What Causes Muscle Mass Loss In Men?

Your hormones could be to blame for muscle loss.

Hormone replacement therapy for muscle gain


  • Sarcopenia (often called age-related muscle loss) can affect both men and women.
  • Muscle mass decreases approximately 3-8% per decade after 30 and can cause balance issues; increasing the likelihood of falls and broken bones.
  • Sarcopenia is a multifaceted process with age-related testosterone decline, poor nutrition, and lack of activity all playing a role in muscle loss.
  • Sarcopenia also tends to increase visceral fat mass, negatively affecting hormone levels in the body. This fat can be problematic if paired with the natural decline in testosterone.
  • By replacing lost testosterone and living an active, healthy lifestyle you can avoid the onset of sarcopenia, restore your muscle to fat ratios to healthy levels, increase muscle mass, and improve overall strength.
Check your testosterone levels with our free hormone assessment.

What causes sarcopenia?

Sarcopenia is most prevalent in men aged 50 years and over; the older you get, the more an issue it can become. Sarcopenia develops after physiological and systemic changes in the body including hormonal changes, inflammation, alterations in skeletal muscle tissue, and oxidative stress. These changes alter muscle protein synthesis. The leading causes of sarcopenia are the passage of time, lack of exercise, poor diet, and reduced hormone levels.

What are the symptoms of sarcopenia?

Many men reach the point when they go to the gym and stop getting the results they’re used to. Sarcopenia is characterized by gradual loss of muscle which increases over the years and leads to general weakness.

Symptoms of sarcopenia include:

  • Low muscle mass or gradual loss
  • Overall weakness and loss of balance
  • Lower stamina
  • Reduced physical activity that further contributes to muscle loss
  • Visceral Fat
  • Frailty, which often leads to falls, instability, and broken bones

How to avoid sarcopenia

Sarcopenia can be caused by factors out of your control, such as serious disease and being bedridden. However, the progress of sarcopenia is highly dependent on lifestyle. With the right lifestyle changes, you can control, avoid and even reverse muscle loss.

Changes include:

  • Optimizing your hormone levels: Testosterone and its derivative estradiol are directly responsible for developing lean muscle, reducing visceral fat, and increasing bone density
  • Improving nutrition: A low fat, healthy diet with lots of protein will help increase muscle and limit visceral fat developing
  • Physical activity: Exercise is vital for burning fat and building muscle
  • Limiting alcohol intake: One or two drinks per day at the most, and have a few days alcohol free per week
  • Not smoking: Smoking slows protein synthesis into muscle
  • Getting enough vitamin D: Studies [2] show that Vitamin D directly increases muscle production and protects from muscle wastage

Sarcopenia is prevalent among those that live a sedentary lifestyle, as is highlighted by the effects of being bedridden on muscle. Studies show that you lose around 1% for every day spent in bed, showing the importance of physical activity on muscle.

Take our free hormone assessment to see how Hormone Replacement Therapy can help you.

Sarcopenia and type 2 diabetes

There is growing evidence [4] in the connection between type 2 diabetes Mellitus (T2DM) and sarcopenia. T2DM’s characteristics negatively affect various aspects of muscle health, including muscle mass, strength, quality, and function through impairments in protein metabolism (muscle building), vascular efficiency (blood flow), and mitochondrial dysfunction (where energy cells struggle to convert sugars into energy).

Men with T2DM often have low testosterone levels, increased visceral fat, and other metabolic syndrome symptoms. The partnership between visceral fat and low testosterone is damaging because testosterone’s aromatization into estradiol from fat lowers overall testosterone levels.

With low testosterone, the biggest issue is visceral fat, which actively lowers your levels. The answer is always to readjust the balance by giving patients testosterone replacement therapy. Testosterone increases metabolism, promotes fat burning, increases muscle mass, and reduces the chance of T2DM and sarcopenia developing.

The importance of muscles

Sarcopenia results from falling hormones, not being physically active enough, a poor diet, and often excess alcohol and smoking. Maintaining healthy muscles and reducing visceral fat is the best thing you can do to protect yourself against age-related disease. Men that keep fit, eat well, and maintain an optimal hormone balance will be at an advantage in achieving a healthier and longer life. The combination of these elements will reduce your risk of losing muscle, frailty, and osteoporosis. The benefits of optimal hormones improve so many aspects of your life.

  • Significantly improve body composition (reduce dangerous visceral fat and improve lean muscle mass)
  • Produce sustained weight loss
  • Combined with lifestyle improvements such as diet and exercise, BHRT produces even better results
  • Reduce the risk of type 2 diabetes and insulin resistance
  • Reduce the risks associated with metabolic syndrome (high blood pressure, high triglycerides, low HDL, elevated blood glucose, increased visceral fat)
  • Increase motivation and physical activity
  • Reduce fatigue, improve sleep quality, and increase energy
  • Improve libido, sexual function, and overall mood

Ready to start hormone replacement therapy? Click below to take the first step.

Other Symptoms of Low Testosterone

Frequently asked questions

HRT stands for hormone replacement therapy. Hormone levels are tested and medications are administered to help hormones such as testosterone and thyroid reach their optimum levels.

TRT stands for testosterone replacement therapy. Testosterone is given to combat decreasing levels in men. This is to fight the usual signs and symptoms of aging such as fatigue, weight gain, loss of libido, and muscle loss.

