However, a similar trial of transdermal T using conventional doses in 274 men aged 65 and older who were frail or intermediate-frail, found no increase in cardiovascular adverse events in T-treated men . The addition of T treatment at a physiological dose does not appear to provide any benefit beyond that of exercise alone, at least over a short timeframe of intervention. Consistent with previous literature, we recently observed that T treatment at a physiological dose did not influence changes in VO2peak in the T alone group (i.e. no exercise intervention) (Fig. 2) 111, 112, 144–146. However, the exercise intervention employed by Hildreth et al. was predominantly resistance-based, which may have reduced the likelihood of observing improvements in aerobic measures . Improvements in VO2peak following exercise training may arise from central and/or peripheral adaptation. It is conceivable that these high VO2peak levels at baseline may have precluded the study’s capacity to demonstrate improvement . However, in this study, the median VO2 peak data at baseline were 40.7 and 40.4 mL/kg/min (in the T and placebo groups respectively) which places these men at the 90th percentile for males aged between 60 and 69 years .
Involvement of a small muscle mass, even when vigorous resistance exercise is performed, does not elevate serum testosterone concentrations above resting levels . If feminizing hormone therapy is stopped, testosterone levels will typically rise, leading to a regain in muscle mass and strength. Whether it represents a viable intervention to increase lean body mass and strength, and/or aerobic fitness in middle-aged to older men without disorders of the hypothalamus, pituitary or testes, remains to be established. The combination of supraphysiological T doses and resistance exercise training has been shown to increase muscular strength more than exercise alone following 10–12-week interventions in healthy young men (aged 19–45 years) 80, 82. Further, a meta-analysis of 47 studies representing 1079 participants reported that older adults can achieve substantial muscular strength gains in major muscle groups (24–29% improvement across leg press, chest press, knee extension and latissimus-pulldown exercises) following resistance training .
Yoga and flexibility workouts play an essential role in supporting overall health, but they’re just one piece of the puzzle when it comes to maintaining ideal testosterone levels. Enhanced flexibility not only aids in injury prevention but also allows for better execution of strength training exercises, which can further boost testosterone. Aim for a mix of moderate and high-intensity sessions to maximize these benefits and keep your testosterone levels optimized.
For comprehensive health benefits, consider adding 1–2 weekly HIIT sessions and moderate aerobic work to your resistance training regimen.18 To optimize your workout for testosterone, keep rest periods short, at about 60 seconds between sets.13 The body should be challenged enough to trigger a hormonal response, but not so much that muscles are exhausted before you’ve achieved your gains. And the more muscle you engage during your workout, the greater your testosterone response after your workout, studies show.8 A 2024 study confirms that a sedentary lifestyle is linked to lower testosterone, which can contribute to a negative cycle involving fatigue, depression, and weakened muscle and bone, especially in older men.1 While it’s true that testosterone plays a major role in muscle growth and training results, it’s not the whole story.
It’s important to gradually increase training intensity and allow for adequate recovery. No, the decrease in muscle strength is generally reversible if hormone therapy is discontinued. Resistance training is particularly effective in maintaining or building muscle mass. Exercise and nutrition play a critical role in mitigating or maximizing the effects of hormone therapy on muscle strength. Testosterone is a potent anabolic hormone, promoting muscle protein synthesis, increasing muscle fiber size, and reducing fat mass. These therapies induce profound physiological changes, including effects on muscle mass and strength.
In young men, the plasma testosterone concentrations were higher at I-preT, I-postT, and 30 min into the recovery, when compared to those of the middle-aged men. Compared to the baseline levels, the T-Testo concentrations were increased at I-preT in middle-aged men only. Arazi et al. studied young and middle-aged men who underwent an 8-week-long progressive resistance training program. The effect of exercise on serum testosterone concentrations in older men is not clearly understood.

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