You have probably seen the ads. Low energy? Low drive? Get your testosterone checked. Maybe you have clicked on one. Maybe you are already wondering if that is what has been going on with you.
You are not alone. In the United States, testosterone prescriptions jumped from about 7.3 million in 2019 to more than 11 million in 2024, and the fastest growth is in men in their late 30s and 40s. Testosterone clinics and online services are everywhere, and getting a prescription is often easier than getting in to see your family doctor.
That boom tells us something real. A lot of men are struggling. You have been pushing through for years, telling yourself it is just a busy season, just getting older, just how life is now. And when you finally look for help, the system has not had much to offer.
So the clinics stepped in. But most of them are focused on one thing: getting your numbers up so you can get back to full speed. Better erections. More muscle. More energy for the grind. What they rarely do is slow down and ask you the question that matters most.
How did you get here in the first place?
Refuelled, never repaired
So why is men’s health still treated so narrowly?
Part of it is that most of the care on offer is built around performance. Get your energy back. Get your drive back. Get your body back. Get back to work. A testosterone prescription fits neatly into that. It promises to restore your output without asking what has been draining it.
If you are honest, that is probably how you have been living too. Most of us were taught early that our worth is in what we produce, provide and push through. When something starts to break down, the instinct is to work harder, find a hack, find a fix and keep going. A quick prescription feels familiar. It asks nothing of you except a refill.
But if you have been running on empty for years, you do not need to be sped up. You need someone to slow down with you long enough to ask what happened.
When did your sleep start to slip? When did the weight start creeping on? What was going on in your life that year? Who do you actually talk to? What are you carrying that nobody else knows about? When was the last time you felt genuinely rested, connected and like yourself?
Those are not soft questions. As you will see below, they are the medical questions. A dropping testosterone level is often your body’s honest response to a life that has asked too much of you for too long. Treating the number without listening to that response is like turning off a smoke alarm without checking for the fire.
And there is a quieter cost. When you are handed a hormone without anyone asking about your life, it reinforces something you may already believe: that what is going on inside you does not really count. That the fix comes from outside. That you should just keep going. You deserve better than that.
Does this sound familiar?
Low testosterone does not usually arrive as one obvious problem. It creeps in as a handful of changes you keep explaining away.
- You are tired all the time, even after a weekend off
- Your interest in sex has faded, and erections are not what they used to be
- You are gaining weight around your middle, even though you are not eating that differently
- You are losing strength, and workouts take longer to recover from
- Your mood is flat or short fused, and things that used to excite you just do not
- Your focus and memory feel foggy
- Your sleep is lighter, broken or never quite enough
Here is the thing. Every one of those can also come from years of poor sleep, constant stress, carrying extra weight, drinking more than you would like to admit, or quietly holding a lot on your own. The feelings are real. But the cause is often further back than the number on your lab report.
What the numbers tell us
True, medically low testosterone with real symptoms is less common than the ads suggest. In a large European study of men aged 40 to 79, only about 2% met that definition. Even among men in their seventies it was around 5%. (EMAS)
What is common is a lower than normal blood level in men whose health is under strain (as referenced in the HIM study):
| Men aged 45+ | Share with below normal testosterone |
|---|---|
| Seeing their family doctor, any reason | About 39% |
| Living with obesity | About 40% |
| Living with obesity and diabetes | About 50% |
In other words, your weight, blood sugar and overall health often shape your testosterone more than your age does.
There is also a bigger trend at work. Men today have lower testosterone than men the same age did a generation ago, and researchers have not fully explained why (Travison et al. 2007). Even young men at a healthy weight have seen average levels fall over the last two decades (AUA 2020).
And here in Canada, the wider picture should stop us in our tracks. About 44% of Canadian men die before age 75, mostly from causes that could have been prevented (CBC). Three out of four suicides are men. Most of us wait more than six days with symptoms before seeing a doctor (Movember), and fewer than half of men say they felt truly listened to when they did (CBC).
Low testosterone is rarely the whole story. It is usually one chapter of it.
