Episode Details

A man of 52 and a woman of 52 walk into the same hormone conversation and get handed the same advice.

Fix the testosterone, fix the fat.

That advice is wrong for at least one of them, and possibly both.

In men, body fat crushes testosterone, so adding more is rarely the answer.

In women, body fat can be CAUSED by excess androgens, so for those ladies adding more is NOT the answer

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From a review in Frontiers in Medicine, October 28, 2026, by Komai and colleagues, a subject Joanne has taught in her Mastering Midlife program for five years.

In men, fat drags testosterone down.

• Excess body fat suppresses testosterone.
• Sex hormone binding globulin (SHBG) rises with age and binds testosterone, leaving less of it active.
• Aromatase, an enzyme stored in fat, converts testosterone into oestrogen.
• So a heavier man prescribed testosterone can end up converting much of it into oestrogen. A futile cycle.

Body fat loss itself is the first testosterone intervention for men.

• Training, protein, sleep, and a calorie deficit you can actually live with come first.
• Resistance training in itself raises testosterone.
• Only once body fat is down, and numbers are still low and symptoms are present, is there a role for testosterone replacement therapy.

In women, the arrow often points the other way.

• Obesity in women is more often linked to a