Written by Dr. Axa Yox, Personal Coach
Dr. Axa Yox is well-known for her expertise in human biology and gut health. The First-Prize Award winner was nominated as a Person of Extraordinary Ability. A founder of Yox Media, Host of W.H.Y. - What, How, Y podcast. Author of book "One Promise."

What if everything we knew about testosterone therapy was wrong? What if behind you, feeling energyless, fatigued, and hesitant to make decisions is not because of stress?

What if the reason could be you being testosterone-less or, to be more accurate, estrogen-full? You see, testosterone is the driving force behind strength, confidence, and decisiveness, shaping everything from your energy levels to your ability to take risks. When its balance is disrupted, fatigue, mood swings, and a lack of motivation can take over, leaving you feeling like a shadow of yourself. Understanding how this essential hormone works and how to optimize it could be the key to reclaiming your vitality, focus, and drive.
In the quest for vitality, strength, and youth, testosterone therapy has emerged as a beacon of hope for millions. It promises everything from increased muscle mass to sharper mental clarity, making it a cornerstone of the anti-aging and wellness industries.
Clearly, such expectations would create one of the most pervasive myths about testosterone therapy, which is that higher levels automatically translate into greater masculinity, strength, and vitality.
While testosterone is undeniably a key player in these areas, the reality is far more nuanced. And here’s the catch: Testosterone isn’t a standalone solution. Without the right lifestyle, it can be rendered ineffective or even counterproductive.
The truth is that testosterone’s power lies in its environment, which means that increasing hormone levels won’t be effective unless you create the conditions for those hormones to thrive. Even more, if you’re not careful, your body might just turn that testosterone into something you wish it didn’t, like estrogen, sabotaging your real goals.
That’s right. Testosterone doesn’t work in isolation. In fact, if your body isn’t primed for it, that extra testosterone might not even stay in its muscle-building form. Instead, it can be converted into estrogen through a process called aromatization.
But before that, let’s discuss some scientific facts.
Cortisol: The silent testosterone killer
Three hormones produced in the human body share the same basic molecular structure derived from cholesterol: sex hormones such as testosterone and estrogen and the well-known stress hormone cortisol.
This means that when the body prioritizes cortisol production in response to stress, it diverts resources away from testosterone synthesis. The same is true for estrogen synthesis. Over time, prolonged stress that leads to consistently high cortisol levels will cause further disruption in the overall hormonal balance. As a result, elevated cortisol can affect risk tolerance by reducing testosterone synthesis and negatively impacting mood and bravery, making individuals more prone to anxiety and cautious decision-making.
Testosterone and estrogen: The power duo
While men typically have higher testosterone and women have higher estrogen levels, both genders require a balance of these hormones for proper physiological function, as they play essential roles in metabolism, mood regulation, and overall vitality.
The logical question would be if excessive testosterone can help. And the answer is: not really. High testosterone can become the source of aggression or convert into estrogen in fat tissue. You see, hormonal balance is essential for overall health. If a shift happens, nature will need to balance the excessive testosterone. If converted into estrogen, the body will be short in testosterone itself and can silently undermine your strength, confidence, and resilience. Untreated low testosterone levels in men can result in fatigue, muscle loss, and reduced libido.
For women, excessive testosterone can contribute to conditions like polycystic ovary syndrome (PCOS), which can cause irregular menstrual cycles, acne, and hair growth in areas more typical for men, while lower than required testosterone in women can lead to decreased muscle mass, lower energy levels, and reduced motivation.
On the other hand, estrogen is equally vital for men and women. In men, it plays a role in brain function, bone health, and cardiovascular protection. In women, it is crucial for reproductive health, mood stability, and metabolic function. Low estrogen contributes to osteoporosis, mood disorders, and cognitive issues.
The balance within
The human body is designed to maintain hormonal balance, but an unhealthy lifestyle can disrupt this equilibrium. One such disruption occurs through a process called aromatization.
Aromatization is the process by which the enzyme aromatase converts testosterone into estrogen. It happens primarily in fat tissue, meaning that the more body fat you carry, the more testosterone gets converted into estrogen. This can lead to an imbalance, suppressing natural testosterone levels and contributing to symptoms like fatigue, mood swings, and decreased motivation. This is why overweight or obese individuals often experience lower testosterone levels and higher estrogen levels, leading to symptoms like weight gain and even gynecomastia (enlarged breast tissue in men).
