Exercise and male hypogonadism: Testosterone, the hypothalamic-pituitary-testicular axis, and exercise training

Abstract

The large improvement in sporting performances in recent decades is partly due to the volume of training that athletes are undertaking. In response to exercise training, testosterone will acutely increase, decrease or have no change in concentration, depending on many factors including exercise modality, intensity, and duration. Exercise training places a tremendous amount of stress on the body, and if excessive or not managed appropriately, it can compromise an athlete’s health and performance. As a result, the endocrine system can become disrupted, Male athletes with chronic training overload may develop the exercise-hypogonadal male condition with a corresponding reduction in resting testosterone levels, possibly due to both central and peripheral regulatory compromises. In addition to low testosterone, these males also exhibit a lack of corresponding luteinizing hormone secretion. Moreover and regrettably, athletes at all levels of competition have been recorded as using exogenous anabolic-androgenic steroids, leading to a pseudo-hypogonadism state. Although rare, some athletes are candidates for testosterone replacement therapy for medical conditions, however physicians should be aware of the sanctioned and permitted use of exogenous hormones by athletes as dictated by the World Anti-Doping Agency.