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  • Writer's pictureTimothy P. Smith MS, RD, LDN

The Boys' Epidemic

Updated: May 31, 2021

The West has its hands full. I'm not talking about Covid. Or the countless other crises we're being subjected to by a few corrupted rich people. No. There's another epidemic taking place in our society, particularly over the last 50 years, that no one seems to be discussing: The average Western man's testosterone has cratered nearly 50% since the 1980s [1], and it's getting worse.

"In the last three weeks alone, I've had two male clients come back with low testosterone.”

As a clinician, I've had the unique opportunity to work with an array of different individuals from all walks of life. I would say that most of the people I have the fortune to work with are women, but I do work with a great number of boys & men, as well.

In my years of experience, I would estimate that 2 in 5 men I work with (over the age of 24-25) will initially come to me with low testosterone, and they don't realize it until I ask them if they've been tested. In the last three weeks alone, I've had two male clients come back with low testosterone.


At this point, one might ask: "Why does this matter to me? Men could probably benefit from having less testosterone anyway; maybe it's a good thing."

The lobster is evidence of the importance of hormones & the role they play in dominance hierarchies we find in complex societies.

Before we answer that, we must understand that testosterone is one of the, if not the most important compound in our bodies; for both women and men. Much of the reason lies in its role as a potent neuroactive hormone, exerting influence on nearly every aspect of our physiology. It is not something that makes guys excitable; humans simply would not exist, in the way we do today, without it.

However, testosterone is particularly important for boys & young men, as it single-handedly facilitates development of biologically necessary secondary characteristics, such as:

  • Muscle growth

  • Bone mineral density

  • Change in voice tone

  • Sexual development

  • Facial hair development [2]

On the surface, such traits may seem insignificant, but these changes set the stage for proper development going into adulthood, both physically & mentally.

Nutrition, exercise, and physical fitness are important habits to ensure adequate testosterone into adulthood.

More specifically, as a boy grows into a man, other interpersonal characteristics become more important to our livelihood than big muscles & height. As an adult in a functional Western society, it's no longer just about being the biggest boy on the playground. Instead, one's position in society is very much based on "competence".


Some markers of competence include characteristics like:

-Cooperation, generosity, and social status [3]

-Improved learning ability [4]

-Increased persistence [5]

-Reduced stress and fear [6]

-Increased muscle & reduced body fat percentage [7]

-Increased energy level [8]

-Increased memory [9]

-Increased competitiveness [10]


Coincidentally, and contrary to popular belief, each of these hallmarks of competence are poignantly associated with higher levels of testosterone.


Alternatively, low testosterone in men seems to be potently associated with:

-Depression & anxiety-related disorders

-Increased cortisol secretion




-Cognitive impairment

-Low Libido


-Erectile Dysfunction [11]

-Increased storage of body fat

-Loss of lean body mass ("Muscle")

-Loss of bone mineral density [7]


"We really don't know. And no research has been done, or is being done to find out why."

Another misconception is that testosterone makes men more aggressive, but there is not much evidence to support this. On the contrary, it does in fact appear that low testosterone actually makes men act in a more aggressive, irritable, as well as feel more anxious. [11]

Even further, men with below normal testosterone seem more likely to struggle with a reduced ability to concentrate, decreased psychomotor speed, and impaired executive cognitive function. [12]


Considering that, we can feel confident that men tend to be better "all-around" when they possess adequate testosterone. Even further, it seems that men become better as testosterone increases, within the established normal range. Not just for themselves & how they feel, but for their partners, their career capabilities, and for our medical system.

A systemic, societal reduction in testosterone has never been seen before; this trend is unprecedented, when compared to any other time in recorded history. Based on these available data, such a reduction will likely result in large-scale societal & epidemiological changes, never before seen.


"So, why should I care about this?"

1.) Men comprise roughly half of our society. Do we really want almost everyone (including women) walking around with a potentially life-disrupting endocrine disorder? We already have a generation of Baby Boomers to nurture for many years to come & we're unsure if our medical system can handle that. And further, we run the risk of passing these hormonal issues onto our progeny. This seems to be the most likely outcome, based on the available trend data.

2.) Also, consider that reduced testosterone increases one's risk for obesity & other related disorders such as depression, anxiety, and even diabetes.

3.) Men have always been, and are usually still responsible our physical labor. Working on oil rigs, power lines, serving as a ship hand, HVAC/construction, roofing, etc. These jobs require a degree of mental & physical acumen that likely cannot be achieved if testosterone levels aren't WNL, as lean body mass ("muscle") & cognition clearly suffer as a result of reduced testosterone. What will this mean for our ability to produce things? To harvest crops?

