · PMID: 27174923 [RCT]
  3. Vechin FC, Vingren JL, Telles GD, et al. Acute changes in serum and skeletal muscle steroids in resistance-trained men. Front Endocrinol (Lausanne). 2023;14:1081056. doi:10.3389/fendo.2023.1081056 · PMID: 37077354 [RCT, Crossover]
  4. Hackney AC, Hackney ZC. The exercise-hypogonadal male condition and endurance exercise training. Curr Trends Endocrinol. 2005;1:101-106. PMID: 31723314 [Review]
  5. Lane AR, Hackney AC. Reproductive Dysfunction from the Stress of Exercise Training is not Gender Specific: The "Exercise-Hypogonadal Male Condition". J Endocrinol Diabetes. 2014;1(2). doi:10.15226/2374-6890/1/2/00108 · PMID: 29657961 [Review]
  6. Ishigaki T, Koyama K, Tsujita J, Tanaka N, Hori S, Oku Y. Plasma leptin levels of elite endurance runners after heavy endurance training. J Physiol Anthropol Appl Human Sci. 2005;24(6):573-578. doi:10.2114/jpa.24.573 · PMID: 16377941 [Cohort]
  7. Khoo J, Tian HH, Tan B, et al. Comparing effects of low- and high-volume moderate-intensity exercise on sexual function and testosterone in obese men. J Sex Med. 2013;10(7):1823-1832. doi:10.1111/jsm.12154 · PMID: 23635309 [RCT]
  8. Ahtiainen JP, Nyman K, Huhtaniemi I, et al. Effects of resistance training on testosterone metabolism in younger and older men. Exp Gerontol. 2015;69:148-158. doi:10.1016/j.exger.2015.06.010 · PMID: 26079649 [RCT]
  9. Schwanbeck SR, Cornish SM, Barss T, Chilibeck PD. Effects of Training With Free Weights Versus Machines on Muscle Mass, Strength, Free Testosterone, and Free Cortisol Levels. J Strength Cond Res. 2020;34(7):1851-1859. doi:10.1519/JSC.0000000000003349 · PMID: 32358310 [RCT]
  10. Gregori G, Celli A, Barnouin Y, et al. Cognitive response to testosterone replacement added to intensive lifestyle intervention in older men with obesity and hypogonadism: prespecified secondary analyses of a randomized clinical trial. Am J Clin Nutr. 2021;114(5):1590-1599. doi:10.1093/ajcn/nqab253 · PMID: 34375393 [RCT]
  11. Vingren JL, Kraemer WJ, Ratamess NA, et al. Testosterone physiology in resistance exercise and training: the up-stream regulatory elements. Sports Med. 2010;40(12):1037-1053. doi:10.2165/11536910-000000000-00000 · PMID: 21058750 [Review]
Note on the evidence: This spoke combines well-supported findings with areas where research is still in flux. Solidly supported is the acute, short-term rise in testosterone after moderate to intense load (D'Andrea and Santi 2020) and the finding that these acute hormone spikes do not predict muscle building in trained men (Morton and Phillips 2016, Vechin 2023). The exercise-hypogonadal male condition and overtraining are supported by review and observational data (Hackney 2005, Lane 2014, Ishigaki 2005), but not proven in every mechanism by large controlled studies. The benefit of movement for testosterone and sexual function through body reshaping is supported by controlled studies (Khoo 2013, Gregori 2021). This text serves information and does not replace medical examination, diagnosis, or treatment. Testosterone replacement therapy is prescription-only and belongs in medical hands. With persistent exhaustion despite training, with loss of libido, with newly appearing erectile problems, or with an unfulfilled wish to have children, a medical assessment should take place. If you have low moods that do not pass, or thoughts of no longer wanting to live, please seek medical or psychotherapeutic help immediately (in Germany the free helpline Telefonseelsorge is available at 0800 111 0 111 or 0800 111 0 222).

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