Severely Low Testosterone in Males with COVID‐19: A Case‐Control Study

Severely Low Testosterone in Males with COVID‐19
Medically Reviewed
March 24, 2021

COVID-19. It’s all around us. And we learn more about it every day. All different kinds of studies are underway to better understand how it affects us, how we can protect ourselves, and what we can do to eliminate it. However, some of the research results have been surprising. Did you know there is a proven link between low testosterone in males and COVID-19?

One case-control study took an in-depth look into how the two interacted among a group of 567 men.

In this article, we will break down that study for you. The results were surprising- and if you are a male with hypogonadism or an extremely low testosterone count, you may find yourself concerned- for very good reason.

Don’t worry, though. Keep reading, and you’ll find that there is a solution. In fact, one that may even address some other issues that you have been experiencing.

What You Need to Know About Case-Control Studies

You hear the terms “researchers found this” or “studies show that,” but very rarely does the article tell you what kind of study or research was done. If you’re lucky, they will provide you with a link so that you can do your own research, but many times the links are too highly technical documents that are difficult for a layperson to figure out.

A case-control study compares two groups of people:

  • Those with the disease or condition under study.
  • And a similar group of people who do not have the disease or condition.

Those with the disease we call “cases” and those without we call “controls.”

These studies are not done in the present time- they look back retrospectively.

Case-control studies are observational. No attempt is made to intervene or alter the course of the disease.

These studies are designed to estimate odds.

Severely Low Testosterone in Males with COVID‐19: A Case‐Control Study

The participants who were included in the study were admitted into a single academic hospital from February 29th and May 2nd, 2020. 567 participants were subdivided according to COVID-19 infection status. 286 (50.5%) patients had COVID‐19, and 281 (49.5%) were healthy controls. The 286 symptomatic male patients with confirmed SARS‐CoV‐2 infection had not yet taken any antivirals or steroids and were admitted because they either had suggestive chest radiography or computed tomography.

At hospital admission, analysis of clinical and laboratory parameters showed significantly lower levels of Luteinizing Hormone (which causes the testicles to make testosterone and Total Testosterone (TT) in patients with COVID‐19 compared to the healthy controls. 89.9% of the patients had a TT level of less than 9.2nmol/L, indicating low testosterone in males.

They then split up the groups further. We won’t go into all the details here but what they found was that the men who experienced outcomes like admission into the ICU or death had lower TT levels. This led the researchers to determine that total testosterone can be an early biomarker of the severity of symptoms that COVID-19 patients will experience.

4-Evidence Based Speculations

More research is needed, but the researchers could make the following four hypotheses from the data they analyzed.

  1. Low T levels in males may simply be a marker of illness severity, which is the case in many other illnesses, including severe viral infections.


  1. Androgens don’t offer great immune support in males, whereas estrogens (and progesterone) can provide adequate protection to females. T levels can’t provide an effective response to the inflammatory and immunological outcome resulting from viral infection.


  1. A background condition of chronic low T levels in males (20% of middle‐aged/elderly men) may cause a greater incidence, higher severity, and increased probability of fatal events in men compared to women.


  1. COVID-19 needs androgen‐regulated proteins to invade host cells. The virus‐host interaction mechanism in males is different and more acutely linked to COVID infection. The hypothalamic‐pituitary‐gonadal (HPG) could induce an acute and dramatic drop in circulating TT in COVID infected males. The subsequent hypogonadal condition may trigger a serious or even fatal case of the disease.

The study also found that COVID-19 infection status was independently associated with lower TT levels and hypogonadism as much as six times more frequently than the healthy control, which strengthened their speculation on the infection’s causal role in androgenic (testosterone) collapse.

The Study’s Conclusion

Most men seeking medical care for symptomatic COVID‐19 show low circulating T levels at the time of hospital admission. Furthermore, these low levels are associated with more severe outcomes like admission into the ICU or death. In around 85% of the cases, sex‐hormones levels suggested secondary hypogonadism.

The case‐control study outlines that T levels in males with COVID‐19 need clinical attention. However, until we determine whether T is simply a marker of ill health, or if measuring it may assist us in targeting a very high‐risk population.

The study also speculated that a group of men at higher risk of severe illness might prompt preventive strategies or new tailor-made protocols for male patients with COVID‐19.


On the whole, there is a proven link between low testosterone in males and COVID-19. The question remains as to which came first- the low-t or the COVID. Until we answer that question, isn’t it best to go ahead and play it safe?

If you already have low T or hypogonadism, isn’t it worth seeking treatment rather than rolling the dice with your health?

T-Therapy for Men

Many men think that hormone shifts, drops, and imbalances don’t happen to them – that’s just something that middle-aged women go through. It’s not something they think they have to worry about. But it is.

Testosterone levels start dropping by 1% each year as early as your 30th birthday. So by the time you are a middle-aged man, you may go through male menopause, aka andropause. Also, some men have unnaturally low levels of testosterone. For example, hypogonadism, a dysfunction of the testicles, can cause unnaturally low levels of testosterone.

Benefits of BHRT For Men

There are many benefits of BHRT. It offers both better quality of life and improved health with the right treatment plan. Also, men who have undergone BHRT report benefits including:

  • Reduced body fat
  • Weight loss
  • Increased energy
  • Lower anxiety
  • Increased muscle mass and strength
  • Boosted sexual performance and desire

When prescribed properly and given to the right individual for the right reason, BHRT is an effective treatment for many hormonal imbalances.

Benefits of BHRT For Women

It’s a common misconception that only women going through menopause can benefit from BHRT. However, women of all ages can suffer from imbalanced hormones. These symptoms can range from mild to severe and disrupt your life and your health.

BHRT can help women who have hormone imbalances caused by menopause, PMS, estrogen dominance, low libido, organ dysfunction (thyroid), or organ removal (ovaries). Furthermore, for women who are struggling to make it through peri-menopause or menopause and keep a semblance of their sanity, BHRT can help:

  • Increase energy and decrease fatigue
  • Relieve hot flashes
  • Knock out night sweats
  • Improve your sleep
  • Ease vaginal dryness and itching
  • Make sex less painful
  • Increase your libido
  • Assist with mental focus and memory
  • Settle mood swings
  • Aid in depression
  • Lose or maintain weight

BHRT’s can even affect your health in positive ways after menopause, as studies have shown that it helps prevent fractures caused by osteoporosis (thinning bones), makes some women less likely to have heart disease, and lowers your chances of dementia.

Are You Ready to Feel Your Best?

Optimizing testosterone levels is an advantageous way to enhance your overall health- and maybe even keep you out of the COVID ICU. Schedule your appointment and start feeling your best today!

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