4.) Again, men comprise nearly half of our society, and it takes two to tango. The expulsion of testosterone from the male population would likely spell the reproductive end of civilization as we know it.

5.) Women and men compliment one another; what one lacks, the other will often make up the difference. Women tend to be more agreeable and higher in extraversion than men, making them great negotiators. They are also more generally intelligent & adaptable than men, while men tend to be better at solving physical problems. Men are always on the front lines in fights & wars. Women are usually much better at interacting with people & animals than men, while men are usually more comfortable working with cars & machines. Women have more oxytocin & estrogen. Men have more serotonin & testosterone.

These are obviously generalizations, but in general, they're accurate. Women and men are unequivocally different. Eliminating testosterone from the male population would mean eliminating an entire half of our society's charisma & available skillset. It would mean the elimination of nurturing, competent masculinity; the existential cost of eliminating such masculinity for our sons and daughters, without anything to take its place, should be obvious by now.

Getting a little apocalyptic in here, as it should.


At this point, if you've read this far, you might ask: "Okay, I understand it's important. But why is it happening?"


That's a great question, and the answer is: We really don't know. And no research has been done, or is being done to find out why.

That's it.

There is no answer.




1.) Travison TG, Araujo AB, O'Donnell AB, Kupelian V, McKinlay JB. A population-level decline in serum testosterone levels in American men. J Clin Endocrinol Metab. 2007 Jan;92(1):196-202. doi: 10.1210/jc.2006-1375. Epub 2006 Oct 24. PMID: 17062768.

2.) Testosterone what it does and doesn't do - harvard health. (2015). Harvard Health. Retrieved from

3.) Dreher JC, Dunne S, Pazderska A, Frodl T, Nolan JJ, O'Doherty JP. Testosterone causes both prosocial and antisocial status-enhancing behaviors in human males. Proc Natl Acad Sci U S A. 2016 Oct 11;113(41):11633-11638. doi: 10.1073/pnas.1608085113. Epub 2016 Sep 26. PMID: 27671627; PMCID: PMC5068300.

4.) Wright, N.D., Edwards, T., Fleming, S.M. et al. Testosterone induces off-line perceptual learning. Psychopharmacology224, 451–457 (2012).

5.) Welker, K. M. and Carré, J. M. (2015) Individual Differences in Testosterone Predict Persistence in Men, Eur. J. Pers., 29, 83– 89, doi: 10.1002/per.1958.

6.) Kirby, Roger. (2014). Testosterone and the struggle for higher social status. Trends in Urology & Men's Health. 5. 10.1002/tre.372.

7.) Finkelstein JS, Lee H, Burnett-Bowie SA, Pallais JC, Yu EW, Borges LF, Jones BF, Barry CV, Wulczyn KE, Thomas BJ, Leder BZ. Gonadal steroids and body composition, strength, and sexual function in men. N Engl J Med. 2013 Sep 12;369(11):1011-22. doi: 10.1056/NEJMoa1206168. PMID: 24024838; PMCID: PMC4142768.

8.) Straftis AA, Gray PB. Sex, Energy, Well-Being and Low Testosterone: An Exploratory Survey of U.S. Men's Experiences on Prescription Testosterone. Int J Environ Res Public Health. 2019 Sep 5;16(18):3261. doi: 10.3390/ijerph16183261. PMID: 31491933; PMCID: PMC6765788.

9.) Ackermann S, Spalek K, Rasch B, Gschwind L, Coynel D, Fastenrath M, Papassotiropoulos A, de Quervain DJ. Testosterone levels in healthy men are related to amygdala reactivity and memory performance. Psychoneuroendocrinology. 2012 Sep;37(9):1417-24. doi: 10.1016/j.psyneuen.2012.01.008. Epub 2012 Feb 15. PMID: 22341731.

10.) Knight, Erik & Morales, Pablo & Christian, Colton & Harbaugh, William & Mehta, Pranjal & Mayr, Ulrich. (2019). The Causal Effect of Testosterone on Men’s Competitive Behavior is Moderated by Basal Cortisol and Cues to an Opponent’s Status: Evidence for a Context-Dependent Dual Hormone Hypothesis. 10.31234/

11.) Dandona, P. and Rosenberg, M.T. (2010), A practical guide to male hypogonadism in the primary care setting. International Journal of Clinical Practice, 64: 682-696.

12.) Lašaitė L, Ceponis J, Preikša RT, Zilaitienė B. Impaired emotional state, quality of life and cognitive functions in young hypogonadal men. Andrologia. 2014 Dec;46(10):1107-12. doi: 10.1111/and.12199. Epub 2013 Dec 8. PMID: 24313565.

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