Treating exercise-associated low testosterone and its related symptoms

ABSTRACT

The Exercise-Hypogonadal Male Condition (EHMC) has been described to occur in athletes who experience low serum testosterone and associated symptoms. While high volumes of endurance exercise can lead to reduced testosterone concentrations in men, similar changes may occur in other sports including anerobic and power sports such as American football, and weight class sports such as wrestling. A reduced testosterone concentration alone does not necessarily warrant treatment, but when it is accompanied by symptoms of hypogonadism, such as fatigue, sexual dysfunction, and/or low bone mineral density (BMD), an athlete’s performance and/or health may suffer. While pharmacological treatments such as testosterone or clomiphene citrate have been shown to be effective in treating hypogonadism, these options are not available to athletes competing in sports governed by the World Anti-Doping Agency. We recommend treatment of EHMC in athletes should include nutritional intervention and modification of training. Recognizing EHMC’s existence in male athletes is important to optimize their health.

KEYWORDS:

• Exercise-hypogonadal male condition
• relative energy deficiency in sports
• hypogonadism
• overtraining

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties. Peer reviewers on this manuscript have no relevant financial relationships to disclose.

Additional information

Funding

This manuscript was not funded.