Urologist Ekaterina Makarova has warned men that low testosterone can trigger hidden health issues ranging from metabolic disorders and heart disease to chronic fatigue.
Writing on her Telegram channel, the Russian sexologist, urologist and andrologist explained that testosterone influences virtually every system in the male body. She cautioned that reduced levels of the hormone disrupt fat and carbohydrate metabolism while decreasing tissue sensitivity to insulin, which can provoke diabetes and cardiovascular illness.
Testosterone is the primary androgen in men, produced primarily by the testicles and regulated by signals from the brain. In addition to regulating male sexual characteristics and muscle mass, the hormone plays a fundamental role in metabolic regulation. When cells become resistant to insulin, the body struggles to process circulating glucose, creating metabolic strain that significantly elevates the risk of heart attacks and strokes.
Bone Density and Mental Health
Makarova added that testosterone helps maintain bone mineral density and prevent the development of osteoporosis. Beyond skeletal strength, she noted that the hormone is deeply connected to mood, energy levels and cognitive performance.
According to Makarova, men with a deficiency may suffer from persistent fatigue, lower motivation, trouble concentrating and a depressed mood. Osteoporosis causes bones to lose density and become brittle, making minor falls far more dangerous, while prolonged hormonal dips are widely recognized by clinicians as contributors to clinical depression and mental fogginess.
Urinary Symptoms and Clinical Tests
The urologist emphasised that testosterone deficiency also impairs urinary quality. She reported that an endocrine shortfall can cause nighttime trips to the bathroom, weaken the urine stream and produce dribbling after urination.
Waking frequently at night to urinate, known medically as nocturia, along with dribbling after urination, are common lower urinary tract complaints that frequently stem from prostate enlargement or pelvic muscular changes. Makarova pointed out that men cannot blame these symptoms exclusively on low testosterone.
She stressed that anyone who suspects they have a testosterone deficiency must undergo a formal medical examination rather than prescribing hormones for themselves. Clinical guidelines caution against unsupervised hormone therapy, which can permanently shut down the body's natural hormone production, disrupt blood counts and increase cardiovascular strain.
Male Infertility and Varicocele
The warning follows earlier statements by Makarova highlighting a global rise in reproductive health challenges. She noted that the number of people unable to conceive a child is increasing both in Russia and across the world.
According to the urologist, male infertility is linked to varicocele in more than 40 percent of cases. A varicocele is an abnormal enlargement of the veins within the scrotum, similar to varicose veins in the legs. The condition can elevate scrotal temperatures, compromise blood flow and impair sperm production, making it one of the most common treatable causes of male fertility problems.
