Testosterone and IBD: What Men with Crohn’s and Colitis Should Know

Inflammatory Bowel Disease (IBD), which includes Crohn’s disease and ulcerative colitis, is a chronic condition that causes significant inflammation in the digestive tract. For men living with IBD, managing symptoms and maintaining overall health can be a complex challenge. 

An often-overlooked aspect of managing IBD in men is the role testosterone plays in their health, especially in those dealing with testosterone deficiency or hypogonadism.

With Crohn’s and Colitis Awareness Week approaching, it’s important to explore the relationship between testosterone and IBD, and how testosterone therapy may offer symptom relief and improve the overall quality of life for men with these conditions.

‍

The Link Between Testosterone and IBD

Testosterone is a hormone most commonly associated with male reproductive health, but its influence extends far beyond that. It plays a crucial role in maintaining bone density, muscle mass, and mood stability, and it also has anti-inflammatory properties that can affect the immune system. 

For men with IBD, the role of testosterone may be even more significant due to the chronic inflammation caused by the disease.

Studies have shown that men with Crohn’s disease or ulcerative colitis are more likely to have lower testosterone levels than men without these conditions. This is because the inflammation that characterizes IBD can interfere with the body’s ability to produce sufficient testosterone. In fact, chronic inflammation can suppress testosterone production, leading to hypogonadism.

‍

The Impact of Low Testosterone in Men with Crohn’s and Colitis

Low testosterone levels can exacerbate many of the physical and psychological symptoms that come with Crohn’s and colitis. Symptoms of low testosterone include:

• Fatigue: Men with low testosterone may experience decreased energy levels, which can compound the fatigue often caused by IBD.
• Decreased muscle mass: Testosterone is vital for muscle health, and low levels can lead to muscle loss and weakness, further limiting a man’s ability to stay active.
• Mood changes: Low testosterone has been linked to depression, irritability, and mood swings, which may intensify the emotional toll of managing a chronic condition like IBD.
• Bone health: Testosterone deficiency can lead to reduced bone density, increasing the risk of osteoporosis, a concern particularly for men already dealing with nutrient absorption issues from Crohn’s or colitis.

‍

Can Testosterone Therapy Help?

Research suggests that testosterone therapy may offer a range of benefits for men with IBD, particularly those with Crohn’s disease who are experiencing hypogonadism. Several studies have demonstrated the positive impact of testosterone on managing Crohn’s disease.

A key study published in Hormone Molecular Biology and Clinical Investigation demonstrated that testosterone therapy in men with Crohn's disease and low testosterone led to a significant reduction in disease activity over a long-term period​.

The study followed 92 men with Crohn’s disease who received testosterone therapy for up to seven years. Researchers observed a notable decline in the Crohn’s Disease Activity Index (CDAI), which measures the severity of the disease, from 239.36 to 71.67 after 84 months of treatment. C-reactive protein (CRP) levels, a marker of inflammation, also dropped significantly from 12.89 mg/L to 1.78 mg/L during the same period​. 

These results suggest that testosterone therapy can reduce inflammation and improve overall disease management in men with Crohn’s disease and low testosterone.

Similarly, another study published in Hormone Molecular Biology and Clinical Investigation examined 13 hypogonadal men with Crohn’s disease who received parenteral testosterone undecanoate for 24 months. These men showed a significant reduction in both their Crohn’s Disease Activity Index (CDAI) and C-reactive protein (CRP) levels. Specifically, the CDAI dropped from 243±19 to 89±9, and CRP levels decreased from 22.7±8.1 to 6.9±2.9 mg/dL.

These reductions highlight testosterone’s potential to reduce inflammation and alleviate symptoms in men with Crohn’s disease.

‍

How Testosterone Helps Reduce Inflammation

Testosterone’s anti-inflammatory effects are particularly valuable for men with IBD. Chronic inflammation is a hallmark of both Crohn’s and colitis, and reducing this inflammation is critical for symptom management and preventing long-term damage to the digestive tract.

Testosterone has been shown to inhibit the production of pro-inflammatory cytokines, such as tumor necrosis factor-alpha (TNF-α), which are elevated in patients with IBD​. By reducing the levels of these inflammatory markers, testosterone can help mitigate the immune system’s overreaction, which is responsible for much of the inflammation in IBD.

In addition to its anti-inflammatory effects, testosterone may also promote the growth and function of regulatory T cells, which play a role in controlling the immune response and preventing the immune system from attacking healthy tissues​.

‍

Testosterone and Overall Health in Men with IBD

Testosterone therapy may offer other health benefits for men with IBD beyond reducing inflammation. By normalizing testosterone levels, men may experience improvements in their energy levels, muscle mass, mood, and bone health, all of which can enhance their quality of life.

Additionally, as testosterone levels improve, so too may the body’s ability to heal and recover from flare-ups or surgeries that are sometimes necessary for the management of Crohn’s or colitis. Men who respond well to testosterone therapy may also experience less reliance on corticosteroids or other medications, which come with their own set of side effects.

‍

Is Testosterone Therapy Right for You?

While testosterone therapy shows promise for men with Crohn’s and colitis, it’s essential to consult with a healthcare provider to determine whether this treatment is appropriate. Testosterone therapy is generally safe when administered under the guidance of a doctor, but it may not be suitable for everyone.

If you have been diagnosed with IBD and are experiencing symptoms of low testosterone, including fatigue, muscle weakness, or mood changes, discussing hormone levels with your healthcare provider may be an important step in optimizing your treatment plan. 

Regular monitoring and a personalized approach to hormone therapy can help you achieve the best possible outcomes for both your testosterone levels and your IBD management.

‍

A New Perspective on Managing IBD

Testosterone plays a more significant role in men’s health than many realize, and for men with Crohn’s disease or ulcerative colitis, addressing testosterone levels could be an integral part of managing their condition. With the evidence supporting testosterone’s ability to reduce inflammation and improve disease outcomes, it may be time for men with IBD to consider how hormone therapy could benefit their overall health and well-being.

If you’re living with IBD and suspect low testosterone might be affecting your health, consult your doctor to explore your options. A comprehensive approach to managing IBD could include testosterone therapy, helping you regain control over your health and improve your quality of life.

‍What other roles does testosterone have in the body? Sign up for our newsletter to get the latest insights on testosterone, hormone therapy, and men’s health.