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Low testosterone in endurance athletes

A new study appearing in the European Journal of Applied Physiology explored low testosterone in endurance athletes, a condition often referred to as exercise-hypogonadal male condition (EHMC, or low testosterone associated with high levels of aerobic exercise) to determine whether these individuals also experience symptoms associated with hypogonadism. Prior to this study, there has been little research conducted in this area of men’s health although there have been reports of high profile athletes retiring from their sport because of clinically low testosterone induced by long term endurance exercise.

Some men with low testosterone levels (typically defined as less than 200 ng/dL) experience symptoms commonly associated with this condition, including low or lack of libido, erectile dysfunction, accumulation of belly fat, loss of muscle tone and strength, mood swings, fatigue, low semen level, hair loss, and weight gain. Such symptoms usually affect older men, as a man’s testosterone levels begin to decline slowly (at a rate of about 1 percent per year) starting around age 30.

Declining testosterone levels may begin sooner or be more pronounced, however, in endurance athletes, as it’s been shown that high amounts of aerobic exercise such as running and biking are associated with low T levels. But do these men experience symptoms of low T as do some of their older peers?

Seventeen men took part in the current study: 9 long-distance runners who had low testosterone levels and 8 nonactive controls. The study investigators measured levels of testosterone, luteinizing hormone, follicle-stimulating hormone, and cortisol, as well as considering Aging Male Symptoms questionnaire scores, bone mineral density, and responses to a food frequency questionnaire.

The findings were as follows:

  • Men in the EHMC group showed a significant reduction in testosterone levels when compared with controls
  • Men in the EHMC group had significantly higher scores on the Aging Male Symptoms questionnaire than did controls. The AMS involves 17 questions about men’s level of energy, sexual desire, need for sleep, morning erections, beard growth, anxiety level, depression, joint pain, muscle aches, and other factors. The higher the score, the more likely one is to experience symptoms of low T
  • Although bone mineral density was similar between the two groups, 3 men in the EHMC group showed signs of osteopenia (a condition in which there is a reduction in bone mass not as serious as seen in osteoporosis)
  • Calorie consumption was significantly reduced in the EHMC group when compared with controls

The authors concluded that low testosterone in endurance athletes is associated with symptoms of low T as well. They also noted that “It is possible that inadequate energy intake is contributing to this condition.”

Read more about causes of low testosterone in our Low T Health Center.


Hooper DR et al. The presence of symptoms of testosterone deficiency in the exercise-hypogonaedal male condition and the role of nutrition. European Journal of Applied Physiology 2017 May 3

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