So even if you boost your testosterone, whether through lifestyle changes or therapy, some of it will always shift into estrogen. The issue arises when this balance tips too far.
The science of aromatization and why fat matters
The link between body fat and estrogen production is well-documented. A landmark 1997 study by Simpson, E. R., published in The Journal of Steroid Biochemistry and Molecular Biology, highlighted how aromatase expression in fat tissue drives estrogen production. Subsequent research further confirmed that fat tissue is a primary site for this conversion.
Yet, there is a crucial aspect we can’t miss mentioning. Healthy fats, particularly unsaturated fats, are essential because they serve as building blocks for cell membranes and hormone synthesis. Even testosterone and other steroid hormones are derived from cholesterol, and a sufficient intake of healthy fats supports their production. Plus, vitamin D, which is a crucial hormone for testosterone production and regulation, is a fat-soluble vitamin, meaning it is stored in fat tissue and requires dietary fat for proper absorption and utilization. Therefore, maintaining an adequate healthy fat intake is essential.
Testosterone needs the right environment to work
Given that both sexes rely on these hormones, the goal is not to maximize one while minimizing the other, but rather to create balance, which is achieved via the formula of longevity: 1. Healthy diet, 2. Stress management, 3. Physical activities, 4. Mental exercises.
By the way, without all four together, even the most carefully calibrated hormone therapy will fall short.
Diet drives hormone optimization
Testosterone is only as effective as the environment you create for it. What you eat plays a critical role in how your body processes testosterone. Diets high in processed sugars and refined carbohydrates can lead to inflammation and insulin resistance, which suppresses natural testosterone production and promotes fat storage. On the flip side, a nutrient-dense whole food diet rich in lean proteins, healthy fats, and fiber can support testosterone production and minimize estrogen conversion.
It is important to know that key nutrients like zinc and magnesium are particularly important for testosterone synthesis, while omega-3 fatty acids help reduce inflammation and support overall hormonal balance.
Exercise is non-negotiable
If you’re not hitting the gym, you’re missing out on one of the most powerful ways to boost testosterone naturally. Resistance training, especially compound movements like squats, deadlifts, and bench presses, has been shown to significantly increase testosterone levels. High-intensity interval training (HIIT) can also be effective, but the key is consistency.
Exercise not only stimulates testosterone production but also helps reduce body fat, which in turn minimizes aromatase activity. In other words, the leaner you are, the less likely it is that your testosterone will be converted into estrogen.
Weight loss enhances testosterone efficiency
Losing excess fat can have a profound impact on your hormonal health. Studies show that even modest weight loss can lead to a significant increase in testosterone levels, as it reduces the amount of aromatase activity in fat tissue. This creates a more favorable hormonal environment, allowing testosterone to function at its full potential.
Does testosterone therapy work the same for everyone?
Another common misconception is that testosterone therapy produces uniform results across the board. The reality is that individual responses can vary widely based on factors like genetics, metabolic health, and lifestyle.
For some, testosterone therapy alone may be sufficient to achieve their goals. For others, additional interventions, such as aromatase inhibitors to prevent estrogen conversion, may be necessary.
Either way, addressing underlying issues like insulin resistance or chronic stress and inflammation is a prerequisite for seeing real results.
Just remember that testosterone therapy is a tool, not a cure-all
Without the right diet, exercise, and lifestyle habits, even the best hormone treatments may fall short. Therefore, if you consider testosterone therapy, focus on creating an environment that nurtures natural hormone balance. Address lifestyle factors first through prioritizing sleep, managing stress, and avoiding excessive alcohol consumption to maximize testosterone levels without any injections.
So, before you decide to jump on the hormone therapy bandwagon, ask yourself: Are you ready to do the work?
Read more from Dr. Axa Yox
Dr. Axa Yox, Personal Coach
Dr. Axa Yox is an emerging voice in human biology, gut health, and longevity. Ending up in the emergency room forced her to focus on health. In 2020, Axa faced the hardship of letting go. Searching for the answer, she transformed her life completely. She has since dedicated her life to helping others dramatically transform their lives through mindset to unleash their true selves. She is the CEO of X Theory, the premiere coaching company. International Keynote Speaker. Future TEDx speaker. Her mission: Every life counts.