Sex Hormone Function

Hormone health is often viewed through the lens of reproductive function, but male sex hormones—particularly Testosterone Total – Male—play a vital role far beyond libido and fertility. Free Testosterone – Male influences everything from energy and muscle mass to cardiovascular function, cognitive resilience, and bone health.

At Intercoastal Health, we approach male hormone evaluation through a functional medicine lens, focusing on biomarker analysis, root-cause identification, and individualized treatment strategies. Rather than simply replacing hormones, we aim to understand why they are out of balance and how to support the body’s natural regulatory systems.

Understanding Testosterone and Male Sex Hormone Function

Testosterone is the primary androgenic hormone in males. It is synthesized mainly in the testes under the direction of the pituitary gland, with a smaller contribution from the adrenal glands producing DHEA-S – Male.
Testosterone’s effects extend throughout nearly every system in the body:

• Musculoskeletal system: Promotes muscle mass, strength, and bone density
  
• Metabolism and insulin resistance
  
• Cardiovascular Function: Supports red blood cell production and vascular integrity
  
• Neurological health: Impacts mood, focus, and cognitive resilience
  
• Reproductive system: Regulates libido, erectile function, and sperm production
  
  

Testosterone interacts with Estradiol – Male, Sex Hormone-Binding Globulin – Male, and progesterone, each playing a critical role in maintaining hormonal balance.

Symptoms of Male Sex Hormone Imbalance

Disruption in testosterone or other male sex hormone levels can present with a wide spectrum of symptoms often mistaken for normal aging or other conditions. Common clinical symptoms include:

• Low libido or sexual dysfunction
  
• Erectile difficulties
  
• Fatigue or loss of stamina
  
• Decreased muscle mass
  
• Increased body fat, particularly abdominal (Metabolic Syndrome)
  
• Mood changes: irritability, anxiety, or depression
  
• Sleep disturbances or insomnia
  
• Difficulty concentrating or memory issues
  
• Decreased bone density or unexplained fractures
  
• Reduced motivation or sense of well-being
  
  

These symptoms often develop gradually and are overlooked until quality of life is significantly affected.

Functional Medicine Evaluation: More Than Just a Testosterone Test

At Intercoastal Health, we use a comprehensive biomarker panel to evaluate male sex hormone function. Testosterone levels fluctuate throughout the day and are influenced by lifestyle, stress, and comorbid conditions—so one isolated lab value is rarely enough.
Core biomarkers we assess include:

Additional tests may include pituitary hormones (LH, FSH), cortisol – Total/AM, thyroid function, and inflammatory markers to rule out broader immune function or endocrine dysregulation.

Functional Reference Ranges Matter

Conventional lab ranges capture 95% of the population, but functional medicine focuses on “optimal.” For example:

• Total testosterone of 300 ng/dL may be “normal,” but most men feel best with 600–800 ng/dL
  
• Free testosterone in the lower third of the range often correlates with significant symptoms
  
• Elevated SHBG may mask low free testosterone despite normal total testosterone
  
  

Evaluating the full hormonal picture—rather than isolated numbers—is essential for accurate diagnosis and treatment.

Causes of Male Sex Hormone Imbalance

Hormonal dysfunction often arises from multiple intersecting factors:

1. Hypogonadism
   
   • Primary: Testicular damage (infection, trauma, chemotherapy)
     
   • Secondary: Pituitary dysfunction, medication, stress, systemic illness
     
2. Aging
   Testosterone declines ~1% per year after age 30; some men develop andropause-like symptoms.
   
3. Chronic Illness
   Obesity and Metabolic Syndrome increase aromatase activity, converting testosterone to estradiol
   
4. Medications
   Opioids, glucocorticoids, antidepressants, statins, and PPIs can suppress testosterone
   
5. Lifestyle Factors
   Poor diet, sleep deprivation, excessive alcohol, endocrine disruptors (BPA, phthalates), chronic stress
   
   

Health Conditions Linked to Low Testosterone

Low testosterone is associated with serious chronic diseases:

• Cardiovascular Function: Increased risk of atherosclerosis and myocardial infarction
  
• Type 2 diabetes and Insulin Resistance
  
• Osteoporosis: Testosterone supports bone mineral density
  
• Metabolic Syndrome: Both cause and consequence of metabolic dysfunction
  
• Depression and cognitive decline: Androgens support neurotransmitter balance
  
  

Functional Medicine Strategies to Support Hormone Balance

Rather than defaulting to hormone replacement, we seek to restore physiologic function:

1. Optimize Sleep and Stress
   
   • Aim for 7–9 hours nightly; screen for sleep apnea
     
   • Incorporate mindfulness, adaptogens, and breathing exercises
     
2. Nutrition and Supplementation
   
   • Ensure zinc, vitamin D, omega-3 fats, and B vitamins
     
   • Limit refined sugars, alcohol, and inflammatory foods
     
   • Support estrogen metabolism with cruciferous vegetables
     
3. Exercise
   
   • Resistance training increases testosterone and receptor sensitivity
     
   • Maintain consistent, moderate exercise
     
4. Address Underlying Conditions
   
   • Treat insulin resistance, thyroid dysfunction, liver or kidney disease
     
   • Review and adjust medications known to suppress testosterone
     
5. Bioidentical Hormone Replacement Therapy (If Needed)
   
   • Topical or injectable testosterone, DHEA supplementation
     
   • Consider HCG or aromatase inhibitors to support fertility and minimize estrogen excess
     
   • Monitor hematocrit (CBC) and PSA regularly
     
     

Monitoring and Long-Term Health

Once a treatment strategy is in place, ongoing tracking of labs and symptoms is vital:

• Total and free testosterone, estradiol, SHBG
  
• CBC and PSA for safety in testosterone therapy
  
• DHEA, LH/FSH to assess axis recovery

Further Reading

• Wu FCW, Tajar A, Beynon JM, et al. “Identification of late-onset hypogonadism in middle-aged and elderly men.” N Engl J Med. 2010;363(2):123–135.
  
• Kapoor D, Clarke S, Stanworth R, et al. “Clinical and biochemical assessment of hypogonadism in men with type 2 diabetes.” J Clin Endocrinol Metab. 2007;92(2):416–423.
  
• Saad F, Aversa A, Isidori AM, et al. “Testosterone as potential treatment for obesity in men with testosterone deficiency.” Obes Rev. 2012;13(3):136–149.
  
• Moran LJ, Pasquali R, Teede H, et al. “Treatment of overweight and obesity in women with polycystic ovary syndrome.” Fertil Steril. 2009;92(6):1703–1707.
  
  

In conclusion, a comprehensive evaluation by a functional medicine practitioner in Florida facilitates identification of cellular-level and molecular imbalances underlying male sex hormone dysfunction. By integrating evidence-based therapies with Peptide Therapy and Longevity Medicine services—where hormone regulation and tissue regeneration are paramount—we offer patients a regenerative, preventive framework to restore hormonal balance and vitality. Call (904) 799-2531 or schedule online.