Beyond Testosterone: A Comprehensive Look at Midlife Men’s Health

Metabolic Health and Cardiovascular Risk

More than 30% of U.S. adults have metabolic syndrome, a condition that may lead to an increased cardiovascular risk. [1] Metabolic syndrome (MetS) isn’t just one condition; it’s a cluster of conditions including increased blood pressure, high blood sugar, excess body fat around the waist, and abnormal cholesterol levels. [2]. Some studies have reported that middle-aged men with metabolic syndrome may be at increased risk for cardiovascular events and mortality. [3]

Implementing lifestyle changes—such as adopting a balanced diet, engaging in regular physical activity, and managing weight may help reduce cardiovascular risks. [4] Even individuals with normal weight but with metabolic syndrome components may be at increased risk, emphasizing the importance of comprehensive metabolic evaluations. [5]

Potential Medication Therapies for Metabolic Health

In addition to lifestyle changes, certain therapies may potentially support metabolic function.  Some clinicians are investigating whether inflammation may be relevant in the context of metabolic health, particularly in individuals managing insulin resistance or obesity-related concerns. [6] Utilizing therapies with anti-inflammatory properties may be relevant in the broader context of metabolic health.

Cognitive Function and Mental Health

Maintaining cognitive health is vital as men age. Engaging in cognitive activities early on in life has been associated with potentially better cognitive function in later years [7]. Research indicates that midlife cognitive engagement, such as problem-solving tasks and continued learning, may positively impact cognitive longevity. [8]

Nearly 1 in 10 adults aged 45+ report cognitive decline, such as worsening memory or focus. [9] These findings underscore the importance of taking proactive steps, like staying mentally active and prioritizing emotional well-being, to support cognitive function throughout the aging process.

Potential Medication Therapies for Cognitive Support

Sometimes referred to as “bonding hormones,” certain naturally occurring peptides have been associated with emotional regulation and social connection. Emerging research is exploring how these peptides may influence cognitive processes, including memory and learning, though further study is needed. [10]

Muscle Preservation and Sarcopenia

Sarcopenia, the age-related loss of muscle mass and strength, may lead to decreased mobility and independence. [11] For adults, weak muscle strength increases with age; studies have found that 5% of adults aged 60 and over have weak muscle strength. [12] In some studies, regular physical activity, particularly resistance training, combined with adequate protein intake, has been associated with a lower incidence of sarcopenia. [13]

One study noted that moderate-to-vigorous physical activity was significantly associated with reduced progression to sarcopenia. [14] A multidisciplinary approach that includes nutrition and movement therapy may support muscle health throughout aging.

Potential Medication Therapies for Muscle Preservation

Some providers are exploring whether therapies that support natural growth hormone production may play a role in age-related muscle changes.

Sexual Health and Erectile Function

It is believed that approximately 52% of U.S. men aged 40–70 experience some form of erectile dysfunction (ED). [15] Erectile dysfunction (ED) is a common concern among middle-aged men and may indicate underlying health issues, including cardiovascular disease. [16]

Addressing lifestyle factors such as smoking [17], alcohol intake [18], and stress management [19] may support erectile health and function. Additionally, regular exercise [20] and a nutritious diet [21] contribute to overall vascular health, which is closely tied to sexual function. It’s important for men experiencing ED to consult healthcare providers to evaluate and manage any underlying conditions.

Potential Medication Therapies for Erectile Function

In some cases, healthcare providers may consider phosphodiesterase type 5 inhibitors (PDE5). These agents are thought to support blood flow during sexual arousal, a physiological process involved in achieving an erection. [22]

Conclusion

A comprehensive approach to midlife men’s health includes more than hormonal balance. Lifestyle modifications and preventive strategies that consider metabolic, cognitive, muscular, and sexual health may contribute to overall well-being and quality of life. Healthcare providers are instrumental in educating and guiding men through this important life stage, supporting the development of personalized care plans informed by clinical judgment.