Testosterone and Men’s Health: More Than Just Sex Drive

By Scott D. Miller, MD, MBA

When most people hear“testosterone,” they think of libido. While sexual health is certainly part of the story, testosterone plays a far broader and more important role in men’s overall health.

Testosterone is a foundational hormone that affects energy, mood, muscle mass, bone density, cognition and metabolic health. In many ways, it acts as a barometer of a man’s overall well-being.

Low testosterone, or “low T,” is both underdiagnosed and overdiagnosed. Some men with clear symptoms—fatigue, decreased strength, increased body fat, low motivation or depressed mood—go untreated. At the same time, others are prescribed testosterone without proper evaluation or true deficiency.

This matters because both low and excessive testosterone carry risks. Untreated low testosterone has been associated with metabolic syndrome, diabetes, decreased bone density, depression and even cognitive decline. On the other hand, giving testosterone to men with normal levels can suppress natural production and lead to unintended consequences.

There are also persistent myths. For years, men were told that testosterone therapy increased the risk of prostate cancer, heart attack, and stroke. More recent, high-quality data have largely challenged these concerns, leading to updated guidance and a more balanced understanding of its safety when appropriately prescribed and monitored.

The key is thoughtful evaluation. A diagnosis of low testosterone should be based on both symptoms and consistently low blood levels, ideally measured in the morning. Treatment decisions should be individualized, weighing potential benefits against risks.

Testosterone is not about turning back the clock or chasing youth. It is about restoring balance. When used appropriately, it can improve quality of life, physical function, and long-term health.

Men’s health is not defined by a single hormone—but when testosterone is optimized, the impact can extend far beyond the bedroom.

Look for my article on “Men’s Health and Hydration: More Than Just Drinking Water” in the next issue.

Scott D. Miller, MD, MBA, is the Medical Director of Robotic Surgery at Wellstar North Fulton Hospital. He is a urologist with Wellstar Urology in Roswell and has practiced in Atlanta for over 20 years. Wellstar North Fulton Hospital offers the Know Your Heart Screening that can determine your risk of heart disease, stroke and other serious conditions. Call 770-956-STAR (7827) to learn more or schedule an appointment.

Scott D. Miller, MD, MBA • Wellstar North Fulton Hospital • 470.956.4230 www.ScottDMillerMD.com