Medically reviewed by Mark Strehlow, MD, Medical Director — September 2026
The things most strongly linked to lower testosterone in men are excess body weight, type 2 diabetes and other serious illness, and certain medicines, especially opioid painkillers and steroids. Short sleep and regular drinking lower it too. Age matters less than many men think until their 70s. Beer’s effect comes from the alcohol, not the hops. And because the symptoms of low testosterone overlap with many other problems, a properly timed blood test tells you more than any list of habits.
What lowers testosterone the most?
| Factor | What the research shows | Evidence |
|---|---|---|
| Excess body weight | The strongest everyday link. Testosterone falls as weight rises, and losing weight raises it. | A pooled analysis of 21,074 men; a review of 24 weight-loss studies |
| Type 2 diabetes and serious illness | A third of men with type 2 diabetes had low testosterone. Cancer and short illnesses lower it too. | A pooled analysis; a clinic study of 103 men |
| Some medicines and drugs | Opioids, long-term steroid medicines and anabolic steroids can cause low testosterone. | A clinical guideline; Cleveland Clinic |
| Short sleep | A week of 5-hour nights lowered daytime testosterone by 10% to 15%. | A lab study of 10 young men |
| Alcohol | About 3 beers a day for 3 weeks lowered it by about 7%. Heavy drinking lowers it too. | A small trial; a review of 21 controlled studies |
| Age | Little average change from 17 to 70, and a clearer drop after 70. | A pooled analysis; long-term studies |
| Little vigorous exercise | Men doing 75 minutes or less a week had slightly lower levels. | A pooled analysis |
| Hops in beer | No good evidence that the amount in beer lowers it. | Lab studies; one beer trial |
Most of this comes from studies of large groups of men. The weight-loss, sleep and alcohol studies show that some of these factors can actually move testosterone.
Does age lower testosterone?
Somewhat, but less than you may have heard. Studies that follow the same men over time have found total testosterone falling by about 1% to 2% a year from middle age. In one of them, the Massachusetts Male Aging Study, men in good health had levels 10% to 15% higher than men with chronic illness, obesity, heavy drinking or regular prescription medicines.
In a pooled analysis of 21,074 men, average testosterone changed little between 17 and 70 and fell more clearly after 70. In an Australian study of 325 men over 40 in very good health, it didn’t fall with age at all. Much of what gets blamed on age is weight and health.
Weight, diabetes and testosterone
In the pooled analysis, testosterone fell steadily as body mass index rose, and diabetes and cancer were each linked to lower levels. Cleveland Clinic notes that most men with symptoms of low testosterone don’t have a problem with their testicles or pituitary gland. The cause is usually obesity or diabetes.
This kind of low testosterone often moves with weight. A review of 24 studies found that a low-calorie diet raised total testosterone by about 83 ng/dL on average, and weight-loss surgery by about 250 ng/dL. The more weight men lost, the more it rose. In a clinic study of 103 men with type 2 diabetes, a third had low testosterone.
Does beer lower testosterone?
Regular drinking lowers it modestly, and heavy drinking can harm the body’s ability to make it.
In a small controlled trial, 10 healthy middle-aged men drank beer with dinner for 3 weeks: about 40 grams of alcohol a day, or roughly 3 standard drinks. For another 3 weeks they drank the same amount of alcohol-free beer. Their testosterone was 6.8% lower after the regular beer. Both beers contained hops, so the difference came from the alcohol.
A review of 21 controlled studies agreed: in healthy men who drank regularly, alcohol was linked to lower testosterone and higher estradiol, a form of estrogen. Over time, heavy drinking can damage the testosterone-making cells in the testicles.
Does beer increase testosterone? No. One small study of 13 men found a brief rise after a single small dose of alcohol, but regular drinking points the other way.
Do hops lower testosterone?
There’s no good evidence that they do at the amounts found in beer.
Hops, the flowers that give beer its bitterness, contain a compound called 8-prenylnaringenin (8-PN), one of the most potent plant estrogens known. That’s why concentrated hop extracts have been tested for hot flashes in women after menopause, in small trials with mixed results.
But the scientists who first identified 8-PN in hops also measured it in beer and found the levels too low to be a concern. And in the beer trial above, where both beers contained hops, it was the alcohol that made the difference. How much alcohol you drink matters more than whether your drink contains hops.