We offer a daily injectable Testosterone Cypionate or a twice-daily Lipoderm cream. Both are bioidentical. We also prescribe Triclozene (Clomiphene Citrate) for men, which can help improve several aspects of male health, including low testosterone levels, hormone ratios and sperm production.

The benefits of HRT are extensive but include the following: healthy heart and blood, less fat, more muscle, stronger bones, improved libido, better sleep, improved memory, spatial ability and mental reasoning, improved mood, and better sex.

You can start your HRT journey by filling out our simple online hormone assessment here.

On average it takes approximately 7 business days from ordering your test kit to receiving your results. This is obviously dependent on how quickly you complete and return the test via free return postage. Once we have received your results, a dedicated medical provider will review this along with your online assessment to create your personalized treatment plan.

This is a very difficult question because there is no definitive answer. Everybody is biologically different and responds to the treatment differently. For detailed information, click here.

The test indicates whether you will benefit from this treatment and what your current hormone levels are. We can then know the proper medication to get your testosterone and thyroid to their optimum levels.

Our blood spot test measures 5 key hormone levels. It offers distinct advantages over traditional testing methods because it eliminates the need for a blood draw – saving patients time and money. Our blood spot test is a simple to use test that is done in the comfort of your own home. It involves a finger prick and 12 drops of blood dropped onto a card. We include free return postage with your test for your convenience.

Yes. HRT is safe when monitored by a licensed medical provider. This is why we require yearly testing and symptoms questionnaires every 2 months.

The treatment is effective for as long as you take it. Once you stop taking HRT your levels will return to the levels they were previously.

You will be charged $99 for the hormone test kit upon your order. Once approved for treatment, you will be charged every other month for your medication. You also will be charged a Medical Membership per month, which allows you to schedule unlimited consultations with your Male Excel medical provider.

What people say

Don't just take our word for it

Mark TRT PATIENT “Since starting HRT, I have lost 25 lbs., lost 4" in my waist,my energy level has increased and my metabolism has really increased. In short, I feel at least 20 years younger!”
John TRT PATIENT “The process was easy. I had some questions but the doctor was excellent and was able to answer them all. The product has worked as advertised, I feel literally a hundred times better! Would recommend Male Excel!”
Jared TRT PATIENT “You guys are awesome, you are helping people get their physical and emotional life back. Always on time with medicine and up to date with follow up. I can't thank your team enough for that!! Keep up the positive work.”
Jeff TRT PATIENT “I was on low T treatment for about a week when I noticed the difference. I have new-found energy, mental clarity and the desire to go out and do things. Over the next few months it has gotten better and better."
Thomas TRT PATIENT “Male Excel has been great to work with and the medications have made a huge difference in my life. Energy levels, sleep, weight loss and sexual stamina. Thank you Male Excel!”
Chris TRT PATIENT “It has only been a couple of weeks but I'm already starting to feel a ton better. Renewed energy and mental clarity has me back to my old self or at least seeing that I can get there. I wouldn't hesitate to recommend Male Excel.”

Studies and References:

Shin, M. J., Jeon, Y. K., & Kim, I. J. (2018). Testosterone and Sarcopenia. The world journal of men’s health, 36(3), 192–198. https://doi.org/10.5534/wjmh.180001

[2] Montero-Odasso, M., & Duque, G. (2005). Vitamin D in the aging musculoskeletal system: an authentic strength preserving hormone. Molecular aspects of medicine, 26(3), 203–219. https://doi.org/10.1016/j.mam.2005.01.005

Gharahdaghi, N., Rudrappa, S., Brook, M. S., Idris, I., Crossland, H., Hamrock, C., Abdul Aziz, M. H., Kadi, F., Tarum, J., Greenhaff, P. L., Constantin-Teodosiu, D., Cegielski, J., Phillips, B. E., Wilkinson, D. J., Szewczyk, N. J., Smith, K., & Atherton, P. J. (2019). Testosterone therapy induces molecular programming augmenting physiological adaptations to resistance exercise in older men. Journal of cachexia, sarcopenia and muscle, 10(6), 1276–1294. https://doi.org/10.1002/jcsm.12472

[4] Mesinovic, J., Zengin, A., De Courten, B., Ebeling, P. R., & Scott, D. (2019). Sarcopenia and type 2 diabetes mellitus: a bidirectional relationship. Diabetes, metabolic syndrome and obesity : targets and therapy, 12, 1057–1072. https://doi.org/10.2147/DMSO.S186600

LeBlanc, E. S., Wang, P. Y., Lee, C. G., Barrett-Connor, E., Cauley, J. A., Hoffman, A. R., Laughlin, G. A., Marshall, L. M., & Orwoll, E. S. (2011). Higher testosterone levels are associated with less loss of lean body mass in older men. The Journal of clinical endocrinology and metabolism, 96(12), 3855–3863. https://doi.org/10.1210/jc.2011-0312

Chiang, J. M., Kaysen, G. A., Segal, M., Chertow, G. M., Delgado, C., & Johansen, K. L. (2019). Low testosterone is associated with frailty, muscle wasting and physical dysfunction among men receiving hemodialysis: a longitudinal analysis. Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association – European Renal Association, 34(5), 802–810. https://doi.org/10.1093/ndt/gfy252