It might sound surprising, but testosterone isn’t just linked to aggression or dominance. If the anger doesn’t settle or starts interfering with your life, don’t ignore it. Feeling more irritable, tense, or reactive after starting testosterone?
Men and women need the proper amount of testosterone to develop and function normally. Although testosterone may make prostate cancer grow, it is not clear that testosterone treatment actually causes cancer. Some men who have a testosterone deficiency have symptoms or conditions related to their low testosterone that will improve when they take testosterone replacement. All of this reduces the active (free) form of testosterone in the body. Among women, perhaps the most common cause of a high testosterone level is polycystic ovary syndrome (PCOS). In addition, what may seem like a symptom of testosterone excess (see below) may actually be unrelated to this hormone.
Clinical outcomes include improved energy, body composition, mood, cognitive function, and sexual performance. Diurnal cortisol testing, which measures cortisol at multiple points throughout the day, reveals the full picture of your stress response. Underlying conditions like PCOS, thyroid disorders, and insulin resistance directly cause hormonal imbalances that require targeted treatment. Endocrine disruptors, chemicals found in plastics, pesticides, personal care products, and industrial pollutants, can mimic or block natural hormones. Inadequate protein intake limits the raw materials your body needs for hormone synthesis. The estrobolome, a collection of gut bacteria, helps regulate estrogen levels. Women experience the most dramatic shift during perimenopause and menopause, when estrogen and progesterone levels drop significantly.
Forty percent over age 45 have levels that doctors consider below the norm ( Generally, men make less testosterone as they get older. "Older men are irritable -- it’s almost never due to testosterone."
When estrogen levels climb too high in men, it can cause water retention, breast tissue development (gynecomastia), mood changes, and diminished testosterone effectiveness. These tests reveal the full landscape of your hormonal health, not just isolated numbers, but how your hormones interact, metabolize, and affect your daily function. Bioidentical hormone replacement therapy uses hormones that are structurally identical to those your body produces. A basic blood test might check TSH and total testosterone but miss the nuanced hormonal picture that explains your symptoms. Estrogen, progesterone, and testosterone influence energy, body composition, mood, and sexual function in both men and women.
"I think it’s a little naive to think it’s all related to testosterone," Matsumoto says. For some doctors, a "male menopause" caused by slowly decreasing testosterone is too far of a leap. Men tend to lose testosterone gradually, about half a percent per year. During menopause, the production of estrogen drops sharply. But other studies show that what’s going on inside men’s body as they reach late-middle age is far different than what happens to a woman. There’s some research that shows that men with low T even have hot flashes just like women do during menopause. But Abraham Morgentaler, MD, founder and director of Men’s Health Boston medical clinic, says he often sees other side effects in his patients.
"Joe Miller and Amber Miller, Founders of 1st Optimal, bring 25+ years of expertise in functional medicine, hormone therapy, peptide design, and clinical nutrition." Individual results may vary based on your unique health profile and medical history. Addressing stress is often the first and most impactful step in restoring hormonal balance. Basic hormone panels (TSH, total testosterone) are typically covered by most insurance plans.
Testosterone is also known to influence aggression and anger in men. These fluctuations can have a profound impact on a man's emotional state and behavior. It’s important to remember that a man’s T levels fluctuate naturally throughout a man's life, with the highest levels typically occurring in young adulthood and gradually declining with age. These emotional responses can reliably lead to misunderstandings, conflicts, and strained relationships. Research tells us that it’s often the case that men find it agonizingly uncomfortable to express their emotional struggles.
However, significant hormonal deficiencies often require medical intervention such as BHRT or TRT to restore levels to an optimal range. Our process begins with advanced at-home lab testing, including comprehensive blood panels, DUTCH hormone metabolite testing, and cortisol mapping. Because cortisol dysregulation undermines every other hormonal pathway, effective stress management isn’t optional. Effective TRT requires ongoing monitoring of testosterone levels, hematocrit, estradiol, and PSA to ensure safety and efficacy. Testosterone replacement therapy restores testosterone to optimal levels in men with documented deficiency. BHRT can address estrogen and progesterone deficiency, improving symptoms like hot flashes, mood instability, bone loss, and cognitive decline. Treatment depends on which hormones are affected, how significantly they’ve shifted, and your individual health profile.