What are the early warning indicators of male hormone health risks?

The core early warning indicators now recognized in the clinical and health management fields are six serological sex hormones: free testosterone and total testosterone deviate from the normal reference range for the same age group, accompanied by abnormal ratios of sex hormone binding globulin, estradiol, luteinizing hormone, and progesterone. Combined with specific physiological somatosensory changes that last for more than one month, the risk can be basically locked in.

I have been doing male endocrine health management for almost 7 years. I have met too many people who misunderstood this indicator. For example, there was a 36-year-old man who was an e-commerce operator. He slept less than 5 hours a day for half a year. He always felt that his back was sore and weak, his beard grew half as slow as before, and his married life was not exciting, so he bought one. After taking a lot of kidney-tonifying products for three months, I didn't get better. When I went to do a blood test, I found that although the total testosterone was at the lower limit of the normal value, the free testosterone was only 30% of the normal level for the same age group, and the sex hormone binding globulin was nearly double the normal value. This is a typical situation where "the index looks good but is actually lacking." There is indeed still controversy over the judgment standards in the industry. Many grassroots organizations still believe that as long as total testosterone is within the normal range, no intervention is needed. However, the guidelines updated in 2022 by the International Society of Male Endocrinology have clearly stated that free testosterone, sex hormone binding globulin and somatosensory symptoms should be combined for joint judgment. The latter is now also the judgment standard adopted by more and more men's departments in tertiary hospitals.

In fact, the male hormone system is like an orchestra that works together. Testosterone is the lead singer, but estradiol and luteinizing hormone are the accompaniment musicians. The louder the lead singer is, the better. If the accompaniment is out of tune, the whole song will still be unlistenable. Just like the 28-year-old fitness enthusiast I met a few months ago, he secretly took testicle-stimulating injections in order to increase his muscles. His total testosterone was 2.5 times higher than the normal value, but his estradiol was also so high that it almost caught up with the median level of the follicular phase of ordinary women. He already had chest swelling and pain and irritability. I thought it was a normal reaction to fitness. If he came half a year later, he might have to have breast correction surgery.

Don’t think that only blood tests are the hard indicators. If you have these symptoms for more than one month in a row, even if the blood test just recently showed no problem, it is best to recheck again every two months: for example, you had to shave once every two or three days in the past, but now it doesn’t matter if you shave once every four or five days.； My belly suddenly gained weight for no apparent reason, especially the fat in my waist and abdomen that I can’t reduce. ； Although I have nothing to worry about, I always feel unmotivated and have no interest in the things I liked before, including sex. ； Some people experience inexplicable hot flashes, night sweats, and poor sleep. These are actually warning signals from the body, so don’t take them seriously. Of course, there is no need to be overly anxious. Nowadays, many people blindly take testicle-stimulating products as soon as they see low testosterone, which can easily mess up the entire endocrine system. If you really have any doubts, just go to a regular endocrinologist or andrologist for a checkup first, and don’t mess around on your own.