Men’s Health
Testosterone & Male Hormonal Health
Low energy, reduced libido and sexual symptoms can be associated with testosterone deficiency — but they can also have many other causes.
“Symptoms come first. Numbers need context.”
Not every man with fatigue, low libido or reduced sexual performance needs testosterone. The first step is understanding why — symptoms alone are not a diagnosis, and biochemistry is read alongside them, not instead of them.
Clinical philosophy
Dr. Molina's Approach to Male Hormonal Health
Not a testosterone number treated in isolation — an assessment of whether symptoms, biochemistry and the wider health picture actually fit together.
Symptoms and biochemistry, together
A number on its own is not a diagnosis, and neither are symptoms alone. The two are read together, because either in isolation can mislead.
Free testosterone and SHBG in context
Total testosterone alone can be misleading. SHBG affects how much is actually biologically available, which is why free testosterone and SHBG are interpreted together rather than total testosterone in isolation.
Looking beyond the number itself
Pituitary hormones (LH/FSH) and prolactin help identify where in the hormonal axis a pattern originates — not just whether a single figure is low.
Metabolic and sleep context
Obesity, insulin resistance and untreated sleep apnoea can all lower testosterone or mimic its symptoms. Treating the number without addressing these is treating the wrong problem.
Fertility plans checked first
Some hormonal treatments can affect fertility. This is asked about, and factored in, before any treatment begins — not discovered afterward.
Monitoring, not a one-time prescription
Treatment, where appropriate, is followed with regular review and bloodwork — not started and left unmonitored.
How diagnosis is made
A Full Hormonal and Metabolic Picture
Assessment looks beyond a single number, considering how these markers relate to one another and to your symptoms.
Total & free testosterone
The primary hormone measured, both bound and unbound.
SHBG
Sex hormone-binding globulin — affects how much testosterone is biologically available.
LH / FSH
Pituitary hormones that help distinguish primary from secondary patterns.
Prolactin
Assessed as a potential contributor to hormonal and sexual symptoms.
Thyroid
Thyroid function can independently affect energy, libido and mood.
Metabolic health
Weight, insulin resistance and metabolic syndrome all interact with testosterone.
Sleep
Poor sleep, including untreated sleep apnoea, can lower testosterone levels.
Fertility plans
Relevant before starting any hormonal treatment that could affect fertility.
Treatment is considered only after appropriate clinical and biochemical assessment — never as a default response to symptoms alone.
Contributing factors
Weight, Sleep and Metabolic Health
Obesity, metabolic syndrome and poor sleep — including untreated sleep apnoea — can all lower testosterone levels or worsen symptoms. Addressing these factors is often part of the picture before, or alongside, any hormonal treatment.
When treatment may be considered
Treatment Only When Clinically Indicated
Testosterone treatment is considered only after appropriate clinical and biochemical assessment, and only when a clear indication is present — never as a default response to symptoms alone, and never for bodybuilding or performance enhancement.
Ongoing care
Monitoring and Safety
Regular follow-up bloodwork while on any treatment
Reviewing symptoms alongside biochemistry, not biochemistry alone
Monitoring for contraindications and relevant safety markers over time
Adjusting or stopping treatment if it isn't clinically appropriate to continue
As with any hormonal treatment, testosterone therapy carries contraindications and risks that are reviewed individually before starting and monitored throughout — it is not appropriate for every man, and is stopped or adjusted if it no longer suits your circumstances.
Contributor & Author — Men’s Health Spain. Selected articles: Testosterone and the body's daily rhythm · Testosterone, explained by an andrologist · What testosterone actually does
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