Sleep, stress and exercise
Sleep. Most of a man’s daily testosterone is released during sleep. In a lab study, 10 healthy young men who slept 5 hours a night for a week had daytime testosterone 10% to 15% lower than when well rested. Obstructive sleep apnea is also a recognized cause of low testosterone. Cleveland Clinic recommends sleeping seven hours a night and treating sleep apnea if you have it.
Stress. Severe, sustained stress can suppress testosterone, especially with too little food and sleep, and levels usually recover with rest. Most of this evidence comes from military training and endurance athletes, so it’s less clear how much everyday stress matters.
Exercise. Men who did 75 minutes or less of vigorous activity a week had slightly lower testosterone. Hard training doesn’t lower it when you eat enough.
Medicines and medical conditions
Some causes of low testosterone take a doctor to find. They include:
- Opioid pain medicines, and medicines used to treat opioid dependence
- Long-term corticosteroid (steroid) medicines
- Anabolic steroid use, and some medicines for prostate cancer and digestive problems
- Obstructive sleep apnea, type 2 diabetes and obesity
- Kidney failure, cirrhosis of the liver, HIV and iron overload
- Problems with the pituitary gland, including high levels of the hormone prolactin
A short illness can lower testosterone too, so tell your provider if you’re unwell when your blood is drawn. Don’t stop a prescribed medicine without talking to the prescriber.
Masturbation, receipts and tap water
- Masturbation. There’s no evidence that it lowers testosterone. In two small lab studies of healthy men, testosterone didn’t change with orgasm. In one of them, levels were higher after three weeks without sex.
- Receipts. Thermal receipt paper can contain bisphenol A (BPA). In a small study, handling receipts for two hours without gloves raised BPA in urine, though less than eating canned soup. The researchers said the health effects are unknown.
- Tap water. An analysis of U.S. drinking water estimated that people get far more estrogen from foods such as milk than from tap water, and concluded those amounts aren’t causing health effects.
When to get your testosterone checked
It’s worth asking about a test if you notice:
- Lower sex drive, fewer morning erections or trouble with erections
- Less muscle, more body fat, or growth of breast tissue
- Low mood, poor concentration or less stamina
- Hot flashes
These symptoms have many causes, from poor sleep to depression, so a blood test matters, done the right way:
- Testosterone is highest in the morning, and a sugary drink can lower it by about 25% for at least two hours. That’s why the test is done early in the morning, fasting.
- The American Urological Association says low testosterone should be diagnosed only after two early-morning tests on different days, together with symptoms. It uses 300 ng/dL as a reasonable cut-off.
- It also advises testing men with diabetes, unexplained anemia or bone loss, or long-term opioid or steroid use, even without symptoms.
Is testosterone therapy the answer?
For men with confirmed low testosterone and symptoms, it can be. The FDA approves testosterone for men with low testosterone caused by a medical condition, and its labeling keeps a limitation of use for low testosterone due to aging alone.
Lifestyle comes first. The American Urological Association recommends lifestyle counseling for every man with low testosterone, and Cleveland Clinic describes nutrition and physical activity as the first treatment, moving on if that hasn’t helped after 6 to 12 months or symptoms are severe.
Testosterone therapy also has real trade-offs:
- It can lower sperm production, so it isn’t for men trying to conceive.
- It can raise blood pressure. In 2025 the FDA required a blood-pressure warning on all testosterone products, and removed boxed-warning language about heart risk after a large trial in men with low testosterone.
- It can raise the red blood cell count, which needs regular blood tests.
- The Endocrine Society advises against starting it in men with prostate or breast cancer, untreated severe sleep apnea or a recent heart attack or stroke, among other conditions.
How we approach low testosterone at Rock Creek Wellness
We look for the cause before we recommend any treatment, testosterone included.
- Evaluation first. We start with your symptoms, health history and medicines. Then come comprehensive blood testing, drawn fasting, and a DEXA body composition scan. For men, the labs include total and free testosterone, estradiol, PSA, thyroid tests, hemoglobin A1c and fasting insulin.