Your body is listening to your life
Think of testosterone production like a thermostat. Your brain is constantly reading what is happening in your body and your life, then deciding how much testosterone to ask for. When the brain senses that times are hard, it turns the dial down. Most of the time, low testosterone is not your body breaking. It is your body adapting.
Here is what your brain is paying attention to.
Stress. Your stress system and your hormone system share the same control room. When you are under pressure for months or years, your body treats it like an emergency, and making testosterone is not a priority during an emergency. The problem is that modern stress never switches off. The job, the bills, the marriage, the kids, the parent who is getting older. Your body stays braced, and the dial stays down.
Sleep. Most of your testosterone is made while you sleep. In one study, healthy young men who slept five hours a night for just one week saw their testosterone drop by 10% to 15%. That is roughly the same as aging 10 to 15 years. Their mood and energy fell right along with it (JAMA 2011). If you snore heavily or wake up exhausted, sleep apnea may be part of the picture too.
Belly fat and blood sugar. Fat around your middle is not just storage. It actively turns some of your testosterone into estrogen, and that tells your brain to make even less. Rising blood sugar adds to the problem. And lower testosterone makes it easier to gain fat and harder to build muscle, so the cycle keeps feeding itself.
Medications and alcohol. Long term pain medications like opioids, regular heavy drinking and some other prescriptions can all turn the dial down (Coluzzi et al. 2018). These rarely come up in a quick testosterone consult.
What you are carrying. Researchers have found that life events like losing a spouse, developing diabetes or gaining weight can affect testosterone as much as ten years of normal aging (Healio). Grief, loneliness, losing your sense of purpose or feeling disconnected from the people around you are not just feelings. They show up in your bloodwork.
Put it together and you can see the loop. Poor sleep raises stress. Stress drives cravings and belly fat. Belly fat lowers testosterone. Low testosterone drains your mood and motivation. Low motivation makes it harder to sleep, move and reach out. And through all of it, you keep showing up to work and telling everyone you are fine.
One tool, not the only tool
Let me be clear. Testosterone therapy is a real treatment, and for men who genuinely need it, it can be life changing. I am not against it. I am against it being the first and only thing anyone asks you about.
In my practice, I do not prescribe testosterone. What I do is look at the whole picture first: your hormones, sleep, metabolism, stress and the life you are living. When the evidence shows that hormone therapy is genuinely the right tool, I work alongside prescribing colleagues so you get it safely, with proper testing and follow up. When it is not, we work on what is actually turning your dial down.
If you feel flat, tired and not like yourself, here is what good care should look like:
- A proper diagnosis. More than one morning blood test, a look at the full hormone picture, and a real conversation about your symptoms.
- A look at the basics. How you sleep, whether you snore, your weight and blood sugar, what you eat and drink, how you move, and what medications you take.
- Stress taken seriously. Not as a personality trait, but as something that physically changes how your body works.
- Questions about your life, not just your labs. Your work, your relationships, your losses, your sense of purpose and who you have in your corner.
- Choosing tools together. Sometimes that includes testosterone. Often, once some of the load comes off, your body starts to recalibrate on its own.
This Movember, I want to raise the bar for men like you. Not just more awareness, but better questions. You are not an engine that needs a tune up. You are a whole person, and your health makes sense in the context of your life.
So yes, get your testosterone checked. And then let someone ask you the bigger question. How did you get here? The answer might be the most important part of getting better.
If you are struggling, you do not have to carry it alone. In Canada you can call or text 988, any time.
About the author
I am Dr. Yousuf Siddiqui, a naturopathic doctor and executive coach. Before medicine, I spent years in large scale real estate development and program management, in a world that measured people by what they could deliver and how long they could keep going. Today my work is built on one belief: what is happening in your body cannot be separated from what you have been carrying and how you have learned to cope with it.
Where to start
If this article sounds like you, you do not have to figure it out alone or keep pushing through.
The Recalibration Program is designed for men who sense something is off and want one practitioner to help them understand why. It begins with a comprehensive assessment of your hormones, metabolism, sleep and stress, alongside a real conversation about your life. From there, we build a plan to help your body recalibrate, not just push harder.
You can book with me through my booking link or contact NutriChem clinic at clinic@nutrichem.com or by calling 613-721-3669
