The presence of symptoms of testosterone deficiency in the exercise-hypogonadal male condition and the role of nutrition
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High volumes of aerobic exercise have been associated with reduced testosterone (T), known as the exercise-hypogonadal male condition (EHMC). Although the presence of low T has been identified, few studies have assessed the presence of androgen-deficient symptoms. The purpose of this investigation is to assess men exhibiting EHMC and evaluate their hypothalamic–pituitary–gonadal axis, the presence of hypogonadal symptoms, and also investigate a possible contribution of inadequate nutrition to the condition.
A cross-sectional design compared 9 long-distance runners exhibiting EHMC to 8 non-active controls. Comparisons included serum T, luteinizing hormone (LH), follicle-stimulating hormone, and cortisol, the Aging Male Symptoms (AMS) questionnaire score, bone mineral density (BMD), and a food frequency questionnaire.
Mean T was significantly reduced in the EHMC group (EHMC 9.2 nmol L−1 vs. CONT 16.2 nmol L−1). The EHMC group demonstrated significantly higher AMS scores (EHMC 27.1 ± 7.3 vs. CONT 19.7 ± 2.5). There were no differences in bone density, although 3 cases of osteopenia were noted for EHMC in the lumbar spine, 1 in the right femur, and 1 in the radius. Energy availability was significantly reduced in EHMC (EHMC 27.2 ± 12.7 vs. CONT 45.4 ± 18.2 kcal d FFM−1).
Men exhibiting EHMC do appear to present with symptoms associated with androgen deficiency. For the most part, these symptoms are limited to those reported on the AMS questionnaire, although there are also some cases of clinically low BMD. It is possible that inadequate energy intake is contributing to this condition.
KeywordsLow testosterone Exercise-hypogonadal male condition Hypogonadism Energy balance
World Anti-Doping Agency
Relative energy deficiency in sport
Exercise-hypogonadal male condition
Urine specific gravity
Dual-energy X-ray absorptiometry
Food frequency questionnaire
Aging male symptom questionnaire
Enzyme-linked immunosorbent assay
We thank the study participants for their time and efforts.
Compliance with ethical standards
Conflict of interest
The authors have nothing disclose.
- Alemany JA, Nindl BC, Kellogg MD, Tharion WJ, Young AJ, Montain SJ (2008) Effects of dietary protein content on IGF-I, testosterone, and body composition during 8 days of severe energy deficit and arduous physical activity. J Appl Physiol (1985) 105:58–64. doi: 10.1152/japplphysiol.00005.2008 CrossRefGoogle Scholar
- Bhasin S, Cunningham GR, Hayes FJ, Matsumoto AM, Snyder PJ, Swerdloff RS, Montori VM (2006) Testosterone therapy in adult men with androgen deficiency syndromes: an endocrine society clinical practice guideline. J Clin Endocrinol Metab 91:1995–2010. doi: 10.1210/jc.2005-2847 CrossRefPubMedGoogle Scholar
- Cohen J (1988) Statistical power analysis for the behavioral sciences, 2nd edn. L. Erlbaum Associates, HillsdaleGoogle Scholar
- Hackney AC (2008) Effects of endurance exercise on the reproductive system of men: the “exercise-hypogonadal male condition”. J Endocrinol Invest 31:932–938 (5022 [pii]) Google Scholar
- Hooper DR et al (2014) Evidence of exercise-induced hypogonadism at the 2011 Ironman World Championships. J Strength Cond Res 28:51Google Scholar
- Loucks AB, Verdun M, Heath EM (1998) Low energy availability, not stress of exercise, alters LH pulsatility in exercising women. J Appl Physiol (1985) 84:37–46Google Scholar
- MacDougall JD et al (1992) Relationship among running mileage, bone density, and serum testosterone in male runners. J Appl Physiol (1985) 73:1165–1170Google Scholar
- von Eckardstein A, Kliesch S, Nieschlag E, Chirazi A, Assmann G, Behre HM (1997) Suppression of endogenous testosterone in young men increases serum levels of high density lipoprotein subclass lipoprotein A-I and lipoprotein(a). J Clin Endocrinol Metab 82:3367–3372. doi: 10.1210/jcem.82.10.4267 Google Scholar