- Cause first. If weight, sleep, alcohol, a medicine or another condition looks like the cause, we’ll tell you and start there. If another specialist would serve you better, we’ll say so.
- Treatment only when it fits. Testosterone therapy is for men whose labs confirm low testosterone. If it’s right for you, your provider goes through the benefits, risks, effect on fertility and monitoring before you decide. Read more about hormone care for men.
- Follow-up testing. If you start therapy, regular lab monitoring is part of prescribing it responsibly, and we adjust from there.
If erections or sex drive are your main concern, see our sexual wellness care. Premier Care is our program that begins with this full evaluation. We’re a cash-pay clinic, and we’ll give you the price at your consultation. Consultations are free.
Common questions
Do testosterone boosters work?
There’s little evidence that they do. When researchers reviewed 50 “T booster” supplements, 90% claimed to boost testosterone, but only about a quarter had published data showing an increase. One in ten contained ingredients with data suggesting a decrease, and 13 had zinc, niacin or magnesium above recommended upper limits. Cleveland Clinic advises seeing a provider rather than buying over-the-counter supplements.
Does bread or sugar lower testosterone?
A sugary drink lowers it for a few hours: in a study of 74 men, a glucose drink cut testosterone by about 25%. Over the long term, the stronger links are with excess weight and type 2 diabetes.
Sources
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- Feldman HA, et al. Age trends in the level of serum testosterone and other hormones in middle-aged men: longitudinal results from the Massachusetts Male Aging Study. Journal of Clinical Endocrinology & Metabolism 2002. PubMed
- Sartorius G, et al. Serum testosterone, dihydrotestosterone and estradiol concentrations in older men self-reporting very good health: the Healthy Man Study. Clinical Endocrinology 2012. PubMed
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- Dhindsa S, et al. Frequent occurrence of hypogonadotropic hypogonadism in type 2 diabetes. Journal of Clinical Endocrinology & Metabolism 2004. PubMed
- Cleveland Clinic. Low testosterone (male hypogonadism). Cleveland Clinic
- Sierksma A, et al. Effect of moderate alcohol consumption on plasma dehydroepiandrosterone sulfate, testosterone, and estradiol levels in middle-aged men and postmenopausal women. Alcoholism: Clinical and Experimental Research 2004. PubMed
- National Institute on Alcohol Abuse and Alcoholism. What is a standard drink? NIAAA
- Santi D, et al. The chronic alcohol consumption influences the gonadal axis in men: results from a meta-analysis. Andrology 2024. PubMed
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- Sarkola T, Eriksson CJ. Testosterone increases in men after a low dose of alcohol. Alcoholism: Clinical and Experimental Research 2003. PubMed
- Milligan SR, et al. Identification of a potent phytoestrogen in hops (Humulus lupulus L.) and beer. Journal of Clinical Endocrinology & Metabolism 1999. PubMed
- Heyerick A, et al. A first prospective, randomized, double-blind, placebo-controlled study on the use of a standardized hop extract to alleviate menopausal discomforts. Maturitas 2006. PubMed
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- Exton MS, et al. Endocrine response to masturbation-induced orgasm in healthy men following a 3-week sexual abstinence. World Journal of Urology 2001. PubMed
- Ehrlich S, et al. Handling of thermal receipts as a source of exposure to bisphenol A. JAMA 2014. PubMed
- Caldwell DJ, et al. An assessment of potential exposure and risk from estrogens in drinking water. Environmental Health Perspectives 2010. PubMed
- Caronia LM, et al. Abrupt decrease in serum testosterone levels after an oral glucose load in men: implications for screening for hypogonadism. Clinical Endocrinology 2013. PubMed
- American Urological Association. Evaluation and management of testosterone deficiency. AUA guideline 2018, validity confirmed 2024. AUA
- Bhasin S, et al. Testosterone therapy in men with hypogonadism: an Endocrine Society clinical practice guideline. Journal of Clinical Endocrinology & Metabolism 2018. PubMed
- U.S. Food and Drug Administration. FDA issues class-wide labeling changes for testosterone products. 2025. FDA
- Clemesha CG, Thaker H, Samplaski MK. ‘Testosterone boosting’ supplements composition and claims are not supported by the academic literature. World Journal of Men’s Health 2020. PubMed
