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Low testosterone may signal more than hormonal changes. Researchers say it could be an important biomarker that helps identify men at greater risk of poor health outcomes later in life.
A major international study involving more than 26,000 men found that those with very low testosterone levels were 18% more likely to die from cancer later in life than men with the highest levels. The findings, published in Lancet Healthy Longevity, add to growing evidence that hormone levels may provide important clues about long-term health risks.
The research comes from the Androgens In Men Study (AIMS), an international collaboration led by Professor Bu Yeap of The University of Western Australia.
Researchers analyzed long-term data from 11 cohort studies conducted across Australia, the United States, and Europe. Blood samples collected earlier in life were evaluated for hormone levels, and the results were matched with cancer outcomes that occurred years or even decades later.
The study examined several sex hormones, including testosterone, dihydrotestosterone (DHT), sex hormone-binding globulin (SHBG), and luteinizing hormone.
“We wanted to know whether the concentration of these hormones in the blood was related to the risk of men being diagnosed with, or dying from, cancer in the future,” Professor Yeap said.
“What we saw was that if a man had low testosterone levels, in the lowest one-fifth compared to the highest one-fifth of the range, their subsequent risk of dying from cancer was higher, even after allowing for age and other health-related factors.”
Researchers Identify a Potential Risk Threshold
Researchers found that cancer risk appeared to increase when testosterone levels fell below 8.6 nanomoles per liter (nmol/L).
“We saw that when baseline testosterone was below 8.6 nmol/L, subsequent cancer risk started increasing,” Professor Yeap said.
“This suggests low testosterone is an important biomarker, so it’s possible that looking at testosterone levels could help us identify men who might do poorly if they get cancer down the track.”
Professor Yeap noted that testosterone levels are influenced by multiple factors. While healthy younger men typically have levels between 10 and 30 nmol/L, levels often decline with age and can also be affected by body mass index, physical activity, and medical conditions such as diabetes.
No Evidence of a Testosterone-Prostate Cancer Link
The findings also challenge a longstanding assumption about testosterone and prostate cancer, as researchers found no evidence that naturally occurring testosterone levels influence prostate cancer risk.
“Since reducing testosterone levels is a treatment for prostate cancer, there’s always been a question of whether the amount of testosterone your own body makes relates to your risk of prostate cancer, but based on our findings, there’s no evidence they are related,” Professor Yeap said.
Researchers did identify potential links involving other hormones. Men with lower levels of SHBG and luteinizing hormone appeared to have a higher risk of developing prostate cancer.
“We did find, however, that men with low levels of SHBG and luteinizing hormone were at higher risk of prostate cancer,” Professor Yeap said.
Researchers Urge Medical Evaluation, Not Supplementation
Researchers say the findings do not mean low testosterone causes cancer or that testosterone therapy should be used to prevent it.
“While we’ve shown low levels are associated with increased risk, we haven’t got any evidence yet that actually giving men testosterone will reduce that risk,” Professor Yeap said.
Instead, he encourages men found to have low testosterone levels to seek a thorough medical evaluation.
“What we would say to men is if they are found for whatever reason to be low in testosterone, it’s important to go to the doctor for a full checkup,” he said.
“It may not show any sign of testicular disease, but it might show other health issues or risk factors they need to address.”
Professor Yeap said low testosterone could serve as an important prompt for men to take a broader look at their health.
“It could be a wake-up call and encouragement for men to engage in more healthy lifestyle behaviors, and to get regular, holistic checkups to stay on top of their health.”
What This Means for Nurses
While testosterone testing is not currently used as a cancer screening tool, the findings suggest low testosterone levels may provide important clues about a patient’s overall health.
For nurses working in primary care, men’s health, oncology, endocrinology, and preventive care settings, abnormal testosterone results may create opportunities to encourage follow-up evaluation, address modifiable risk factors such as obesity and physical inactivity, and reinforce the importance of routine health screenings.
As healthcare increasingly emphasizes prevention and early risk identification, the study highlights the value of looking beyond a single laboratory result and considering what hormone levels may reveal about a patient’s broader health status.
