Acute and chronic effects of different training protocols on testosterone levels in men: a systematic review

Background: This systematic review examines the physiological basis of age-related testosterone decline and the acute and chronic effects of different exercise protocols on testosterone levels. This study aimed to evaluate the influence of different training modalities on testosterone responses and explore the potential relevance of these findings to age-related hormonal changes, including andropause. Methods: A systematic literature search was performed in PubMed, Web of Science, Scopus, and Google Scholar from July to October 2025. Studies were considered for inclusion if they investigated the acute and chronic effects of various exercise protocols on testosterone levels and andropause-related outcomes in humans. Twenty studies met the eligibility criteria after the screening process and were included in the qualitative synthesis. Results: This bidirectional effect of exercise on testosterone might play a role in maintaining anabolic–catabolic balance and may be relevant to the physiological processes associated with andropause in older men. Regular, age-appropriate, and capacity-appropriate exercise programs might support testosterone regulation; however, their direct effects on andropause-related symptoms are unclear. While these findings provide important insights into exercise-induced hormonal regulation, most of the included studies were conducted in younger, healthy, or athletic populations. Therefore, the observed responses should primarily be interpreted as mechanistic or physiological evidence rather than direct clinical evidence applicable to men experiencing andropause. Conclusions: In conclusion, exercise-based lifestyle interventions could represent a promising supportive strategy for maintaining testosterone homeostasis and mitigating the features associated with age-related decline in testosterone levels. However, since most of the included studies were conducted in younger, athletic, or otherwise non-clinical populations, the current evidence should be interpreted primarily as mechanistic and supportive rather than as direct clinical evidence for men with established andropause. The PROSPERO Registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD420261345492, CRD420261345492.

Andropause; Exercise; Hypogonadism; Male health; Testosterone; Training intensity

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